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At MVP Health Care, we're on a mission to create a healthier future for everyone. That means embracing innovation, championing equity, and continuously improving how we serve our communities. Our team is powered by people who are curious, humble, and committed to making a difference-every interaction, every day. We've been putting people first for over 40 years, offering high-quality health plans across New York and Vermont and partnering with forward-thinking organizations to deliver more personalized, equitable, and accessible care. As a not-for-profit, we invest in what matters most: our customers, our communities, and our team.
What's in it for you:
- Growth opportunities to uplevel your career
- A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team
- Competitive compensation and comprehensive benefits focused on well-being
- An opportunity to shape the future of health care by joining a team recognized as a Best Place to Work For in the NY Capital District, one of the Best Companies to Work For in New York, and an Inclusive Workplace.
You'll contribute to our humble pursuit of excellence by bringing curiosity to spark innovation, humility to collaborate as a team, and a deep commitment to being the difference for our customers. Your role will reflect our shared goal of enhancing health care delivery and building healthier, more vibrant communities.
About the Opportunity
As a Professional, Prospective Review in Health Management - UM Prospective Review, you will play a crucial role in ensuring the quality and efficiency of our prospective review process. You will work closely with the healthcare team to review and assess the appropriateness of medical services, treatments and high dollar medical equipment. This is an exciting opportunity to contribute to the improvement of patient care and outcomes.
What You'll Do
- Conduct comprehensive reviews of medical records and treatment plans to determine if the requested services are appropriate based on established guidelines and medical criteria across multiple lines of business.
- Utilize your clinical expertise to evaluate medical necessity and collaborate with MVP Medical Directors to determine the effectiveness of proposed treatments/equipment.
- Document clinical summations, recommendations and send appropriate correspondences accurately and within regulatory timeframes.
- Communicate with healthcare providers and members to collect pertinent information, discuss review outcomes and provide appropriate referrals within MVP.
- Remain up to date with industry standards and guidelines, complete required competency training and proficiency examinations to ensure compliance and best practice.
- Participate in team meetings and training sessions to enhance your knowledge and skills.
- Contribute to process improvement initiatives to streamline the prospective review process.
- Other duties as assigned by leadership.
Skills and Experience
- Education, Licensures, & Certifications
- Current RN (NY or VT)
- Years of Experience (Required & Preferred)
- Minimum of 3-5 years clinical experience required
- Case management certification preferred
- Required Job Skills
- Able to manage multiple tasks in a fast-paced environment.
- Strong clinical knowledge, critical thinking skills and understanding of medical terminology, procedures, concepts.
- Ability to work independently to analyze complex medical information.
- Effective communication skills, both written and verbal.
- Ability to work independently and collaboratively in a team environment.
- Proficiency in using computer systems and software for documentation, data entry and day-to-day work functions.
- Preferred Job Skills
- Prior Utilization review experience
- Knowledge of Government Insurance Programs (Medicare, Medicaid)
Working Conditions
Secure, Quiet area for Desk/Computer to maintain HIPPA compliance
Travel Requirements
Potential for travel to regional offices
Worksite Designation
- Virtual based out of Schenectady NY
Pay Transparency
MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.
We do not request current or historical salary information from candidates.
$69,383.00-$92,279.00
MVP's Inclusion Statement
At MVP Health Care, we believe creating healthier communities begins with nurturing a healthy workplace. As an organization, we strive to create space for individuals from diverse backgrounds and all walks of life to have a voice and thrive. Our shared curiosity and connectedness make us stronger, and our unique perspectives are catalysts for creativity and collaboration.
MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications.
To support a safe, drug-free workplace, pre-employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our Talent team at .
The Utilization Review Physician collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical records for the patient population and Hackensack University Medical Center.
These include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of care, as outlined in the responsibilities below.
Education, Knowledge, Skills and Abilities Required: 1.
LanceSoft is seeking a travel nurse RN Utilization Review for a travel nursing job in Arcata, California.
Job Description & Requirements
- Specialty: Utilization Review
- Discipline: RN
- Start Date: 04/13/2026
- Duration: 13 weeks
- 40 hours per week
- Shift: 8 hours, days
- Employment Type: Travel
- 3+ Year of experience required.
- BLS Required.
- ACLS Required.
