• Clinical Denials & Appeals Specialist

    Northwell Health (Melville, NY)
    …and knowledge gaps. Job Responsibility Serves as liaison between the patient and facility/ physician and the third party payer. Prepares and defends level of care and ... medical necessity for assigned case. Collaborates with physician advisor, payor representative and site case managers to facilitate appropriate level of care… more
    Northwell Health (01/06/26)
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  • Oncology Nurse Navigator 2 - Surgical Oncology…

    Rush University Medical Center (Chicago, IL)
    …The Oncology Nurse Navigator 2 is a registered nurse (RN) who works with physician practices and multi-disciplinary teams to promote the effective utilization of ... The Oncology Nurse Navigator 2 functions as a liaison between patients, physician practices, the hospital, and the community performing functions that meet the… more
    Rush University Medical Center (01/06/26)
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  • Respiratory Therapy

    Trevecca Center for Rehabilitation and Healing (Nashville, TN)
    …the administrator in development of the annual budget. Appropriate and effective utilization of staff. Managing key operations and financial levers to achieve budget ... plan of treatment and obtaining appropriate approvals from referring physician . Communicating with supervisor and interdisciplinary team members regarding patient… more
    Trevecca Center for Rehabilitation and Healing (01/03/26)
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  • Case Manager RN

    HCA Healthcare (San Antonio, TX)
    …for certification and reimbursement of care. Discusses alternate level of care with physician . Refers cases not meeting acute care criteria to Physician Advisor ... hospital staff, physicians, patients and caregivers for purposes of efficient resource utilization + Keeps current of requirements by JCAHO, HCFA and other… more
    HCA Healthcare (01/03/26)
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  • Analyst, Claims

    East Boston Neighborhood Health Center (Revere, MA)
    …health and well-being of our patients and communities. Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or part of the ... referrals and claims-related data in an effort to provide utilization reports to other departments. Insurance Department: * Must...Excellent Malpractice Coverage + A Designated Medical Staff Office for Physician Support + Free Parking + And Much… more
    East Boston Neighborhood Health Center (01/01/26)
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  • Manager Provider Network Management

    AmeriHealth Caritas (Washington, DC)
    …annual goals and objectives. **Contracting** + Responsible for hospital and physician network development and management. + Develops and recommends policy changes ... operations in a fashion that helps alleviate backlogs and ensures the optimal utilization of resources. + Resolves individual provider complaints in a timely manner… more
    AmeriHealth Caritas (01/01/26)
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  • Clinical Services Coordinator

    Baylor Scott & White Health (Plano, TX)
    …communication skills. This role is the central point of communication for the utilization of all providers (greater than 40) within the Temple Cardiology Departments ... Works with providers, departmental administration, making decisions to maximize provider utilization , and other management staff to create and/or revise master… more
    Baylor Scott & White Health (12/31/25)
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  • Clinical Supervisor RN

    Children's Home Healthcare (Amarillo, TX)
    …is consistent with federal and state guidelines and in compliance with physician 's orders. 3. Oversight of plans of treatments, telephone orders, and discharge ... for Home Health services from insurance company. 7. Attend quarterly Utilization Review meetings as designated by the Director of Professional Services.… more
    Children's Home Healthcare (12/31/25)
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  • Operating Room Scheduling Coordinator

    HCA Healthcare (Atlantis, FL)
    …of surgical procedures in the operating room. This role ensures optimal utilization of operating room resources, maintains accurate records, and collaborates with ... and effective patient care. This role is the central link between physician office staff, operating room staff, surgeons, anesthesiologists, nursing teams, surgical… more
    HCA Healthcare (12/30/25)
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  • Case Manager RN

    HCA Healthcare (San Antonio, TX)
    …for certification and reimbursement of care. Discusses alternate level of care with physician . Refers cases not meeting acute care criteria to Physician Advisor ... hospital staff, physicians, patients and caregivers for purposes of efficient resource utilization + Keeps current of requirements by JCAHO, HCFA and other… more
    HCA Healthcare (12/30/25)
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