- St. Luke's University Health Network (Allentown, PA)
- …outpatient denials for experimental, coding or other issues that may require record review . Provides billing with information needed to obtain payment of claims. ... Remote within local geography after orientation. JOB DUTIES AND...minimum of 2-5 years' experience in case management and/or utilization management. + Prefer financial experience related to appeal… more
- V2X (Madison, MS)
- …effective and efficient management of government property. _While this is a remote opportunity, the preferred candidate will reside within a commutable location to ... Physical Inventory, Subcontractor Control, Reports, Relief of Stewardship and Liability, Utilization , Maintenance, and Property Closeout. + Travel to conduct site… more
- US Foods (Rosemont, IL)
- …days (Tue, Wed, Thur) per week at our Rosemont Illinois office as well as remote two days per week. **This position has been segmented as Hybrid meaning there is ... compensation programs, including, but not limited to, annual pay structure review , merit increase budgeting, and geographic differential analyses to ensure ongoing… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- **Join the BlueCare team at BCBST as a Clinical Review Manager\!** In this role, you will complete medical reviews for utilization management within the BlueCare ... You'll have the opportunity to collaborate with the BlueCare Utilization Management team, Case Managers, and other departments\. The...8\-5 pm EST or 9\-6 pm EST\. + Fully remote , at home position\. + There is an option,… more
- Molina Healthcare (Augusta, GA)
- …rate tracking and supplemental data impact reporting. + Develop Medical Record Review project reporting to track progress and team productivity reporting. + ... and other statistical methodologies to predict future trends in cost, utilization , and performance. + Assist with research, development and completion of… more
- CareFirst (Baltimore, MD)
- …experience working in Care Management, Home Health, Discharge Coordination and/or Utilization Review . **Preferred Qualifications:** + Bilingual - fluent in ... of care. Utilizing experience and skills in both case management and utilization management including proficiency in MCG to determine medical necessity, appropriate… more
- Actalent (Tulsa, OK)
- …with engineering and design production leadership teams to plan, execute, and review client funded projects. Communicate all relevant activities and action plans to ... requirements are documented and accurately assigned to facilitate maximum efficient utilization and meaningful capacity planning. + Prepare regular financial and… more
- Sedgwick (Greensboro, NC)
- …and physician filings and decisions on appropriate treatments recommended by utilization review . **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Adjuster - Liability ( Remote - Needs Home State Lic and Must obtain NY lic) Are you looking… more
- WM (Bar Harbor, ME)
- ** Remote position with up to 75% travel required.** **Qualified candidates need to reside near a major airport within New England.** I. Job Summary Manages the full ... reliable vehicles are available to meet operational requirements. + Manages effective utilization and right-sizing of vehicle assets. + Ensures all fleet are… more
- Sedgwick (Grand Rapids, MI)
- …+ Oversee timely payments for TTD, medical, and vendor bills; ensure appropriate vendor utilization . + Review aging claims to prevent delays in file closure. + ... in Financial Services & Insurance Client Performance Manager - Workers Compensation | Remote | Travel Required Are you looking for an opportunity to join a… more
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