Firstsource Advantage Reviews Jobs in Usa

The WeCARE Physician is the role of Review Physician supports the Medical Director in the implementation of standard operation policies and procedures to ensure that UBA WeCARE complies with all New York City's HRA contractual requirements.

Key Responsibilities are:-To conduct medical reviews of Clinical Assessments/Clinical Reassessments for finalization, complete Wellness Plans dispositions for UBA WeCARE clients, and act as a clinical support for UBA WeCARE staff in the fulfillment of funder, (NYC HRA), contracted goals.

-Conduct medical reviews of Clinical Assessments completed by Qualified Health Professionals -Displays knowledge of medical conditions and SSA disability criteria.-Review prior WeCARE documentation, documentation provided by the client, prior and current Clinical Assessment/Clinical Reassessments, previous Medical Evaluation and Substance Use Assessment (when indicated).-Review, address, and correct any inconsistencies in the history obtained by the QHP-Order and review additional specialty assessments as indicated -Review and update Reasonable Accommodations and work limitations.-Determine appropriate medical diagnoses.

Assess the stability of client's medical issues.-Obtain medical documentation from EPIC, PSYCKES, and Bronx RHIO.-Enter information/complete appropriate forms in HRA (funder) database (SEAMS).

-Complete off-line/paper when medical record system SEAMS, is not functioning completely or is partially working.

-Ensure all off-line paper documents and medical records obtained from outside sources are scanned into SEAMS within 24 hours.

-Review the SSA sequential evaluation process conducted by the QHP to ensure accuracy.-Review provided wellness documentation from treatment providers -Check for medical documentation in EPIC, PSYCKES, and Bronx RHIO-Update and review reasonable accommodations and limitations-Ensure the FCO is correct and that the FCO justification contains relevant information -Review Wellness extensions with Medical Director and provide summary justifications for same-Able to assist and motivate clients to comply with WeCARE process.

Able to assist clients to access services to reduce barriers to compliance with WeCARE appointments.

-Knowledge of medical and behavioral health diagnoses.-Knowledge of various software systems including SEAMS, EPIC, PSYCKES, Bronx RHIO, etc.

-Possess strong computer skills with knowledge of Microsoft Office applications.

-Knowledge of SSA disability application process is preferred.Experience with NYC HRA preferred.Two years of professional experience in medical or clinical practice.Complete Wellness Enhancement Forms as indicated for Wellness track clients Medical and computer software (SEAMS, EPIC) and medical depository information databases (example PSYCKES, Bronx RHIO)In addition to a competitive salary of $180,000-220,000, we offer LTD, STD, paid malpractice, health, dental, vision and a 403(b).

Interested candidates should have a current unrestricted NYS Doctor of Medicine license to practice and American Board of Medical Specialties or American Osteopathic Association Board Certification and send an updated CV to Senior Recruiter, Desiree Aulet at Montefiore is an equal employment opportunity employer.

Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.

At Javitch Block LLC, we are looking for dependable and enthusiastic people interested in building a career with our great firm. Javitch Block LLC (JB) is looking for a full-time Associate Attorney - Pleading Review to work in our Fairlawn office and your qualifications and skill set may be an ideal match for this exciting career opportunity.

The Pleading Review Attorney will be responsible for reviewing complaints, letters and other pleadings and determining whether we have sufficient grounds to proceed based upon Federal and State and Client regulations. As part of an organization, the Pleading Review Attorney is responsible for remaining in compliance with all protocols in line with our organization goals, strategy, and values. Secondary responsibilities may include court appearances, file management, and collections negotiations.

The Ideal Candidate:

• Attorney will review pleadings for accurate information, including but not limited to, venue, balances, correct named parties, statute of limitations, proper documentation, proper theories of recovery
• Attorney may assist in legal research to ensure pleadings and laws contained therein are up-to-date with applicable laws
• Good communication skills
• Strong pleading and complaint experience with a knowledge of collections related court documents.
• Strong motivation, demonstrated by ability to work both independently and as part of a team.
• Computer and word processing skills including Word, PowerPoint, Excel along with quick ability to learn new technical programs

Education/Training/Experience:

• One (1) to two (2) years of experience in the Creditors’ Rights or Collection fields preferred.
• Juris Doctor Degree (J.D.)
• Must be licensed in state of Ohio
• Intermediate knowledge of Microsoft Word, Excel

Javitch Block offers a comprehensive benefits program including health insurance, paid vacation/personal time, 401(k), life insurance, and short and long-term disability.

