- Virtua Health (Pennsauken, NJ)
- …resource group and payers.Documentation* Appropriate and complete documentation of clinical review and denial management in the case management documentation system ... counseling sessions. Eligibility for benefits is governed by the applicable plan documents and policies. For more benefits information click here… more
- City of New York (New York, NY)
- …Executive Director, Financial Review & Claims Processing who will: - Manage, plan and develop the operational activities of DFRP, ICP and SNAP-CR Directors as ... they administer their specific program areas which are responsible for initiating adverse actions on cash assistance cases due to information obtained via computer matches, sanctioning individuals who fail to cooperate with child support requirements, seek… more
- Molina Healthcare (San Francisco, CA)
- …works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, ... + Provides telephone, clerical, and data entry support for the Care Review team. + Provides computer entries of authorization request/provider inquiries, such as… more
- Providence (Missoula, MT)
- …offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life ... **Job Shift:** Day **Career Track:** Business Professional **Department:** 3500 UTILIZATION REVIEW **Address:** MT Missoula 500 W Broadway **Work Location:** St… more
- The Cigna Group (Bloomington, MN)
- **Job Summary** The Quality Review & Audit Sr. Manager will lead the Operations Testing team for our Strategy, Testing Center of Excellence, and Vendor team. This ... This role is also anticipated to be eligible to participate in an annual bonus plan . We want you to be healthy, balanced, and feel secure. That's why you'll enjoy… more
- MUFG (Tempe, AZ)
- …portfolios to identify deterioration or negative management control trends and review compliance with policies, guidelines, and regulations. + Prepare periodic Risk ... Serve as Examiner-In-Charge (EIC) for complex portfolios or processes. As EIC, effectively plan , coordinate and oversee all aspects of on-site activities. + Focus on… more
- PeaceHealth (Eugene, OR)
- **Description** PeaceHealth is seeking a RN Admissions Coordinator/Utilization Review - Psychiatric Unit for a Per Diem/Relief, 0.00 FTE, Variable position. The ... The benefits included in positions less than 0.5 FTE are 403b retirement plan for caregiver contributions; wellness benefits, discount program, and expanded EAP and… more
- Molina Healthcare (Las Vegas, NV)
- **Job Description** **Job Summary** Provides support for member clinical review processes specific to applied behavioral analysis (ABA) services. Responsible for ... proficiency. **Preferred Qualifications** * Utilization management experience. * Health plan /managed care organization experience. To all current Molina employees:… more
- WellSpan Health (York, PA)
- …guidelines. + Demonstrates initiative and resourcefulness by communicating results of claims review activity to PCS and PFS Leadership. + Serves as point person ... health benefits Flexible spending and health savings accounts Retirement savings plan Paid time off (PTO) Short-term disability Education assistance Financial… more
- JPMorgan Chase (Wilmington, DE)
- **Description** As a Card & Connected Commerce Marketing Copy Review Analyst you will contribute to a strong controls environment as an integral part of the first ... care coverage, on-site health and wellness centers, a retirement savings plan , backup childcare, tuition reimbursement, mental health support, financial coaching and… more