- Hackensack Meridian Health (Hackensack, NJ)
- **The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of ... but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of care, as outlined in the responsibilities… more
- GE HealthCare (Manhattan, NY)
- **Job Description Summary** The Operations Support Specialist will manage compliance Lifecycle management of test equipment (EOL, new requirements, service delivery ... and processes. + Key liaison for Zones to lead resolution and engaging necessary resources needed to proactively resolve...are dependent on the facts and circumstances of each case . The specific compensation offered to a candidate may… more
- PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
- …access to therapies through the patient's healthcare provider. Patient Support Specialist typically works in a support capacity to benefit verification ... questions and/or triage calls to the assigned concierge or case manager. + Works on problems of limited scope....to the office or physician. + Proficient in conflict resolution over the phone and maintenance of professional phone… more
- Sedgwick (Houston, TX)
- …Fortune Best Workplaces in Financial Services & Insurance Sr. Claims Specialist , E&O, D&O | Professional Liabilty **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + ... manages claims through well-developed action plans to an appropriate and timely resolution . + Conducts or assigns full investigation and provides report of… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Quality Outcomes Specialist position is responsible for assessing and facilitating clinical systems and/or processes to ensure that care ... equitable. This position identifies outcomes variances, taking initiative for timely resolution of potential concerns, and utilizes ability to synthesize an analysis… more
- St. Luke's University Health Network (Allentown, PA)
- …Assists in preparing reports regarding denials to include volumes, number of appeals, case resolution , and impact on revenue and trending. + Facilitates ... patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all… more
- CDM Smith (Des Moines, IA)
- …subcontract change requests, bid comparisons, new work item estimates, and resolution of potential schedule/work problems. Communicates concerns or near misses to ... manager. Performs other duties as assigned. **Job Title:** Construction Specialist 3 **Group:** PSF **Employment Type:** Regular **Minimum Qualifications:**… more
- City of New York (New York, NY)
- …furtherance of this mission, the BXDA seeks experienced and enthusiastic IT Service Specialist 2 who will: - Provide second level (L2) support for desktops, laptops, ... - Install and maintain a comprehensive in-house application (eg Case management) - Communicate effectively with end-users to ensure...teams to report and escalate issues and track their resolution . Work Schedule: Thursday thru Monday 8am to 6pm… more
- SAIC (Springfield, VA)
- …Security. This position will be responsible for Continuous Evaluation/Continuous Vetting Case Control. This position is located in Springfield VA. **_This contract ... create reportables, create cases, and forward to personnel security specialist -Investigators, all reportable information from employees and contractors meeting… more
- Community Based Care of Brevard, Inc. (Orlando, FL)
- …through internal and external reviews to include In-Home and Out-of-Home Care case management file reviews and adoption related services. The incumbent will be ... in Child Welfare Quality Assurance reviews to assure that case management activities are in compliance with Florida Statues,...use judgment and provide a processes to ease group resolution of issues; clarify points of view and terminology… more