- Centene Corporation (New York, NY)
- …of all appeals requests + Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry ... **Hours: 8:30am-5pm EST Monday - Friday.** **Position Purpose:** Performs clinical reviews needed to resolve and process appeals...analyzing the basis for the appeal + Ensures timely review , processing, and response to appeal in accordance with… more
- CommonSpirit Health (Englewood, CO)
- …We are seeking a highly skilled individual to develop and submit clinical appeals , expertly crafting physician-aligned letters based on federal and ... regulations, including CMS rules and the Two-Midnight Rule, while leveraging clinical criteria and prioritizing medical necessity to defend inpatient status. This… more
- State of Colorado (Denver, CO)
- …collaboration + Diversity and inclusion + Strong family and community partnerships The Clinical Mental Health Clinician III works in the 24-hour state ... need to change treatment assignment (under supervision of licensed clinician ) Individual Intervention: The Clinical MHC III...appeal with the State Personnel Board or request a review by the State Personnel Director. An appeal or… more
- State of Colorado (Chaffee County, CO)
- CDOC (Social Worker/Counselor III) - Mental Health Clinician - (BUENA VISTA) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5100324) Apply ... CDOC (Social Worker/Counselor III) - Mental Health Clinician - (BUENA VISTA) Salary $6,885.00 - $9,639.00 Monthly...for inmates experiencing acute mental health crisis. + Renders clinical direction to non- clinical staff in mental… more
- City and County of San Francisco (San Francisco, CA)
- …and + May perform Quality Improvement activities such as chart audit and compliance review . + The 2932 Senior Behavioral Health Clinician performs related duties ... Francisco continuously accepts applications for all permanent Senior Behavioral Health Clinician 2932 positions. Rather than publishing separate job ads for every… more
- State of Colorado (Denver, CO)
- Mental Health Clinician I - Colorado Mental Health Hospital in Fort Logan Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5092575) Apply ... Mental Health Clinician I - Colorado Mental Health Hospital in Fort...addresses safety violations in patient care areas. Using therapeutic clinical skills, anticipates and initiates intervention at an appropriate… more
- State of Colorado (Denver, CO)
- Mental Health Clinician II - Colorado Mental Health Hospital in Fort Logan (South Denver) Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5089657) Apply Mental Health Clinician II - Colorado Mental Health Hospital in Fort Logan (South… more
- City and County of San Francisco (San Francisco, CA)
- …of San Francisco continuously accepts applications for all permanent Behavioral Health Clinician 2930 positions. Rather than publishing separate job ads for every ... Homelessness and Supportive Housing and the Department of Public Health can then review your application and contact you directly with details about their positions.… more
- State of Colorado (Pueblo, CO)
- Social Worker/Counselor III - Clinical Work Lead Continuity of Treatment Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5097088) Apply Social ... Worker/Counselor III - Clinical Work Lead Continuity of Treatment Salary $82,620.00 -...Lastly, this position works with Unit Management Teams to review Unit Schedule and group needs to suggest appropriate… more
- Virtua Health (Mount Laurel, NJ)
- …Practice Managers to provide efficiencies in operational workflows related to clinician coding. Review and Resolution of Interdepartmental Coding-related Issues: ... Coding Audit Response: Conducts Trains new coders to utilize the medical record, clinical , coding and abstracting systems, in conjunction with UHDDS and other rules… more
- State of Colorado (Denver, CO)
- …who operates under the supervision of a licensed psychologist within Clinical Services. This position is generally responsible for utilizing knowledge, ... supervision, and the provision of psychoeducational treatment groups and assistance with clinical treatment groups. The Health Technician II may support the … more
- US Tech Solutions (May, OK)
- …Pharmacist/ Clinician is an operation-based role that conducts criteria based & clinical review of medical data collected to perform prior authorization as ... per policy and procedure. + The Pharmacist/ Clinician will apply clinical knowledge to plan...urgent PA request as needed. **Responsibilities:** + Evaluate and review all prior authorization requests and render coverage determinations… more
- Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
- …, and Incarcerated Veteran requests. Incumbent prepares the request for initial review /orders by the clinician , schedules all appointments into the decentralized ... processing all requests from VA Regional Offices to include appeals board for Compensation and Pension (C&P), to Environment...and the flexible use of a wide range of clinical flow processes relating to access to care across… more
- Commonwealth Care Alliance (Boston, MA)
- …medical, behavioral, and social needs. The RN uses evidenced-based care approaches, clinical skills, education, and training to influence the clinical outcomes ... communities across various locations. This position reports to the CIC APC Clinical Manager. **Supervision Exercised:** No, this position does not have direct… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …needs across the continuum of care by leveraging member partnership, pre-service clinical utilization review , case and disease management processes, skill sets ... a critical component of BCBSMN Medical Management team as the primary clinician providing condition and case management services to members. Your Responsibilities *… more
- Cardinal Health (Richmond, VA)
- …+ Take any action necessary for any denials received by the payor to inform the clinician of changes that may need to happen in order to not delay patient care. + ... Complete any pre-service appeals to obtain paying approval based on medical necessity....medical necessity. + Communicate effectively with all RCM and clinical staff to ensure appropriate treatment can be provided,… more