You can learn more about Javitch Block LLC at

• Serves as the LPHA for Integrated Assessment and Treatment Plan (IATP) Ensures the IATP is compliant with regulations and best practices
• Provides clinical feedback and guidance to clinicians to ensure medical necessity and diagnosis are supported.
• Ensures appropriate treatment recommendations Ensures completion of risk assessment and appropriate safety planning steps.
• Ensures completion of all required screening and/or assessment tools and utilization of results in treatment planning.
• Completes documentation supporting all activities related to review and authorization of the IATP.
• Performs diagnostic assessments, collects diagnostic information, and determines immediate treatment plan needs with patients.
• Requests medical consultation, where indicated, in a diligent and timely manner.
• Completes treatment plan in conjunction with patient, identifying goals/objectives that are connected to needs identified in the assessment.
• Provides behavioral health therapy to individuals, families and/or groups identified as having behavioral health needs.
• Coordinates with Emergency Response Service and other crisis service teams for clients presenting who may be a danger to self or others.
• Maintains records in accordance with TrilliumPlace policies, as well as state and federal oversight agencies and accreditation agencies including Joint Commission, Medicaid, Medicaid Rehabilitation Option, Illinois Department of Public Health, and Commercial Insurances.
• Acts as a liaison and resource between the community and patient needs; coordinates treatment goals with community agencies, primary care physicians, court system, and managed-care entities.
• May provide supervision to Carle Health clinicians who provide assessment and treatment.
• May supervise counseling or social work students assigned to department.
• Participates in in-service and competency training of students or staff. Prepares special reports as needed on activities, and work group activities.
• Meets clinical productivity standards and compliance standards for all documentation and clinical charts.

Essential Functions of the job:

• Review and validate QC data and test records.
• Support investigations related to Out of Specification (OOS), Out of Trend (OOT), and Out of Expectation (OOE) results.
• Ensure compliance with current Good Manufacturing Practices (cGMP) in the laboratory.
• Assist in the technical documentation of investigations and change control assessments to evaluate the impact on product quality, in alignment with FDA/EU regulations, international standards
• Undertake other duties as required.

This position is ideal for candidates who are detail-oriented and committed to quality assurance in the pharmaceutical industry.

Education/Experience Required:

• Bachelor’s Degree or above in Chemistry, Biochemistry, or Biotechnology related scientific discipline. Scientific degree (ideally chemistry, biochemistry, biotechnology or related).
• Minimum 4 years working experience in an FDA-regulated biotechnology or pharmaceutical company is required.
• Working knowledge and experience with chemistry analytical methods such as HPLC, GC, TOC, Capillary Electrophoresis (CGE-Reduced, CGE-Non-Reduced, and Capillary Zone Electrophoresis), etc.
• Strong working knowledge with USP/EP and cGMP/EU GMP.
• Technical writing experience.
• Familiar with instrument and equipment validation.
• Impressive, demonstrable track record and skills/experience gained within a similar position(s), at a similar level.
• Credible and confident communicator (written and verbal) at all levels.
• Strong analytical and problem-solving ability.
• Hands-on approach, with a ‘can do’ attitude.
• Ability to prioritize, demonstrating good time management skills.
• Excellent attention to detail, with the ability to work accurately in a busy and demanding environment.
• Self-motivated, with the ability to work proactively using own initiative.
• Committed to learning and development
• Self-motivated, with the ability to work proactively using own initiative.

Computer Skills:

• Strong PC literacy required; MS Office skills (Outlook, Word, Excel, PowerPoint).

Travel:

• Must be willing to travel approximately 10%.
• Ability to work on a computer for extended periods of time.

Job Title: Health Service Reviewers (RN)

Pay (openings for each location/market):

• Albany up to $52/hr
• Central Islip up to $60/hr

Overview: These RNs will be doing a mix of standard quality audits, complaint initiated investigations, and more. When they are onsite, the amount of time that they are at the location is dependent on the audit that is required. It is expected that Health Service Reviewers will be traveling onsite about 85% of the time.

These individuals will be traveling to IDD housing to do state required Recertification (must be done every 15 months) or investigating specific complaints (disease outbreak, falls, etc.).

Travel: 85% of this role is traveling to sites. It is more location based and they will be traveling to the counties that surround their location. If anyone is traveling and not able to return home, they are able to coordinate accomodations through the travel office and miles/food will be reimbursed at the federal rate. If they are not onsite, they can work from home or in the DOH office.

