- Genmab (Berkeley Heights, NJ)
- …provide a positive experience. This position reports to the Patient Services Manager , Call Center Operations.The creation of our new internal Genmab Patient Services ... verifications, research of prior authorizations and support through the appeals processEvaluate and refer patients to appropriate financial assistance… more
- PharmaCord (Cincinnati, OH)
- …reside in the state of Ohio. When you join the team as an Executive Case Manager , you'll have the opportunity to make a difference in the lives of our patients each ... prescriptions or cases are handled in a timely manner. An Executive Case Manager has the ability to translate knowledge into patient friendly language and education.… more
- PharmaCord (Jeffersonville, IN)
- …Acquisition team immediately at ###@pharmacord.com When you join the team as the Case Manager , you'll have the opportunity to make a difference in the lives of our ... closure to include; benefit investigations, prior authorizations / denial appeals , determining financial qualifications for assistance programs and assisting… more
- The Crucible (Oakland, CA)
- Job Type Full-time Description Come join The Crucible as our Office Manager for the opportunity to use your expertise in administration, bookkeeping, customer ... arts education nonprofit located in West Oakland! The Office Manager is the lead for ordering materials, equipment, and...fit, what you'd bring to The Crucible and what appeals to you about this position. Due to the… more
- Catholic Health Services (Melville, NY)
- …Health was named Long Island's Top Workplace! Job Details The Utilization and Appeals Manager (UAM) proactively conducts clinical reviews and appeals ... and/or escalates denial when appropriate. + Submits all (initial and/or appeals ) reviews and/or letters within contractual or regulatory timeframes. + Collaborates… 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 Location: Los ... the safety net required to achieve that purpose. Job Summary The Manager , Appeals & Grievances (A&G) & General Operations (Clinical) is responsible for the… more
- Nuvance Health (Danbury, CT)
- *Description* *Summary:* The Manager , Denials Prevention & Appeals Operations is responsible for the direct oversight of daily operations of clinical denial ... This position will work closely with the Denials Prevention & Appeals Administration Manager to guide the development and implementation of new programs and… more
- BronxCare Health System (Bronx, NY)
- …the analysis and preparation of responses to payor denials and develop strong appeals for the purpose of securing reimbursement for acute care services provided to ... identification of patterns and trends identified during the course of appeals preparation. Conduct departmental performance improvement audits, analyze findings and… more
- Catholic Health Services (Melville, NY)
- …services and coordinates utilization/ appeals management review. + Assist Utilization and Appeals Manager in setting up communications with payors and/ or ... facility departments. + Develops/validates daily work lists for Utilization and Appeals Manager . + Assist with all insurance and regulatory audits and provides… more
- Elevance Health (Columbus, OH)
- ** Manager II Grievance/ Appeals ** **- Claims Support** **Office Locations:** _The selected candidate must reside within a reasonable commuting distance of the ... unless an accommodation is granted as required by law._ The ** Manager II Grievance & Appeals ** responsible for management oversight of grievances and appeals … more
- Public Storage (Plano, TX)
- …and preferred stocks trade on the New York Stock Exchange. **Job Description** The Senior Manager , Property Tax Appeals and Analysis, is a key member of the ... Public Storage tax team, responsible for strategically managing the property tax appeals process across a national portfolio. This position reports directly to the… more
- Walmart (Bentonville, AR)
- **Position Summary ** The Senior Manager , Incident Management, will play a critical role within the Last Mile Delivery, Trust and Safety organization. This position ... supports the Incident Management program, which is responsible for responding to all reported incidents that occur with Walmart deliveries in the Last Mile. The team manages a high volume of incidents and is responsible for driving consistency and quality… more
- Mount Sinai Health System (New York, NY)
- …as per department protocol (IPRO Discharge Appeals / Insurance requests) + Support Appeals Nurse / Manager by confirming status of denials + Tracking status ... + Requests or provides Medical Records as required for appeals , On / Off-site Insurance reviews + Implements.../ Off-site Insurance reviews + Implements first step of appeals process to assist Appeals Nurse and… more
- New York State Civil Service (Albany, NY)
- …Duties Description Under the direction of the Clerk of the Court, the Building Manager oversees maintaining the Court of Appeals building and grounds and courier ... service in the Court of Appeals . The Building Manager supervises and coordinates the twenty-four hours, seven days a week maintenance activity and performs other… more
- Hawaiian Electric (Honolulu, HI)
- …working on all aspects of litigation matters from case inception to judgment and appeals . Role: Manager Number of Vacancies: 1 Location: Honolulu - Oahu Hiring ... LEGAL Division at Hawaiian Electric Company has 1 Management vacancy available. (Role: Manager ) This posting seeks to fill at either the Associate General Counsel or… more
- Garnet Health (Middletown, NY)
- …for the day to day operation of the CDI department and DRG Denials appeals process. The Manager will develop, implement and evaluate processes, policies and ... Administrator, Coding & Clinical Documentation Improvement and Patient Access, the Manager of Clinical Documentation Integrity (CDI) and DRG Denials is responsible… more
- Molina Healthcare (Kenosha, WI)
- …for leading, organizing and directing the activities of the Grievance and Appeals Unit that is responsible for reviewing and resolving member complaints and ... * Leads, organizes, and directs the activities of the Appeals & Grievances unit that is responsible for reviewing... and grievance processing/resolution, including 2 years in a manager role. * Experience reviewing all types of medical… more
- Actalent (Sacramento, CA)
- Job Title: Appeals and Grievances Registered Nurse Job Description We are seeking a skilled professional to join our team and handle member appeals and ... post-service concerns, reviewing medical records and documentation to evaluate appeals , conducting timely and accurate first-level clinical reviews using guidelines… more
- The County of Los Angeles (Los Angeles, CA)
- …quality assessment and assurance monitoring processes; and handle informal complainant appeals . Health Facilities Program Manager , Nursing positions are required ... HEALTH FACILITIES PROGRAM MANAGER , NURSING Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4626091) Apply HEALTH FACILITIES PROGRAM MANAGER… more
- LA Care Health Plan (Los Angeles, CA)
- Customer Solution Center Appeals and Grievances Quality Auditing Specialist II Job Category: Administrative, HR, Business Professionals Department: CSC Appeals & ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II is...assisting the Appeal and Grievances Compliance, Training and QA Manager to develop a successful and cohesive unit with… more