- CA State RN license required. - SS
#HCRR
About LanceSoft
Established in 2000, LanceSoft is a Certified MBE and Woman-Owned organization. Lancesoft Inc. is one of the highest rated companies in the industry. We have been recognized as one of the Largest Staffing firms and ranked in the top 50 fastest Growing Healthcare Staffing firms in 2022. Lancesoft offers short- and long-term contracts, permanent placements, and travel opportunities to credentialed and experienced professionals throughout the United States. We pride ourselves on having industry leading benefits. We understand the importance of partnering with an expert who values your needs, which is why we’re 100% committed to finding you an assignment that best matches your career and lifestyle goals. Our team of experienced career specialists takes the time to understand your needs and match you with the right job Lancesoft has been chosen by Staffing Industry Analysts as one of the Best Staffing Firms to Work for.LanceSoft specializes in providing Registered Nurses, Nurse Practitioners, LPNs/LVNs, Social Workers, Medical Assistants, and Certified Nursing Assistants to work in Acute Care Centers, Skilled Nursing Facilities, Long-Term Care centers, Rehab Facilities, Behavioral Health Centers, Drug & Alcohol Facilities, Home Health & Community Health, Urgent Care Clinics, and many other provider-based facilities.
Benefits
- Weekly pay
- Medical benefits
JOB DESCRIPTION
We are seeking detail‑oriented Document Reviewers to ensure documents meet defined standards for accuracy, formatting, and compliance. In this role, you will systematically review and compare documents against established guidelines using structured checklists, identify inconsistencies, and proofread for quality and clarity. This position is ideal for individuals with strong attention to detail and experience in editing, proofreading, or document quality review.
Key Responsibilities:
- Meet productivity and quality benchmarks in a deadline‑driven environment of 100 assets/items per week.
- Review documents against predefined guidelines and standards using structured checklists..
- Compare documents for accuracy, consistency, and compliance with requirements.
- Identify and document errors, omissions, formatting issues, and inconsistencies.
- Proofread content for grammar, spelling, punctuation, and overall clarity.
- Verify document formatting, layout, and presentation align with established standards.
- Confirm documents have incorporated recommended changes
- Record findings clearly and escalate issues as needed.
- Maintain accuracy and consistency while handling repetitive review tasks.
REQUIRED:
- 2+ years of experience reviewing documents for accuracy on a daily basis.
- Strong attention to detail and ability to spot inconsistencies or errors.
- Excellent reading comprehension and written communication skills.
- Comfort working with structured checklists and completing repetitive tasks.
PREFERRED:
- Degree or coursework in English, Communications, Journalism, Writing, or a related field.
- Experience working with style guides or compliance‑based documentation.
- Familiarity with educational formatting standards and document comparison processes.
LOCATION:
- This role requires you to live in Houston, TX or a surrounding area, so you can be on-site at least once every three months for meetings etc.
- When not on-site, you can work from home.
HOURS:
- 7am – 3:30pm or 7:30am – 4pm CST.
- Monday – Friday.
DURATION:
- This is a contract job through April of 2027.
At Tata Technologies we make product development dreams a reality by designing, engineering, and validating the products of tomorrow for the world’s leading manufacturers. Due to our continued growth, we are now recruiting for a Quality Review Coordinator (Quality Engineer) to strengthen our team in Columbus, GA.
Quality Review Coordinator (Quality Engineer)
Job Location: Columbus, GA
Duration: Full time
Citizenship Requirement: U.S. Citizen
Key Responsibilities:
Good understanding of Engine Manuals and other pertinent instruction and/or Approved Technical Data
Perform necessary mathematical computations to determine extent of nonconformance and complete appropriate paperwork.
Review and document previous history including part characteristic yield information when required by procedure or determining disposition recommendation.
Disposition basic Rework, Scrap, RTV tasks; Invoke repairs authorized by MRB via approved SRP and recommended Accept/Repair under the guidance of lead.
(Verifies/documents nonconforming characteristic classification of features being dispositioned.
Attach/record partner MRB dispositions.
Basic Qualifications:
High School Diploma or equivalent
U.S. citizenship is required, as only U.S. citizens are authorized to access information under this program/contract.
Preferred Qualifications:
1 year of inspection/quality experience required.
Previously approved by the MRB
Additional Information:
Must be a U.S. Citizen. This position may require access to systems/tools that are restricted to individuals who possess US citizenship.
Equal Opportunity Statement:
Tata Technologies Inc. is an Equal Opportunity/ Affirmative Action employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, veteran status, disability, or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.
Tata Technologies: Engineering a better world.
