- CareFirst (Baltimore, MD)
- …of members for Commercial lines of business. Ensures quality management of the clinical appeal process to reduce the risk of State and Federal Regulatory fines ... for Care Management. We are looking for an experienced clinical leader in the greater Baltimore metropolitan area who...who is willing and able to work in a hybrid model. The incumbent will be expected to work… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse (RN) Manager , Appeals and Grievances General Operations ( Clinical ) Job Category: Clinical Department: CSC Appeals & Grievances ... the safety net required to achieve that purpose. Job Summary The Manager , Appeals & Grievances (A&G) & General Operations ( Clinical ) is responsible for the… more
- Elevance Health (FL)
- **Nurse Appeals - Litigation & Legal Support** **In Office Expectation:** This role is **Virtual** ; This role enables associates to work virtually full-time, with ... skill development. _Please note that per our policy on hybrid /virtual work, candidates not within a reasonable commuting distance...and is dependent on court hearing schedules. The **Nurse Appeals - Litigation & Legal Support** is responsible for… more
- Elevance Health (Indianapolis, IN)
- **Nurse Appeals ** **Location: Indiana** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... onboarding and skill development. Please note that per our policy on hybrid /virtual work, candidates not within a reasonable commuting distance from the posting… more
- Elevance Health (Union, NE)
- **SCA Appeals Representative I** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... onboarding and skill development. **_Please note that per our policy on hybrid /virtual work, candidates not within a reasonable commuting distance from the posting… more
- Elevance Health (FL)
- ** Appeals Medical Director - Medicare** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... onboarding and skill development. Please note that per our policy on hybrid /virtual work, candidates not within a reasonable commuting distance from the posting… more
- CenterWell (Denver, CO)
- …to preserve and recover revenue while maintaining the highest level of clinical and regulatory integrity and compliance. Manages the Denials Management data ... and appeal process. The Director, Home Health Grievances & Appeals assists members, via phone or face to face,...+ Oversee the process for direction and support to clinical and operational leadership regarding Medicare and governmental audit… more
- Garnet Health (Middletown, NY)
- …Health Medical Center. Responsibilities Under the direction of The Administrator, Coding & Clinical Documentation Improvement and Patient Access, the Manager of ... to make your career home with us as a CLinical Documnetaion Specialist on our CDI team at/in Garnet...day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement… more
- Elevance Health (Denver, CO)
- …Management Pharmacist ( Clinical Pharmacist) **Location(s):** Denver, CO, Las Vegas, NV ** Hybrid :** This role requires associates to be in-office 1 - 2 days per ... pharmacy benefits. By leveraging the power of new technologies, our strong, clinical -first lens and deep pharmacy expertise, we are actively defining our innovative… more
- State of Colorado (Pueblo, CO)
- Patient Financial Services Manager - Program Management II Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5191516) Apply Patient Financial ... Services Manager - Program Management II Salary $95,892.00 - $120,000.00...position is open to current Colorado residents only Weekly Hybrid Working Arrangements Minimum 2 days In Office and… more