The Judge Group Jobs

* Evaluate clinical service requests from members and providers * Utilize clinical judgment and organizational criteria to adjudicate requests...

* Patient Care & Evaluation * Perform comprehensive evaluations for patients with physician referrals. * Accurately interpret evaluation findings...

Our client is seeking a full-time Pediatric Cardiac Sonographer to join their team in Houston, TX. If you meet the qualifications and are interested...

* Base Salary: $235K + 20% incentive bonus (80% productivity, 10% quality, 10% customer service metrics) * Schedule: Monday to Friday, daytime...

* Conduct peer reviews to evaluate clinical appropriateness of coverage requests. * Stay informed on the latest treatments, including cutting...

The team comprises 2 pharmacy technicians and 1 additional pharmacist. Ideal Candidate Background: * Experience in retail, hospital, or home...

We are actively hiring experienced Clinical and Coding Auditors to support inpatient medical claims audits with a focus on DRG/APR-DRG validation...

Our Physicians utilize their clinical knowledge to provide an evidence-based approach to reviews, adjudicating requests for commercial and...

Doctor of Medicine (M.D.), Doctor of Osteopathy (D.O.), or M.B.B.S. • Board certification in Family Medicine or Internal Medicine • An active, unrestricted...

Utilize their clinical knowledge to provide an evidence-based approach to reviews, adjudicating requests for commercial and Medicare D medications...

* Analyze and Audit Claims: Utilize advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to review medical records...

We are seeking an experienced Addictionologist to join our team and play a key role in diagnosing, treating, and managing patients with substance...

We are seeking a board-certified pulmonologist to serve as the Medical Director of our outpatient pulmonary clinic in Prescott, AZ. We are conducting...

Provide clinical expertise and support for all departments and divisions related to payor's Medicare Supplement (Medigap) and Individual Supplemental...