Tata Technologies would like to thank all applicants for their interest, each application will be reviewed against the set criteria for the role. We would like to advise that only candidates under consideration will be contacted. If you do not hear from us within 10 working days following the closing date it will mean that unfortunately your application has not been successful. We will however retain your details for any suitable future opportunities.
Position Title: Medical Reviewer
Work Location: Remote
Assignment Duration: 12 Months
Job Description:
We are seeking a contract Medical Reviewer to support our international Botox Therapeutic Neurotoxin team. The ideal candidate will be responsible for the medical review of clinical and scientific data related to the use of Botox for various therapeutic indications.
Key responsibilities include ensuring the accuracy and compliance of content with regulatory and company standards, providing expert medical input on clinical documents and safety information, and collaborating with cross-functional teams globally.
Qualifications:
The candidate should have a medical degree (MD or equivalent), clinical experience in neurology, physical medicine, or related fields, and a solid understanding of regulatory requirements for therapeutic neurotoxins. Experience with Botox or neurotoxin therapies is strongly preferred. Excellent communication and detail-orientation are essential.
Must have experience as a Reviewer OUS, understanding regulatory complexities of international markets.
Position Title: Clinical Review Clinician - Appeals
Work Location: Remote - Nationally sourced (Preference for 2 candidates in AZ)
Assignment Duration: 6 months
Work Schedule: 8:00 AM - 5:00 PM EST or CST
Work Arrangement: Remote
Position Summary
Schedule is 8-5 EST or CST hours. Staff will work when there are members of the supervisor/leadership on.
Cases are assigned in round robin fashion for staff to review and work.
Background & Context
The Organization's clinical team handles various types of authorization and claim review requests from various markets nationwide, processing clinical reviews to ensure members have the best outcomes and access to care needed.
Key Responsibilities
Nurses review case files, add, update or edit authorizations.
Work closely with the MD team to make final decisions on cases.
Process clinical reviews to ensure members have access to care needed.
Help reduce provider abrasion by processing retrospective claim reviews.
Work closely with supervisors, senior clinicians, and the coordinator team on end-to-end case processes.
Participate in team collaboration via Teams group chats for routine questions.
Qualification & Experience
Education/Certification (Required): Associate in nursing, Bachelor's in nursing or higher.
Licensure (Required): RN, LPN
Licensure (Preferred): LVN
Must haves:
Medicare knowledge
InterQual or Milliman Experience
Clinical reviews for Utilization Management or Appeals
Nice to haves:
Medicare Appeals Experience
Disqualifiers:
Not having a valid/active RN/LPN license
Performance indicators:
Productivity expectations vary based on platform.
Prime: 7 CPD
iCP: 9 CPD
CenPas: 20 CPD cases per day
95% quality on all cases
Candidate Requirements
Education/Certification
Required: Associate in nursing, Bachelor's in nursing or higher.
Preferred:
Licensure
Required: RN, LPN
Preferred: LVN- Years of experience required
- Disqualifiers
- Best vs. average
- Performance indicators
Must haves: Medicare knowledge, InterQual or Milliman Experience, Clinical reviews for Utilization Management or Appeals
Nice to haves: Medicare Appeals Experience
Disqualifiers: Not having a valid/active RN/LPN license
Performance indicators: Productivity expectations vary based on platform. Prime 7 CPD, iCP 9 CPD and CenPas is 20 CPD cases per day with 95% quality on all cases
Best vs. average: Productivity expectations are set based on platform.- Top 3 must-have hard skills
- Level of experience with each
- Stack-ranked by importance
- Candidate Review & Selection
1
Utilization Management or Appeals review background (1 plus year)
2
Medicare NCD/LCD and InterQual/Milliman Software (1 plus year)
3
Retrospective claims clinical reviews (1 plus year)
The Review Assistant II is responsible for inbound and outbound communication in support of case review activities including collection and confirmation of data integrity in support of clinical review services.
Essential functions include interpreting review guidelines to facilitate forward movement of the case review process including requests for clinical information, treatment plans, and more.
Join Our Team as a Website Tester at Little Wheel
Little Wheel is a gambling technology company focused on researching and building products that put players first. We are currently hiring Website Testers across Michigan, New Jersey, Pennsylvania, and West Virginia.
This is a great opportunity to earn extra income on a flexible schedule while helping us test online casinos. No prior experience is required, and all training is provided.
This is a short-term contract, with opportunities for ongoing work for high performers.
