• Medical Services Coordination Specialist I/II/III

    Excellus BlueCross BlueShield (Rochester, NY)
    …to care management programs + Provides administrative support to the grievance and appeals process within the + Medical Services department Level III (in ... assigned to non-care managers are monitored by the care manager + The care manager provides feedback...under pressure. + Demonstrates proficiency in basic navigation and utilization of department specific applications: care management… more
    Excellus BlueCross BlueShield (08/27/25)
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  • Pharmacy Clinical Coordinator

    CareOregon (Portland, OR)
    …Montana, or Wisconsin. Job Title Pharmacy Clinical Coordinator Exemption Status Exempt Department Pharmacy Manager Title Pharmacy Operations Manager Direct ... pharmacy program activities as assigned. Essential Responsibilities + Prepare drug utilization reports and analyses for the Pharmacy & Therapeutics Committee. +… more
    CareOregon (08/19/25)
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  • Case Management Representative - Full Time - Days

    Houston Methodist (The Woodlands, TX)
    …assistance and data management support to the case management and social work department to facilitate efficient utilization of resources and discharge planning ... care benefits + Supports and assists with concurrent insurance denials and appeals process, transmission of utilization reviews to insurance companies,… more
    Houston Methodist (09/06/25)
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  • Quality & Patient Safety Specialist - Registered…

    Beth Israel Lahey Health (Cambridge, MA)
    …We're part of a long, proud medical tradition. Look the part. Follow your department 's dress code. **2. Listen and communicate with care:** Let your words and deeds ... use voicemail, start with a hello, your name and department , and "How may I help you?" + Ask...If you're unable to resolve a situation, find a manager who can. **9. Protect confidentiality and privacy:** It's… more
    Beth Israel Lahey Health (08/08/25)
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  • Patient Account Representative - Chambersburg…

    WellSpan Health (Chambersburg, PA)
    Position Function: Under the direction of the Patient Account Manager , is responsible for the billing of Medicare, Medical Assistance, Blue Cross, Highmark Blue ... that important deadlines are met. Informs Assistant Patient Account Manager of any problems which would prevent the timely...etc. 6. Participates in special projects conducted by the department or other area as workload permits. 7. Participates… more
    WellSpan Health (08/29/25)
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  • Administrative Assistant II/Correctional Health

    The County of Los Angeles (Los Angeles, CA)
    …an assistant to the manager of a line operation in a County department . Experience at the level of the Los Angeles County's Class of Administrative Assistant I ... making recommendations to line managers on matters such as: utilization of personnel; allocation of funds; workload and workload...manager of a line operation in a County department . In the County of Los Angeles, the level… more
    The County of Los Angeles (06/19/25)
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  • Supervisory Immigration Services Officer

    Citizenship and Immigration Services (San Diego, CA)
    …Applies expert level of knowledge of the Immigration and Nationality Act, Administrative Appeals Unit and Board of Immigration Appeals decisions to make ... instructions designed to improve operations, promote the development and utilization of greater skills, and provide standards for determining...full resume will be made available to the hiring manager if you are referred. Be clear and specific… more
    Citizenship and Immigration Services (09/03/25)
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  • Senior Inpatient Coder (Remote)

    WMCHealth (Valhalla, NY)
    …Provider Solutions Inc. City/State: Valhalla, NY Category: Clerical/Administrative Support Department : Health Info Mgmt-WMC Health Union: No Position: Full Time ... Job Details: Job Summary: The Senior Inpatient Coder is responsible for addressing appeals to insurance companies and coding highly complex medical records using the… more
    WMCHealth (08/30/25)
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  • Network Relations Consultant

    Elevance Health (Norfolk, VA)
    …resolution through direct contact with providers, claims, pricing and medical management department . + Identifies and reports on provider utilization patterns ... impacting provider satisfaction, researches and resolves complex provider issues and appeals for prompt resolution. + May be responsible for coordinating… more
    Elevance Health (09/05/25)
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  • Chief Psychiatrist - Behavioral Health Medical…

    Humana (Springfield, IL)
    …implementation of the Quality Management (QM) program; and work closely with the Utilization Management (UM) of services and associated appeals related to adults ... strategic management of behavioral and physical health services, including Utilization Management (UM), Quality Improvement, and value-based payment programs. The… more
    Humana (08/29/25)
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