- Mount Sinai Health System (New York, NY)
- …concerns. 7. Identifies trends, patterns and findings. 8. Fields issues of concurrent risk management concerns, and/or of a medical , legal and ethical nature. 9. ... of preliminary reports, and determination of priority of investigation given risk management assessment. 10. Collaborates with the Director /Senior Director … more
- City and County of San Francisco (San Francisco, CA)
- …Nurse Consultant, Nurse Manager, and/or Nurse Case Managers to review complex claims and establish medical protocols. 13. Advises the Occupational Nurse ... the Worker's Compensation Supervisor assists and provides first-line oversight of claims adjusting and processing teams for the Workers' Compensation Division.… more
- Atlantic Health System (Morristown, NJ)
- …3+yrs of relevant healthcare claims experience + 2+yrs of relevant Medical Malpractice litigation experience + Management Experience Preferred #LI-AW1 At ... with the ability to handle a variety of matters related to claims , policy development, and professional review activities. Responsibilities + Review professional… more
- PeaceHealth (Vancouver, WA)
- …growth, collaboration, and safety-where your expertise truly makes a difference._ The Director Clinical Risk Management Operations is responsible for leading and ... risk management risk investigations and response to events, potential claims , and grievances presented against caregivers, physicians and the organization for… more
- City of Lakeland (Lakeland, FL)
- …wellness initiatives/clinic. Responsibilities include directly supervising Safety, Health Benefits, and Claims Team Leaders; Risk Management support staff and ... administering a self-insured program. + Makes data-driven recommendations to the Risk Management and Purchasing Director concerning the City's insurance needs. +… more
- Otsuka America Pharmaceutical Inc. (Hartford, CT)
- …**Core Content Development** + Under the guidance of the Associate Director , Medical Communications, draft and maintain high-priority, foundational scientific ... The Manager, Medical Core Content is a team-level operational role...external regulations. This position reports directly to the Associate Director , CNS Scientific Communications. **Job Description** **Key Responsibilities Include:**… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- THIS IS NOT A REMOTE POSITION We are hiring a Medical Records Clerk/Coder to assign procedure, and diagnosis codes for insurance billing, review claims data, ... correspond with insurance companies to obtain accurate reimbursement for healthcare claims . This person will also be responsible for analyzing, abstracting,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case ... identifies and refers potential quality of care and utilization issues to Medical Director . + Utilizes appropriate communication techniques with members and… more
- Boehringer Ingelheim (Ridgefield, CT)
- …data, claims data, data processing, modeling, visualizations. Sr. Associate Director Requirements: + Bachelors degree from an accredited institution and a ... US Brand (Oncology), Marketing, Sales, Patient Excellence, Market Access and Medical Affairs. Identify data needs, business requirements, translate to reporting… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case ... identifies and refers potential quality of care and utilization issues to Medical Director . + Utilizes appropriate communication techniques with members and… more