- Dana-Farber Cancer Institute (Brookline, MA)
- …front-end prior authorization, biosimilar drugs, pharmacy-benefit exclusion drugs, and claims . Located in Boston and the surrounding communities, Dana-Farber Cancer ... overturned. + Appropriately escalates complex cases to Drug Authorization Supervisor or Manager of Prior Authorizations. + Monitors email communication to the Drug… more
- Geisinger (Danville, PA)
- …providers into coded form procedure codes that can be utilized for submitting claims to payers for reimbursement. A joint effort between the healthcare provider and ... complete and accurate coding. + Communicates to Coding Quality and Professional Manager any new diagnoses, procedures, technologies, etc. + documented within patient… more
- Bechtel Corporation (Chandler, AZ)
- …preparation of documents and the management of subcontracts + Assists Subcontract Manager or more senior Subcontract Professionals in completion of the various tasks ... formation and post award changes. + Knowledge of risk and insurance provisions, claim preparation, and resolution strategies in coordination with legal and claims… more
- Veterans Affairs, Veterans Health Administration (Minneapolis, MN)
- …the resume submitted and qualified candidates will be referred to the hiring manager every 2 weeks. Responsibilities The Minneapolis VA Health Care System is seeking ... and peer review. Participates in clinical review process such as tort claims , peer reviews, management reviews and administrative activities, as directed by the… more
- GE Vernova (Boston, MA)
- …to PMO Sourcing team. + Ensures appropriate marine operations risks, contracts and claim management awareness and know-how in his/her unit. + Has the authority ... together with the GEV projects sourcing manager to negotiate Frame Agreements, Purchase Orders conditions within its scope of responsibility and manage contracts… more
- Elevance Health (Lake Mary, FL)
- …Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... impact decision making tools + Recommends policy changes and claim 's system changes to pursue cost savings. + Reviews...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Superior Ambulance Service (Elmhurst, IL)
- …Onboarding new staff + Assuring Medicare/Medicaid requirements are met by staff working claims by revising and creating policies for employees to follow + Assuring ... work is being maintained by all employees by maintaining communication with Reimbursement Manager + Maintain work split and make sure workload is balanced among… more
- Northrop Grumman (Mclean, VA)
- …determining appropriate insurance coverage and loss protection strategies. - Manage insurance claims , monitor progress, and assist with claim adjustments. - ... Corporate Risk Management team. Reporting to the Senior Property & Casualty Insurance Manager , this position serves as the primary risk management partner for the… more
- Elevance Health (Lake Mary, FL)
- …organizations. **How you will make an impact:** + Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider network ... and specialty care procedures and recommends policy changes and claim 's system changes to pursue cost savings. + Reviews...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- HUB International (Raleigh, NC)
- …experience and in-depth knowledge of insurance markets, policy provisions, claim processes, business environment, and risk mitigation, applies independent and ... discretionary judgment to make decisions independent of manager approval on books of insurance business for which the incumbent is responsible. These include… more