Summary: Based in NY, working at the direction of the New York State Department of Health (NYSDOH), Office of Aging and Long-Term Care, this individual will conduct surveillance and investigation activities related to Intermediate Care Facilities for Intermediate Care facilities for Individuals with Intellectual Disabilities (ICF/IDD). Duties include but are not limited to participating in surveys or complaint investigations, document finding, draft Statement of Deficiencies (SOD) within specified timeframes, testifying in administrative hearing ad needed.

The position is majority travel and will be onsite at facilities.

Qualifications:

• Strong interpersonal skills with the ability to communicate professionally with colleagues, supervisors, providers, medical and administrative personnel and residents/patients.
• Excellent communication (verbal & written) skills.
• Ability to work independently with minimal supervision.
• Ability to relate effectively to clinical and administrative personnel and patients.
• Computer proficiency with the ability to learn and understand new review programs and monitoring tools.
• Able to travel to on-site facility within New York State, required.
• Must have a valid driver's license & the ability to travel to on-site facilities review assignments.

Education/Experience:

• Registered Professional Nurse (RN). Currently licensed and registered in New York State, required.
• Bachelor’s degree, in any health care related field.
• Two (2) years clinical experience with individuals with intellectual disabilities or in developmental disability facilities and deemed QIDP (Qualified Intellectual Disability Professional and ability to meets the federal requirements for attaining QIDP Certification with six (6) months of hire date.

Hours: Monday-Friday 8am-5pm

The Medical Review Specialist is responsible for reviewing, analyzing, and interpreting medical documentation to support eligibility determinations and alternative treatment evaluations in alignment with Christian Healthcare Ministries’ guidelines and values. This role exists to ensure medical review decisions are accurate, evidence-based, and applied consistently while maintaining compassion and clarity in member interactions.

At the highest level, the Medical Review Specialist focuses on clinical analysis, guideline interpretation, and professional judgment, supporting sound decision-making that upholds CHM’s mission, stewardship, and commitment to member care.

WHAT WE OFFER

• Compensation based on experience.
• Faith and purpose-based career opportunity!
• Fully paid health benefits
• Retirement and Life Insurance
• 12 paid holidays PLUS birthday
• Lunch is provided DAILY.
• Professional Development
• Paid Training

PRIMARY RESPONSBILITIES

• Review and analyze complex medical records to assess eligibility, appropriateness of services, and alignment with CHM medical guidelines.
• Apply clinical judgment and established criteria to support consistent, evidence-based eligibility determinations.
• Conduct medical literature reviews and research to support recommendations, alternative treatment considerations, and guideline application.
• Collaborate with the Eligibility Review Supervisor, Medical Director, and Medical Review leadership to ensure alignment and consistency in medical review decisions.
• Communicate clearly and compassionately with members and internal teams regarding medical review outcomes, addressing questions and concerns professionally.
• De-escalate sensitive or emotionally charged interactions while maintaining CHM standards and values.
• Maintain accurate documentation of medical review findings, rationale, and decisions within CHM systems.
• Stay current on medical research, industry standards, and regulatory considerations relevant to medical review activities.
• Uphold strict confidentiality and HIPAA compliance in all handling of protected health information.

CORE COMPETENCIES & SKILLS

• Medical analysis and critical thinking – Interpret complex medical information and applies clinical reasoning.
• Evidence-based decision making – Utilizes research and guidelines to support review outcomes.
• Clear and compassionate communication – Explains medical determinations in an understandable and empathetic manner.
• Case management and prioritization – Manages multiple cases while meeting accuracy and timeliness standards.
• Documentation and compliance – Maintain thorough, accurate records aligned with regulatory and internal requirements.
• Collaboration – Works effectively with leadership, medical reviewers, and cross-functional teams.

REQUIRED QUALIFICATIONS & CONSIDERATIONS

Education

• Bachelor’s degree in a healthcare-related field (e.g., nursing, health sciences, biology) preferred.
• Equivalent clinical or medical review experience may be considered in lieu of a degree.

Experience

• Prior experience in medical record review, utilization review, clinical review, or a related healthcare role preferred.
• Experience applying medical guidelines or clinical criteria to eligibility or treatment determinations strongly preferred.
• Familiarity with HIPAA regulations and protected health information handling required.
• Experience working with EMR/EHR systems, medical coding, or health information systems is a plus.

Certifications

• No certifications required at time of hire.
• Clinical licensure or healthcare-related certifications (e.g., RN, LPN, CPC) are a plus but not required.

