- Elevance Health (Costa Mesa, CA)
- **Telephonic Nurse Case Manager II ** **Sign on Bonus: $5000.** **Location: This role enables associates to work virtually full-time, with the exception of ... therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II ** is responsible...as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
- Elevance Health (Grand Prairie, TX)
- **Nurse Case Manager II ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... from 11:30 AM to 8:00 PM EST. The **Nurse Case Manager II ** is responsible...as applicable. + Assists in problem solving with providers, claims or service issues. Assists with development of utilization/care… more
- Elevance Health (St. Louis, MO)
- **Telephonic Nurse Case Manager II ** **Sign On Bonus: $3000** **Hours: Monday thru Friday 10:30am - 7pm Central Time** **Location** : This role enables ... therefore Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II ** is responsible...treatment plans. + Assists in problem solving with providers, claims or service issues. **Minimum Requirements:** + Requires a… more
- AO Smith (Lebanon, TN)
- Regional Field Service Manager II Date: Dec 4, 2025 Location(s): Lebanon, TN, US, 37090 Company: A. O. Smith Corporation Hybrid, Onsite or Remote: Remote PRIMARY ... SCOPE OF RESPONSIBILITY: Position reports to the Field Service Engineering Manager SPECIFIC DUTIES/ACCOUNTABILITIES(List in order of importance) + Aligned with… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …policies and procedures and related health plan functions such as member services, claims , and the referral process. As well as functions related to legislative and ... the Health Plan Essential Accountabilities: Level I + Review / prep clinical case for clinical staff. + Navigates and utilizes corporate applications; core claims… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …compliance and regulatory requirements. Primary activities include substantiating referrals, case planning and research, conducting onsite or desk audits, clinical ... in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned,… more
- LA Care Health Plan (Los Angeles, CA)
- …Social Worker; current and unrestricted California License. Licenses/Certifications Preferred Certified Case Manager (CCM) Accredited Case Manager ... Care Management Specialist II Job Category: Clinical Department: Care Management Location:...skills and judgement. Management of the caseload assigned by Manager includes: coordinating health care benefits, providing education and… more
- Sutter Health (Modesto, CA)
- …patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely ... management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and… more
- ZOLL Medical Corporation (Houston, TX)
- …Hospitalists, CT Surgeons etc.), Nurse Practitioners, Physician Assistants, nurses, case managers and administrators. Other duties include selling the value ... intake and reimbursement to ensure appropriate and timely filing of billing claims + Maintain credentialing/access to all assigned accounts at all times… more
- Elevance Health (Indianapolis, IN)
- **eCOB Specialist II ** **Location:** Virtual, this role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... Friday, 8:00 am - 4:30 pm The **eCOB Specialist II ** responsible for researching and investigating other coverage for...when they are entitled. + Determines primacy on each case using a complex set of Primacy Rules as… more
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