- Fallon Health (Worcester, MA)
- …policies and standards; problems lacking clear precedent are usually reviewed with the Director , UM and PA prior to taking action. **Responsibilities** **Primary ... Twitter and LinkedIn. **Brief Summary of Purpose:** The Manager, Prior Authorization RN manages all staffing and activities related...in internal and external meetings, on behalf of the Director , as needed. + Becomes the SME to work… more
- CVS Health (Hartford, CT)
- …from your laptop. **Fundamental Components:** * Utilization management - The medical director will perform concurrent and prior authorization reviews with peer ... to its membership. Aetna is looking for a medical director to be part of a centralized team that...plus. **Preferred Qualifications:** Previous Experience in Utilization Management / Claims Determination with another Health Plan / Payor or… more
- AIG (Atlanta, GA)
- …+ Bachelor's Degree or equivalent required. Multi-state adjuster licenses preferred. + Prior claims management experience desired. + Must possess excellent ... customers to manage risk. Join us as a Managing Director Complex Claims to play your part...expertise interpreting insurance contracts. + In depth knowledge of claim handling procedures, claims performance strategies, and… more
- NDCP (Duluth, GA)
- …terminations of employment of individuals on WC-related leave(s) with the applicable HR Director prior to any involuntary termination of employment. + Serve as ... claims management, including proactive management of WC claims to accelerate claim closure, mitigate risks, and manage financial exposure. The ideal… more
- University of Colorado (Aurora, CO)
- …+ Establishes tracking mechanisms to monitor deliverables on assigned grants. + Obtains prior approval from Executive Director /PI and sponsor as indicated for ... **Finance & Accounting Assistant Director ** **Description** **University of Colorado Anschutz Medical Campus** **Department: College of Nursing** **Job Title:… more
- American Water (Camden, NJ)
- …Insurance (or Director , Insurance), you will be responsible for overall claims management (including, uninsured claims ) at American Water. You will oversee ... with people at all levels in an organization. * Prior experience leading and managing a complex claims...and financial lines of insurance, with an emphasis on claim trends and the litigation landscape. * Prior… more
- Commonwealth Care Alliance (Boston, MA)
- …states will not be considered at this time._** **Position Summary:** Reporting to the Director , Claims Operations and Quality Assurance, the Claims Sr. ... the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible… more
- City of New York (New York, NY)
- …Within AO, exists Office of Revenue that houses SNAP-CR. They establish SNAP claims for the agency according to the Federal SNAP guidelines to recover inaccurate ... supervise staff (PAAII, PAAI, Eligibility Specialist II) involved in Claims processing. - Monitor and distribute cases in the...and SNAP only sites, Quality Control and Internal Audits prior to establishing in WMS. - Conduct day to… more
- Commonwealth of Pennsylvania (PA)
- Director (County Fiscal Officer 1) (Local Government) - Armstrong County Area Agency on Aging Print ... (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5063156) Apply Director (County Fiscal Officer 1) (Local Government) - Armstrong County Area Agency… more
- Prime Healthcare (Farmers Branch, TX)
- …seeking new members to join our corporate team! Responsibilities The Corporate Director of Billing Optimization is responsible for the strategy, management and ... optimization and improved metrics across the clearing houses. The Director will partner with revenue cycle and business office...are not limited to: 837 files, billing edits, clean claim rate standards, billing errors and trends, as well… more