- Providence (Seattle, WA)
- **Description** **THE ROLE** The Senior Director Utilization Management & Denials - Administration is 100% remote. The role requires a broad knowledge and focus ... engages processes, procedures, and practices to minimize RAC, CERT, ADR regulatory denials . Implements appropriate procedures to mitigate clinical commercial and… more
- Trinity Health (Livonia, MI)
- …and Local Health Physician Champions, Chief Medical Officers, HM Executive Leadership, clinical staff, coding and denials teams to facilitate documentation ... **Shift:** Day Shift **Description:** **POSITION PURPOSE** Responsible for directing Clinical Documentation Integrity (CDI) activities for the Health Ministries (HM)… more
- SSM Health (Jefferson City, MO)
- …of responsibility is all post-billed denials (inclusive of clinical denials ). Engages with key leadership including regional leaders to identify and ... staff retention and engagement. + Understands complexities involved in supporting denials activities spanning multiple states, regional health ministries, payer… more
- Gallatin Center for Rehabilitation and Healing (Gallatin, TN)
- …data quality and maximize therapist efficiency. Managing Medicare Medical Review and Denials Management process in conjunction with the Regional CareRite ... GENERAL PURPOSE: The Assistant Director of Rehabilitation is responsible to assist with all but not limited to internal departmental communication and operations,… more
- UPMC (Moosic, PA)
- …interests, we invite you to learn more and apply today! The Senior Medical Director provides guidance for clinical operational aspects of the program, including ... Community Care was created by a leadership team whose clinical experiences as behavioral health providers compelled them to... needs of Community Care members. The Senior Medical Director also participates in regional and company… more
- UNC Health Care (Chapel Hill, NC)
- …responsibilities for other UNC hospital campus functions. Summary: Responsible for assisting the Regional Director of Clinical Care Management in overall ... for the daily operations of the Utilization Management and Clinical Denials Management functions of the department...direction to designated department leadership and staff members. Assists Regional Director in ensuring that the department… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Sr. Regional Administrator position is responsible for activities of multiple, on and off-campus practice locations within a specific ... practices. This position will lead the integration of multiple operational and clinical leadership structures, promote the business growth of the clinic network,… more
- Billings Clinic (Billings, MT)
- …and/or continued stay *Proactively interacts with payers and proactively sends clinical reviews to prevent inpatient denials *Proactively communicates with ... about Billings Clinic (our organization, history, mission, leadership and regional locations) and how we are recognized nationally for our… more
- HCA Healthcare (Pensacola, FL)
- …consultation on contracting, pricing, and analysis of managed care issues. Offers clinical support for appeals and denials process, discharge planning, case ... Officer (CMO) ensures high quality, patient-centered care by leading clinical and quality initiatives that support the provision of... leadership in the facility + You will assemble regional physician advisory panels to provide ongoing feedback to… more
- Guthrie (Sayre, PA)
- …Insurance Billing Specialists I and related support staff. Works closely with Director , Manager, Supervisor and Application Analyst on day to day priorities and ... and skills for the position. Essential Functions: 1. Identifies and evaluates denials for assigned payers and/or specialties to determine specific issues and… more
- Spokane County (Spokane, WA)
- …evaluation of guidelines and benefit determination. + Consults with the Medical Director for any service authorization denials . + Determines financial ... within the Community Services Department (CSD): Behavioral Health Agency Clinical Integrated Care, the Behavioral Health Administrative Services Organization… more
- Guthrie (Sayre, PA)
- …other hospital departments as appropriate to track and monitor the status for denials and appeals. c) Collects and aggregates clinical , financial, and variance ... licensure or eligibility for licensure required Experience: Minimum of five years clinical experience in an acute health care setting. Must possess strong… more
- Universal Health Services (Jeffersonville, IN)
- Responsibilities Wellstone Regional Hospital is a 100-bed acute care facility located in Jeffersonville, Indiana and has been providing quality health care to the ... Assures that good customer service practices are utilized. Maintains denials and appeals logs and reviews the progress of...LPN. Experience: A minimum of one (1) year direct clinical experience in a psychiatric or mental health treatment… more