About Christian Healthcare Ministries

Founded in 1981, Christian Healthcare Ministries (CHM) is a health care sharing ministry for Christians. CHM is a nonprofit, voluntary cost-sharing ministry through which participating Christians meet each other’s medical bills. The mission of CHM is to glorify God, show Christian love, and experience God’s presence as Christians share each other’s medical bills.

• Ensure scientific accuracy and clinical appropriateness and validity of promotional materials from a medical/scientific standpoint
• Serve as a member of the Promotional Review Board or PRB

Relationships:

• Reports to a Director level employee in Medical Information and works with stakeholders throughout and at external agencies.
• Key relationships include Marketing, Legal, Regulatory Affairs and Medical Affairs.

Essential Functions:

• Provide critical review of promotional pieces to ensure medical accuracy, validity and appropriateness of content in accordance with approved labeling, scientific data and relevant laws, regulations to support the safe and effective use of products by patients and the medical community.
• Determine appropriateness of data and references used to support promotional claims and marketing messages and provide proactive recommendations and/or guidance for alternative da-ta/references/language where needed
• Align and collaborate with key cross-functional stakeholders including other Promotional Review Board or Promotional Review Board or PRB reviewers and commercial team members on issues or concerns related to promotional materials or claims
• Engage with commercial business partners early in the development of promotional materials to enhance efficiency, when applicable
• Review, provide comments and document verdicts for all assigned promotional materials within PRB workflow system based on assigned deadlines
• Participating in Promotional Review Board or PRB meetings as assigned
• Remain current with medical literature and data in assigned therapeutic area

Education Qualifications:

• PharmD (Doctor of Pharmacy) or MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine) or NP (Nurse Practitioner) with a minimum of two years of relevant professional experience (e.g. academic or clinical or industry experience)

Additional Qualifications:

• Thorough understanding of the US pharmaceutical industry or healthcare landscape, promotional review process and relevant guidance and compliance requirements
• Detail-oriented with demonstrated editorial skills

Medical Promotional Review Specialist

6-month contract

Must be able to work on a W2

Hybrid in Plainsboro, NJ

TOP 3 “MUST HAVES”:

1. Demonstrated expertise in reviewing medical literature and independently evaluating scientific validity and clinical appropriateness of promotional content.

2. Proven ability to clearly and concisely communicate scientific information

3. Demonstrated ability to build and maintain collaborative relationships across multiple disciplines

PURPOSE:

Ensure scientific accuracy and clinical appropriateness and validity of promotional materials from a medical/scientific standpoint

Serve as a member of the Promotional Review Board (PRB)

ESSENTIAL FUNCTIONS:

• Provide critical review of promotional pieces to ensure medical accuracy, validity and appropriateness of content in accordance with approved labeling, scientific data and relevant laws, regulations and NNI policies to support the safe and effective use of products by patients and the medical community.

• Determine appropriateness of data and references used to support promotional claims and marketing messages and provide proactive recommendations and/or guidance for alternative da-ta/references/language where needed

• Align and collaborate with key cross-functional stakeholders including other PRB reviewers and commercial team members on issues or concerns related to promotional materials or claims

• Engage with commercial business partners early in the development of promotional materials to enhance efficiency, when applicable

• Work with the Medical Director for the assigned product(s)/therapeutic area(s) to increase efficiency, medical alignment, and mitigate risk of promotional claims

• Review, provide comments and document verdicts for all assigned promotional materials within PRB workflow system based on assigned deadlines

• Participate in PRB meetings as assigned

• Remain current with medical literature and data in assigned therapeutic area(s)

• Participate in relevant internal and external meetings and trainings on new guidance/regulations, new scientific information and marketing strategy

QUALIFICATIONS:

• PharmD / MD/ DO / NP with a minimum of two years of relevant professional experience (e.g. academic, clinical or industry experience); post-doctoral fellowship may be substituted for professional experience, as appropriate

• Thorough understanding of the US pharmaceutical industry and healthcare landscape, promotional review process and relevant guidance and compliance requirements

• Detail-oriented with demonstrated editorial skills

• Strong organization and prioritization skills

• Ability to work on cross-functional teams

• Ability to critically analyze and apply scientific data in a customer-focused manner

• Strong verbal and written communication skills

• Effective negotiation skills and ability to influence others

Insight Global is seeking Technical Evaluation Review Board/CCB Coordinator to join our team for an exciting opportunity to work on a unique government contract. The contract assists in acquisition and technical sustainment engineering and will augment government resources. The coordinator manages government technical review board submissions, ensuring all programs meet required deliverables and are fully prepared for review before board meetings. They control document accuracy, track changes, and maintain compliant review packages across all stakeholders. The role requires confidently driving engineers and IPTs to meet requirements and deadlines, including pushing back when inputs are incomplete. This is a highly organized, assertive position focused on accountability, readiness, and execution.

