- Mass General Brigham (Somerville, MA)
- …trends and cycles of the business and industry and see the "big picture." Review and analyze facility and professional claims in support of MGBHP's medical ... General Brigham. Job Summary Perform DRG validation and quality audit on claims , providing coding expertise in the application of medical and reimbursement policies… more
- Walgreens (Fairmont, NC)
- …and federal laws/regulations allow, accountable for performing day-to-day non- clinical pharmacy operations, administrative activities; Ensures efficient pharmacy ... to customers' requests in a timely manner and answers non- clinical questions to ensure a positive customer experience. Models...for efficient workflow. At the direction of the Pharmacy Manager or pharmacist, prepares, and files reports and records… more
- ICL (New York, NY)
- …that we are currently seeking a full-time candidate for the role of Case Manager Supervisor (CMS) to join our team! - Veterans preferred for specific VA Shelter ... in accordance with the performance of the tasks mentioned below CASE MANAGER SUPERVISOR TASKS: 1. STAFF COORDINATION & COMPLIANCE: Assist in ensuring staff… more
- Walgreens (Fairfield, NJ)
- …of medications and drug interaction awareness. Offers preventive and clinical healthcare services, including immunizations, diagnostic testing, and patient outcome ... (eg patient consultation, medication management, drug therapy reviews, and perform clinical , or wellness services such as immunizations, diagnostic testing, and… more
- Corvel (Cincinnati, OH)
- …customers. Primary source of quality assurance and information for MCO's Claims team. Supports management by handling quality assurance and escalated issues, ... & RESPONSIBILITIES: Conduct quality reviews/audits to ensure appropriate management of the claims and office, score the office performance, and make suggestions and… more
- Sutter Health (Modesto, CA)
- …team, nursing management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and ... patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely… more
- Sutter Health (Burlingame, CA)
- …team, nursing management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and ... patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely… more
- US Tech Solutions (Columbia, SC)
- …to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of ... of care Referrals, etc.). Participates in data collection/input into system for clinical information flow and proper claims adjudication. Demonstrates compliance… more
- Veterans Health Administration (Las Vegas, NV)
- …Maintains stock at primary and secondary inventory locations for all clinical and administrative services. This involves pulling stock inventory and material ... from main inventory for delivery; replenishing stock inventory; interacting with clinical and administrative customers to ensure issues and needs are identified and… more
- Catholic Health Services (Fort Lauderdale, FL)
- …Objective Responsible for the billing and timely follow up of all assigned Medicaid claims for Nursing Home and Hospital in a cost effective and efficient manner. ... agencies (ie, DCF). Essential Functions Billing of all Medicaid claims via the SSI software (and when appropriate web...management tool. Complete A/R spreadsheets and be prepared to review details with management at scheduled monthly review… more
- Walgreens (West Long Branch, NJ)
- …Walgreen Co. Pharmacy Code of Conduct. Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including utilizing pharmacy systems ... the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and… more
- Trinity Health (Athens, GA)
- …to identify budget variances; and prepares related reports for senior management review . Keeps Regional Manager informed of issues affecting program costs, ... Type: Full time Shift: Description: POSITION PURPOSE Functions as General Manager responsible for the oversight and coordination of the day-to-day operations… more
- Veterans Health Administration (Hampton, VA)
- …Procurement Planning. Takes the lead and coordinates with the Network Contract Manager (NCM) and associated Service Area Office. Collaborates and negotiates with ... Opens in a new windowLearn more about federal benefits. Review our benefits Eligibility for benefits depends on the...knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position.… more
- Intermountain Healthcare (Salt Lake City, UT)
- …Pharmacy Services and Scripius. This position contributes to the strategic and clinical direction of the department. The Manager identifies and promotes ... activities, physician communication/education, retail/community pharmacy, NCQA qualification, information services, clinical intervention programs, drug usage evaluation programs, and pharmacy… more
- Veterans Health Administration (Tulsa, OK)
- …career very rewarding. Opens in a new windowLearn more about federal benefits. Review our benefits Eligibility for benefits depends on the type of position you ... knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position....Opens in a new windowLearn more about federal benefits. Review our benefits Eligibility for benefits depends on the… more
- University of Maryland Faculty Physicians, Inc. (Towson, MD)
- Performs the investigation of adverse events, near misses, and potential claims and suits and actively participates in developing and implementing loss prevention ... and other duties as assigned. EDUCATION and/or EXPERIENCE * Bachelor's degree or in clinical health care with Master's preferred * Three to five years nursing and/or… more
- Veterans Health Administration (Cincinnati, OH)
- …career very rewarding. Opens in a new windowLearn more about federal benefits. Review our benefits Eligibility for benefits depends on the type of position you ... knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position....Opens in a new windowLearn more about federal benefits. Review our benefits Eligibility for benefits depends on the… more
- Walgreens (Des Moines, IA)
- …Walgreen Co. Pharmacy Code of Conduct. Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including utilizing pharmacy systems ... the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and… more
- Walgreens (West Sand Lake, NY)
- …Walgreen Co. Pharmacy Code of Conduct. Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including utilizing pharmacy systems ... the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and… more
- Veterans Health Administration (St. Louis, MO)
- …career very rewarding. Opens in a new windowLearn more about federal benefits. Review our benefits Eligibility for benefits depends on the type of position you ... knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position....Opens in a new windowLearn more about federal benefits. Review our benefits Eligibility for benefits depends on the… more
