- Alameda Health System (San Leandro, CA)
- SLH Case Manager RN + San Leandro, CA + San Leandro Hospital + SLH Social Services + Part Time - Day + Care Management + $58.74 - $97.91 per hour + Req #:42605-31625 ... FTE:0.7 + Posted:October 28, 2025 **Summary** **JOB SUMMARY** The SLH Case Manager RN is responsible for providing comprehensive case management services to clients… more
- Warren Equipment Company (Tulsa, OK)
- **Description** TEAM UP WITH US! The Senior Facilities Manager oversees and manages all aspects of facility operations across multiple dealership sites, ensuring ... the facility infrastructure capital plan. . Inspect facilities and evaluate space utilization across multiple sites to ensure efficient use and alignment with… more
- Catholic Health Services (Melville, NY)
- …for services and coordinates utilization / appeals management review. + Assist Utilization and Appeals Manager in setting up communications with payors ... Managers, physician advisors and facility departments. + Develops/validates daily work lists for Utilization and Appeals Manager . + Assist with all insurance… more
- Nuvance Health (Danbury, CT)
- *Description* *Summary:* The Manager , Denials Prevention & Appeals Operations is responsible for the direct oversight of daily operations of clinical denial ... position will work closely with the Denials Prevention & Appeals Administration Manager to guide the development...the Physician Advisors or attending physicians to support concurrent appeals . * Monitor and analyze utilization data… more
- CareFirst (Baltimore, MD)
- …mandates. Directs the activities and serves as a resource for associates within the Appeals and Grievances Department for Government Programs. We are looking for ... educational and training presentations for internal and external stakeholders. Supports the Manager of Clinical Appeals and Analysis in the development and… more
- CareFirst (Baltimore, MD)
- …+ Demonstrated knowledge of regulatory and accreditation requirements, understanding of appeals process and utilization management, and systems software used ... contribution programs/plans (all benefits/incentives are subject to eligibility requirements). ** Department ** Clinical Appeals and Analysis **Equal Employment… more
- Beth Israel Lahey Health (Charlestown, MA)
- …difference in people's lives.** This is a remote based role. Reporting to the Manager , Patient Financial Services, the Clinical Analyst plays an important role in a ... high-profile team tasked with handling all commercial and government clinical appeals and audit processes. The Clinical Analyst will perform high-level clinical… more
- Children's Mercy Kansas City (Kansas City, MO)
- …review functions utilizing InterQual and/or MCG screening guidelines, and clinical denials/ appeals oversight. Participates in department and hospital performance ... to integrated inpatient teams; assists Director in the management of department ; including personnel and fiscal management and development of, and training… more
- Mount Sinai Health System (New York, NY)
- …Nurse denial phone calls for UM Nurse to follow + Prioritizes work as per department protocol (IPRO Discharge Appeals / Insurance requests) + Support Appeals ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front...To maintain front end operations of the Case Management Department by monitoring all incoming correspondence and ensuring it… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... concurrent and extended stay reviews. + Prepares and submits appeals to third party payors. + Maintains appropriate records...third party payors. + Maintains appropriate records of the Utilization Review Department . + Performs related duties,… more
Related Job Searches:
Appeals,
Appeals Manager,
Department,
Department Manager,
Manager,
Utilization