Must Haves:

• BS/MS in engineering/specialty area
• 7 yrs directly related experience (5 yrs with MS degree)
• Active secret level security clearance or higher
• Strong planning, coordination, and organizational skills with the ability to manage multiple priorities
• Demonstrated experience developing, maintaining, and assessing technical baselines within controlled programs
• Familiarity with engineering standards, manufacturing methods, and configuration management practices, including military and ASME-guided environments
• Working knowledge of technical drawing conventions and engineering documentation controls
• Proficiency with Microsoft Office tools to prepare data-driven reports, metrics, and formal documentation
• High attention to detail, strong writing and verbal communication skills, and the ability to manage time effectively
• Ability to sit on-site at Hill AFB in Clearfield, UT Monday-Wednesday

Plusses:

• Experience supporting configuration and data management activities within a defense or government program environment
• Working knowledge of Air Force or DoD engineering release processes, configuration control standards, and technical documentation lifecycle management
• Familiarity with Engineering Change Proposals (ECPs), Interface Control Documents (ICDs), and associated revision and audit activities
• Prior involvement with functional and physical configuration audits, including coordination with suppliers or government facilities
• Training or certification in configuration or data management disciplines (e.g., CMPIC or similar)
• Demonstrated ability to maintain and protect complex engineering baselines for hardware and software systems
• Strong judgment and decision-making skills aligned with regulatory, contractual, and policy requirements
• Commitment to continuous learning and maintaining up-to-date technical proficiency

The Estimator is responsible for ensuring all flooring bids are technically accurate, competitively structured, and financially sound before submission to customers. This role serves as the final quality control checkpoint for bid accuracy, scope alignment, and margin protection across new construction and large project bids.  

They will work closely with sales, estimating, purchasing, and operations to ensure bids are properly structured, risk is identified early, and projects are prepared for successful execution. 

This position requires extensive experience in flooring estimating, construction bidding, and plan/spec review, with the ability to identify scope gaps, quantity errors, and pricing risks before bids are released. This role plays a critical part in protecting company margin, preventing costly project mistakes, and improving bid quality across the organization. 

Primary Responsibilities:

Bid Strategy & Quality Control

• Review large and complex flooring bids prior to submission.
• Validate takeoffs, material quantities, labor assumptions, and pricing structures.
• Ensure bids align with project plans, specifications, and scope requirements.
• Identify risk areas such as:
• Scope gaps
• Quantity miscalculations
• Incorrect product specifications
• Margin erosion
• Installation complexity
• Provide feedback and corrections to estimators and sales teams before submission.

Preconstruction Review

• Review architectural plans and specifications for flooring scope.
• Confirm scope alignment between drawings, specifications, and proposals.
• Identify missing scope or potential change order risks prior to bid submission.
• Assist estimating team in improving bid structure and consistency.

Margin Protection

• Ensure bids meet company margin expectations.
• Identify pricing risks before customer submission.
• Flag bids that require leadership review.

Bid Process Improvement

• Identify recurring estimating errors and training opportunities.
• Develop internal bid review standards and checklists.
• Support ongoing estimator training and quality improvement.

Post-Award Project Validation

• Review awarded bids to confirm final scope and pricing accuracy.
• Ensure project setup in ERP reflects the approved bid structure.
• Confirm correct materials, quantities, and pricing before purchasing.

Cross-Department Coordination

• Work closely with sales, estimating, purchasing, operations, and finance to ensure projects are properly prepared for execution.

Required Experience

• 5–10+ years of construction estimating experience
• Extensive flooring estimating experience
• Experience reviewing construction plans and specifications
• Strong knowledge of flooring materials and installation methods
• Experience preparing or reviewing large project bids
• Strong understanding of construction scopes and subcontractor bidding
• Advanced Excel skills
• Experience with estimating software

Preferred

• Experience estimating large multifamily or production builder projects
• Experience with takeoff software such as:
• MeasureSquare
• PlanSwift
• Bluebeam

No Recruiters, please.