- Lincoln Financial (Raleigh, NC)
- …are excited to be hiring a **Manager, Compliance testing team** role in our Retirement Plan Services business line in our Fort Wayne office or remote. In this role ... of experience in lieu of Bachelor's) Working knowledge of retirement plan administration, nondiscrimination testing and 5500's _Nice-to-haves:_ ASPPA QKA Working… more
- Prime Therapeutics (Raleigh, NC)
- …decision we make. **Job Posting Title** Vice President Client Engagement - Large Plan - REMOTE **Job Description** The Vice President Client Engagement leads the ... oversight to the extended teams who support this large multi-state Blue health plan and is accountable for driving alignment and collaboration (through the Blue… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role Brighton Health Plan Solutions (BHPS) provides Case Management / Medical Management services to its clients. Clinical Coordinator facilitates case ... GED is required. + Strong skills in medical record review . + Familiarity with medical terminology a plus. +...tasks as identified and/or assigned. About At Brighton Health Plan Solutions, LLC, our people are committed to the… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- About The Role Brighton Health Plan Solutions (BHPS) is seeking an experienced Healthcare Claims Examiner skilled in the interpretation of Hospital and Ancillary ... adhering to the specified turnaround times. + Perform quality review of claims and logic changes/updates in Impact. +...school education is a plus. About At Brighton Health Plan Solutions, LLC, our people are committed to the… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …client-facing reports, dashboards, and analyses. + Lead program performance review presentations with clinical program managers, client account managers, and ... a plus. + Experience with Predictive Analytics a plus. About At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is… more
- Brighton Health Plan Solutions, LLC (NC)
- …respond to escalated issues and pertinent information on claims requiring adjudication. + Review and process High Dollar claims and conduct quality reviews of claims ... or comparable experience in the healthcare field preferred. About At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …programmatic audit results and ensure existing and new regulatory initiatives. + Review multiple reports for statistical and financial tracking purposes to identify ... + Experience in health platform build and implementation. About At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare… more
- LifePoint Health (Rutherfordton, NC)
- …adaptation and outcome of care management as prescribed in the initial Utilization Review Plan with regard to resources, appropriateness of care and adherence ... specific departmental goals, standards, and objectives which directly support the strategic plan and vision of the organization. Assesses the quality of patient care… more
- Truist (Charlotte, NC)
- …(Required) **Work Shift:** 1st shift (United States of America) **Please review the following job description:** Perform closing functions for Grandbridge and ... to time. + Perform commercial/multifamily closing responsibilities, including due diligence review , property, liability and flood insurance review , borrower… more
- CVS Health (Raleigh, NC)
- …to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC ... have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal… more