- Sharp HealthCare (San Diego, CA)
- …and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit ... Administration team members. Assumes additional responsibilities in the absence of the Director . **Required Qualifications** + 5 Years in HMO or Health Insurance… more
- Huron Consulting Group (Chicago, IL)
- …US Work Authorization required **PREFERRED QUALIFICATIONS** + Experience with comprehensive healthcare data sets ( claims , financial performance, clinical, and ... and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling… more
- Molina Healthcare (San Antonio, TX)
- …adequacy, financial performance and operational performance, in alignment with Molina Healthcare 's overall mission, core values, and strategic plan and in compliance ... accurate and timely maintenance of critical provider information on all claims and provider databases. Responsible for contracting/re-contracting of standard deals,… more
- Community Health Systems (Tucson, AZ)
- …consistent adherence to standards and best practices. + Review and manage claims , potential liability cases, and related legal documentation in coordination with ... **Qualifications** + Associate degree required; Bachelor's degree in Nursing, Healthcare Administration, Risk Management, or related field preferred. + Minimum… more
- Beth Israel Lahey Health (Boston, MA)
- …manipulate complex , large databases including Medicare and other insurance claims data. 6. Advanced skills with Microsoft applications which may include Outlook, ... Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases. **Competencies:** 1. **Decision… more
- Prime Healthcare (Anaheim, CA)
- …quality, compassion and community! West Anaheim Medical Center, a member of Prime Healthcare , offers incredible opportunities to expand your horizons and be part of ... hospital dedicated to providing the community with high-quality, compassionate healthcare . Key services include general medical and surgical inpatient care… more
- Johns Hopkins University (Baltimore, MD)
- …who demonstrates subject matter expertise in operational internal auditing and the healthcare and/or higher education industry. Manages multiple complex internal ... of complex audits covering health plan functions such as claims processing, premium billing, encounter data, utilization management, risk adjustment, provider… more
- Carnival Cruise Line (Miami, FL)
- …reviewing care plans, coordinating with internal stakeholders, supporting disability claims , and facilitating return-to-work planning. The Manager also escalates ... planning in compliance with regulations and employment obligations. + Support disability claims and benefits review for crew unable to return to duty. +… more
- Mount Sinai Health System (New York, NY)
- …and other accrediting agencies. This individual, in conjunction with the Senior Director , participates in the orienting, training and mentoring new staff to the ... Management & Patient Safety Department. This involves collaborating with the Senior Director to develop educational plans for instructing staff about the medical… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Clinical Risk Manager reports to the Director of Risk Management and Patient Safety and is responsible for reviewing, summarizing, analyzing, ... presenting and monitoring safety events, claims management, loss prevention and reduction, patient safety related quality improvement activities and supporting the… more