• Clinical Appeals Coordinator

    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
    Centene Corporation (07/16/25)
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  • Pharmacy Clinical Coordinator (Prior…

    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
    CareOregon (07/12/25)
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  • Social Worker (Program Coordinator )

    Veterans Affairs, Veterans Health Administration (White City, OR)
    …Veterans at high risk for suicide. The COMPACT Act Social Work Program Coordinator provides outreach, manages administrative and clinical reviews, provides case ... Rehabilitation Center & Clinics (SORCC) provides a variety of clinical programs with a wide range of outpatient services...OF ASSIGNED DUTIES: The COMPACT Act Social Work Program Coordinator functions as a coordinator for care… more
    Veterans Affairs, Veterans Health Administration (07/11/25)
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  • Pharmacy Coordinator

    Highmark Health (Salem, OR)
    …obtain necessary and/or additional information when necessary. + Consult with staff clinical pharmacist for guidance and assistance as necessary. + Document all ... through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical staff. +… more
    Highmark Health (07/15/25)
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  • Coding Audit Training Specialist

    Intermountain Health (Salem, OR)
    … provides advanced training to hospital coding staff, compliance, CDI, physicians, and clinical staff. This Coordinator serves as a subject matter expert for ... audit and monitor all areas of hospital coding. The coordinator works with providers and clinical staff...compliance and the CDI team. + Audits and creates appeals for all payer and regulatory denials and downgrades… more
    Intermountain Health (07/16/25)
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