- MedStar Health (Elkridge, MD)
- General Summary of Position The Pharmacy Technician, Clinical Coordinator serves as a crucial link between healthcare providers, patients, payors and pharmacies, ... ensuring access to prescribed medications, catering to patients with unique healthcare needs. The Clinical Coordinator may assist in all areas of clinical … more
- Elevance Health (Hialeah, FL)
- Anticipated End Date: 2025-08-11 Position Title: LTSS Service Coordinator - Case Manager Job Description: LTSS Service Coordinator (Bilingual in Spanish/English) ... an accommodation is granted as required by law. The LTSS Service Coordinator is responsible for conducting service coordination functions for a defined caseload… more
- Northwestern Memorial Healthcare (Chicago, IL)
- …employees. Ready to join our quest for better? Job Description The Operations Coordinator Patient Accounting reflects the mission, vision, and values of NM, adheres ... & reporting of candidates for bill. Outbound compliant bill submission, clinical documentation requirements and any other communication required (verbal or written)… more
- State of Colorado (Denver, CO)
- …coordinates and implements medical and psychiatric crisis intervention in clinical emergencies assuring compliance with nursing standards and policies/procedures. ... anticipating problems, planning interventions strategies and assigning responsibilities. Provides clinical and administrative supervision of nursing staff on duty.… more
- State of Colorado (Grand Junction, CO)
- …Mental Health Partners, Assessment Specialists, Client Managers Behavioral health staff and clinical director to consult with facility (including clinical & ... of the department's action. For more information about the appeals process, the official appeal form, and how to...this position, please direct your inquiries to our ADA Coordinator , Nancy Schmelzer, at cdhs_###@state.co.us or call ###. ~THE… more
- Centene Corporation (Salem, OR)
- …analyze and report verbal and written information regarding member and provider clinical appeals , including information follow up + Prepare response letters ... for member and provider clinical appeals and ensure letters are compliant with State and NCQA standards. + Maintain files and logs for all appeals +… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Coordinator I (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances Location: Los ... safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Coordinator I supports the Customer Solution Center … more
- CVS Health (Sacramento, CA)
- …Summary** Responsible for Oversight of that that investigates and resolution of appeals scenarios for all products, which may contain multiple issues and, may ... responses from multiple business units. Ensure timely, customer focused response to appeals . Identify trends and emerging issues and report and recommend solutions.… more
- Munson Healthcare (Traverse City, MI)
- …and initiating the authorization process. 10. Identifies and facilitates appeal responses, gathers clinical packets for appeals , and follows up on appeals ... experience in a revenue cycle role (billing, registration, insurance verification, referral coordinator , etc) . Ability to work independently and problem solve with… more
- Centene Corporation (Phoenix, AZ)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... **Position Purpose:** Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.… more
- Centene Corporation (Phoenix, AZ)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... **Position Purpose:** Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances from members.… more
- Centene Corporation (Phoenix, AZ)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... Purpose:** Analyze and resolve verbal and written claims and authorization grievance/ appeals from providers and members. Resolve all State inquires related to… more
- Commonwealth Care Alliance (Boston, MA)
- …, operations, pharmacy, dental, reporting, and member services. + Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in day-to-day ... 011540 CCA- Appeals & Grievances **Position Summary** Appeals ...strict deadlines. + When necessary collaborate with care teams, clinical staff, family members, and other involved in providing… more
- Robert Half Accountemps (Los Angeles, CA)
- …guidelines for use by examiners or Participant Services Representatives. * Assist Appeals Coordinator with the preparation of Benefits Committee appeal cases. ... IPA Group in Los Angeles is in the immediate need of a Grievance & Appeals Specialist. The Grievance & Appeals Specialist, will be in responsible for… more
- Squirrel Hill Health Center (Pittsburgh, PA)
- …Health Center (SHHC), is a Federally Qualified Health Center (FQHC), seeking a dedicated Clinical Support Coordinator to join our team. The ideal candidate will ... and insurance companies to streamline the authorization process. The Clinical Support Coordinator will assist SHHC Providers...of approval or denial statuses, including next steps for appeals if necessary. + Documentation: + Accurately… more
- CareOregon (Portland, OR)
- …Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Pharmacy Clinical Coordinator - (Prior Authorization) - Contingent Exemption Status Exempt ... use reviews. + Review medication prior authorization requests and appeals . + Develop and implement clinical educational...requests and appeals . + Develop and implement clinical educational programs to improve drug utilization and quality.… more
- CVS Health (Oklahoma City, OK)
- …day. **Position Summary** Responsible for intake, investigation and resolution of appeals , complaints and grievances scenarios for all products, which may contain ... responses from multiple business units. Ensure timely, customer focused response to appeals , complaints and grievance. Identify trends and emerging issues and report… more
- Elderwood (Cheektowaga, NY)
- …handles Third Party appeals , peer to peers as applicable and with clinical oversight provided by the LPN/RN MDS Coordinator . Attends team meetings at ... Salary $18.50 - $23.07/Hour Overview Managed Care Coordinator Overview The Managed Care Coordinator assists and supports the LPN/RN MDS Coordinator with case… more
- HCA Healthcare (Manchester, NH)
- …care like family! Jump-start your career as a Medical Staff Services Coordinator today with Catholic Medical Center. **Benefits** Catholic Medical Center, offers a ... Come join our team as a Medical Staff Services Coordinator . We care for our community! Just last year,...play a key role in the integration of HCA Clinical Strategies and HCA systems. 1. Medical Staff Administration… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Management (CM) Coordinator position is a proficient CM representative that provides technical, clerical and data management support ... and other community resources and transportation. In addition, the CM Coordinator position anticipates independent actions necessary to provide competent and… more
