- Trinity Health (Darby, PA)
- …ensure timely claims resolution + Working knowledge of Commercial, Managed Medicaid and Managed Medicare Payers and Policies, Medicare and Medicaid ... ensure timely claims resolution + Working knowledge of Commercial, Managed Medicaid and Managed Medicare Payers and Policies, Medicare and Medicaid … more
- Virginia Mason Franciscan Health (Bremerton, WA)
- …more! **Responsibilities** **Job Summary / Purpose** The Utilization Management ( UM ) Director is responsible for the market(s) development, implementation, ... reconsiderations. In collaboration with the Division Director Care Coordination, the UM Director develops strategies to achieve departmental and CommonSpirit Health… more
- Immigration and Customs Enforcement (IN)
- …conduct of all aspects of management of assigned functions related to administrative management. Reviews and approves URC leave, training, and travel requests. ... Requests (MedPARs) for select reimbursable health care services and medical claims review. Ensures subordinate staff provide adequate coverage (eg, TDY and… more
- Fallon Health (Worcester, MA)
- …training is conducted so that office staff is able to complete daily billing and claims responsibilities + Works with FH UM , Provider Relations, and Claims ... to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE- in the region. **Brief summary of purpose:** The… more
- Molina Healthcare (Bothell, WA)
- …**Job Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of ... appropriate care at the most effective setting. Evaluates the effectiveness of UM practices. Actively monitors for over and under-utilization. Assumes a leadership… more
- Molina Healthcare (Bothell, WA)
- … Medicaid or Medicare. **PREFERRED EDUCATION:** Master's in Business Administration , Public Health, Healthcare Administration , etc. **PREFERRED EXPERIENCE:** ... **Job Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of… more