Role Overview
As a Website Tester, you will:
- Participate in user experience testing on various online casino platforms.
- Follow step-by-step instructions to complete assigned tasks.
- Record feedback and report bugs or usability issues.
- Provide detailed insights into your testing experience.
- Complete all testing assignments within set timelines.
Requirements
To be eligible, you must:
- Be at least 21 years old.
- Reside in one of the following states: Michigan, New Jersey, Pennsylvania, or West Virginia.
- Own a laptop or desktop computer.
- Be able to complete a short, paid online training and onboarding process.
No previous testing or gambling experience is needed. You will not be gambling with your own money, and there are no fees or out-of-pocket costs. All the interactions/game-play would be for testing purposes.
Compensation and Benefits
- Guaranteed earnings of at least $1,000 for approximately 20 hours of testing.
- Minimum of $25/hour, with higher pay for faster testers.
- $100 bonus upon completing the onboarding program.
- Flexible schedule – choose when you want to work.
- Work from home – test websites from the comfort of your own space.
- Fast payments – get paid after each of the 4 testing stages.
- Excellent support – coordinators available daily from 6 AM to 11 PM ET.
What Our Testers Say
"Great side gig for some extra cash. The team is very communicative and will answer any questions/concerns!" – Maria, Trustpilot (2021)
"Tasks are clearly explained with step-by-step instructions. You can work when it's convenient. Support is very helpful and responsive." – Anonymous, Glassdoor (2025)
Read more reviews on Glassdoor, Trustpilot, and Google.
Equal Opportunity Statement
Little Wheel LLC is proud to be an Equal Opportunity Employer. We are committed to creating an inclusive environment for all applicants and employees, regardless of race, religion, color, national origin, gender identity, sexual orientation, age, disability, or veteran status. We celebrate diversity and strive to create a workplace where everyone feels valued.
Company Info
Website: Address: Little Wheel LLC, 250 Pehle Ave, Suite 200, Saddle Brook, NJ 07663 Phone: (833) 313-7490
Join Our Team as a Website Tester at Little Wheel
Little Wheel is a gambling technology company focused on researching and building products that put players first. We are currently hiring Website Testers across Michigan, New Jersey, Pennsylvania, and West Virginia.
This is a great opportunity to earn extra income on a flexible schedule while helping us test online casinos. No prior experience is required, and all training is provided.
This is a short-term contract, with opportunities for ongoing work for high performers.
Role Overview
As a Website Tester, you will:
- Participate in user experience testing on various online casino platforms.
- Follow step-by-step instructions to complete assigned tasks.
- Record feedback and report bugs or usability issues.
- Provide detailed insights into your testing experience.
- Complete all testing assignments within set timelines.
Requirements
To be eligible, you must:
- Be at least 21 years old.
- Reside in one of the following states: Michigan, New Jersey, Pennsylvania, or West Virginia.
- Own a laptop or desktop computer.
- Be able to complete a short, paid online training and onboarding process.
No previous testing or gambling experience is needed. You will not be gambling with your own money, and there are no fees or out-of-pocket costs. All the interactions/game-play would be for testing purposes.
Compensation and Benefits
- Guaranteed earnings of at least $1,000 for approximately 20 hours of testing.
- Minimum of $25/hour, with higher pay for faster testers.
- $100 bonus upon completing the onboarding program.
- Flexible schedule – choose when you want to work.
- Work from home – test websites from the comfort of your own space.
- Fast payments – get paid after each of the 4 testing stages.
- Excellent support – coordinators available daily from 6 AM to 11 PM ET.
What Our Testers Say
"Great side gig for some extra cash. The team is very communicative and will answer any questions/concerns!" – Maria, Trustpilot (2021)
"Tasks are clearly explained with step-by-step instructions. You can work when it's convenient. Support is very helpful and responsive." – Anonymous, Glassdoor (2025)
Read more reviews on Glassdoor, Trustpilot, and Google.
Equal Opportunity Statement
Little Wheel LLC is proud to be an Equal Opportunity Employer. We are committed to creating an inclusive environment for all applicants and employees, regardless of race, religion, color, national origin, gender identity, sexual orientation, age, disability, or veteran status. We celebrate diversity and strive to create a workplace where everyone feels valued.
Company Info
Website: Address: Little Wheel LLC, 250 Pehle Ave, Suite 200, Saddle Brook, NJ 07663 Phone: (833) 313-7490
