Reviewer

• Determine the medical appropriateness of requested services by reviewing clinical information and applying evidenced-based guidelines
• Interact with providers, members, internal and external service teams to obtain necessary information and communicate determinations
• Conduct inpatient reviews to determine financial responsibility and processes requests within required timelines
• Collaborate with multidisciplinary teams to promote Banner Health's Integrated model
• Adhere to UM policies and procedures.

Remote RN Utilization Management Care Reviewer at Banner Health

RN Utilization Management Care Reviewer

Remote RN Utilization Management Care Reviewer at Banner Health determining medical appropriateness of services. Collaborating with care teams to optimize member outcomes and support safe transitions.

• Use rubrics and supplemental information to provide fair and consistent evaluations with encouraging, specific, and actionable feedback
• Maintain an in-depth knowledge of every component of curriculum within assigned workload
• Swiftly respond to student outreach and return evaluations to students within 48 hours of submission
• Work with Goal Lead to provide proactive outreach to students in need of academic assistance
• Participate in Reviewer online community
• Support academic integrity validation and processing potential violations
• Participate in quality assurance processes and project improvement activities, as needed

Reviewer evaluating student projects at Southern New Hampshire University

Reviewer responsible for evaluating student project submissions at Southern New Hampshire University. Provide actionable feedback and ensure academic integrity in evaluations.

• In-person interview may be required during the hiring process
• Manage relationships with internal and external customers/vendors

MD Appraisal Reviewer managing automobile appraisals at Mercury Insurance

MD Appraisal Reviewer

MD Appraisal Reviewer managing automobile appraisals at Mercury Insurance. Collaborating with internal and external teams to ensure efficient processes and accurate valuations.

Reviewer jobs in Arizona

See all jobs on JobTailor

RN Utilization Management Care Reviewer

Reviewer

MD Appraisal Reviewer