- Baylor Scott & White Health (Plano, TX)
- …+ When adverse events harm patients, the CRM, led by the Corporate Director of Risk Management , investigates to evaluate patient harm. If organizational ... Clinical Risk Manager (CRM) directs and coordinates clinical risk management for The Heart Hospital Region in North Texas....risk is found, the Corporate claims manager will review the event further. The CRM… more
- US Tech Solutions (Columbia, SC)
- …and established clinical criteria to service requests or provides health management program interventions. + Utilizes clinical proficiency, claims ... prioritize effectively and have critical thinking skills. + Experience in case management or care coordination and telephonic care experience is preferred. + A… more
- Pinkerton (IN)
- …is to protect our clients. To do this, we provide enterprise risk management services and programs specifically designed for each client. Pinkerton employees are one ... The Human Resources Manager will support the regional Human Resources Director by performing various functions, including recruiting, new hire processing, employee… more
- Healthcare Services Group, Inc. (Sacramento, CA)
- …Job Type:Full-Time - Remote (20% Travel) Reports To: Human Resources Director Responsibilities Healthcare Services Group (HCSG) is currently seeking to fill ... join our growing Corporate Team! This position reports to the Human Resources Director . This role is primarily responsible for the investigation, and resolution of… more
- Constructive Partnerships Unlimited (Brooklyn, NY)
- …parties. 3. Produces Agenda and takes minutes at special team meetings/ management meetings and transcribes and distributes the same. 4. Type's correspondence ... borough supervisory staff. Prepares various payroll reports for review as requested by the Director and/or Vice President. 8. Serves as liaison for Sr. Director ,… more
- BAYADA Home Health Care (Pennsauken, NJ)
- …Complete claim denial management functions to ensure timely follow-up with denied claims and complete root causes analysis to determine ways to prevent claims ... from denying. + Process balance transfers, adjustment requests, refunds and corrected claims as part of accounts receivable management responsibilities. +… more
- Centene Corporation (Phoenix, AZ)
- …flexibility. **Position Purpose:** Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high ... and large dollar cases + Coordinate transplant requests from pre-approval to claims payment processes and assist with approved transplant center process within… more
- AmeriHealth Caritas (Newark, DE)
- …analysis of claims and appeals, and the review of medical management authorizations.; + Research and Investigate member and/or provider appeals and grievance ... it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other… more
- Access Dubuque (Dubuque, IA)
- …innovative advantages to our clients, including resource consulting, safety and loss control management , claims management , and more. At Kunkel, we take ... our clients; including: comprehensive nursing services, resource consulting, safety and loss control management , and claims management . **Work with us, not… more
- BAYADA Home Health Care (Pennsauken, NJ)
- …Complete claim denial management functions to ensure timely follow-up with denied claims and complete root causes analysis to determine ways to prevent claims ... from denying. + Process balance transfers, adjustment requests, refunds and corrected claims as part of accounts receivable management responsibilities. +… more