- Guardian Life (Harrisburg, PA)
- …Group Disability claims experience to join our dynamic Appeals Team. The **Appeals Case Manager II ** (ACM 2) is responsible for adjudicating assigned ... appeals for Group Life and Disability claims . The ACM 2 provides a full and fair...minimum of 5 years of Group Disability and/or Life claims experience + A minimum of 3 years of… more
- Elevance Health (Rancho Cordova, CA)
- **Telephonic Nurse Case Manager II ** **Sign on Bonus: $5000.** **Location: This role enables associates to work virtually full-time, with the exception of ... therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II ** is responsible...as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
- Elevance Health (Columbus, GA)
- **Nurse Case Manager II ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... from 11:30 AM to 8:00 PM EST. The **Nurse Case Manager II ** is responsible...as applicable. + Assists in problem solving with providers, claims or service issues. Assists with development of utilization/care… more
- Sutter Health (Burlingame, CA)
- …patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely ... management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and… more
- Texas Veterans Commission (Waco, TX)
- …Representation for Veterans Benefit Administration. . Knowledge of Microsoft Office products, Claims Case Management System to include generating and analyzing ... **Management* **Organization:** **TEXAS VETERANS COMMISSION* **Title:** *TVC - District Manager ( Manager II )* **Location:** *Texas-Waco* **Requisition… more
- AO Smith (Lebanon, TN)
- Regional Field Service Manager II Date: Dec 4, 2025 Location(s): Lebanon, TN, US, 37090 Company: A. O. Smith Corporation Hybrid, Onsite or Remote: Remote PRIMARY ... SCOPE OF RESPONSIBILITY: Position reports to the Field Service Engineering Manager SPECIFIC DUTIES/ACCOUNTABILITIES(List in order of importance) + Aligned with… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …policies and procedures and related health plan functions such as member services, claims , and the referral process. As well as functions related to legislative and ... the Health Plan Essential Accountabilities: Level I + Review / prep clinical case for clinical staff. + Navigates and utilizes corporate applications; core claims… more
- Elevance Health (Dearborn, MI)
- …with the CBA, the CBA provisions will prevail._** The **Clinical Care Manager II ** provides assessments, referrals, and counseling. Conducts telephone ... questions and listen to member in order to assess case and determine needs. + Give referral and/or make...+ Conduct business in a professional manner. + Troubleshoot claims issues. + Investigate and research to resolve customer… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …compliance and regulatory requirements. Primary activities include substantiating referrals, case planning and research, conducting onsite or desk audits, clinical ... in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned,… more
- Zurich NA (Denver, CO)
- …other computer-based systems. This role will be filled at either theAttorney Level II orLevelIII.The hiring manager will determine the appropriate level based ... Liability Staff Legal Counsel II or III 128248 Zurich is looking for...conducting post-trial activities where appropriate. We look for demonstrated case analysis ability and a track record of proven… more
- ZOLL Medical Corporation (Houston, TX)
- …Hospitalists, CT Surgeons etc.), Nurse Practitioners, Physician Assistants, nurses, case managers and administrators. Other duties include selling the value ... intake and reimbursement to ensure appropriate and timely filing of billing claims + Maintain credentialing/access to all assigned accounts at all times… more
- LA Care Health Plan (Los Angeles, CA)
- …Social Worker; current and unrestricted California License. Licenses/Certifications Preferred Certified Case Manager (CCM) Accredited Case Manager ... Care Management Specialist II , D-SNP Team (12 month Assignment) Job Category:...skills and judgement. Management of the caseload assigned by Manager includes: coordinating health care benefits, providing education and… more
- Elevance Health (Nashville, TN)
- **eCOB Specialist II ** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... 8:00 am - 4:30 pm EST. The **eCOB Specialist II ** is responsible for researching and investigating other coverage...when they are entitled. + Determines primacy on each case using a complex set of Primacy Rules as… more
- HCA Healthcare (Thornton, CO)
- …Do you want to join an organization that invests in you as a(an) RN Case Manager ? At HCA HealthONE Mountain Ridge, you come first. HCA Healthcare has ... a difference. We are looking for a dedicated RN Case Manager like you to be a...facilities those services required. Performs telephonic clinical reviews with claims insurance personnel to facilitate reimbursement for the delivery… more
- Elevance Health (Indianapolis, IN)
- …a schedule of Wednesday - Sunday or Thursday - Monday. The **Transplant Nurse II ** will be responsible for providing case and/or medical management for members ... **Transplant Nurse II ** **Location:** Virtual: This role enables associates to...preparation for advancement to the senior level. Within the case management role will within the scope of licensure… more
- US Tech Solutions (Chesapeake, VA)
- …all levels to enable decision making at most appropriate level **Duties:** + Nurse Case Manager is responsible for face to face and telephonically assessing, ... and multiple diagnoses that impact functionality. + Reviews prior claims to address potential impact on current case... claims to address potential impact on current case management and eligibility. Assessments include the member's level… more
- PPL Corporation (Allentown, PA)
- …that support education, sustainability, and wellbeing. Overview The **Associate Project Manager ** is the single point of accountability for small to routine ... Project Leader for complicated projects. The **Project and Contract Manager ** position is the single point of accountability for...of both. Assigned work location may change. In the case of remote work, physical presence in the office/on-site… more
- The County of Los Angeles (Los Angeles, CA)
- MANAGER , AUTOPSY OPERATIONS AND SUPPORT SERVICES Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4670156) Apply MANAGER , AUTOPSY ... Forensic Technician (https://www.governmentjobs.com/careers/lacounty/classspecs/1065384?keywords=Supervising%20Forensic%20Technician%20&pagetype=classSpecifications) for Los Angeles County. Option II : Four years of experience assisting pathologists in… more
- PPL Corporation (Allentown, PA)
- …typically be sought by the Project Leader for complicated projects. The **Project Manager ** position is the single point of accountability for large PPL Electric ... status, recognizing trends and project variances, and implementing corrective action. ii . Reporting project status, forecasting cash flows and final project cost… more
- The Toro Company (Bloomington, MN)
- …growth, the Residential and Landscape Contractor (RLC) division is seeking a Marketing Manager who will lead Toro's snow product platforms for the North American ... Partner with brand management to prepare marketing collateral, key claims , and consumer language related to promotions, advertising, public relations,… more