- Humana (Lincoln, NE)
- …clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments involve moderately complex to complex issues where the ... case consideration of the Medicare rules, Humana policies and medical necessity. The Medical Director ...includes computer based review of moderately complex to complex appeals for coverage for drugs using resources outlined above… more
- Humana (Frankfort, KY)
- …part of our caring community and help us put health first** The Corporate Medical Director provides medical interpretation and decisions about the ... and determining the best course of action. The Corporate Medical Director provides medical interpretation...the managed care industry including Medicare, Medicaid and or Commercial products + Possess analysis and interpretation skills with… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding ... or their respective auditors JOB DUTIES AND RESPONSIBILITIES: + Conduct retrospective medical record reviews for clinical validation of diagnosis and procedure code… more
- Humana (Juneau, AK)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Carson City, NV)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- CVS Health (Austin, TX)
- …of covered benefits in the Commercial and Medicare environment. This Medical Director provides subject matter expertise in clinical and payment policy ... CVS Health company, has an outstanding opportunity for a Medical Director . Ready to take your career...of Aetna clinical and coding policy and experience with appeals , claim review, reimbursement issues, and coding is preferable,… more
- Robert Half Finance & Accounting (Carlisle, PA)
- Description We are looking for a dedicated Revenue Cycle Management Director to lead and manage all aspects of our client's revenue cycle operations. This position ... * Oversee the revenue cycle processes for Medicaid, Medicare, managed care, commercial payers, and sliding fee programs. * Establish and enforce billing policies… more
- State of Colorado (Denver, CO)
- …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... of notice or knowledge of the action: Colorado State Personnel Board/State Personnel Director , Attn: Appeals Processing, 1525 Sherman Street, 4th Floor, Denver,… more
- City and County of San Francisco (San Francisco, CA)
- …service examination process is subject to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or the Civil Service ... is responsible for overseeing a broad range of waterfront commercial , maritime, and public access facilities that are held...item(s) constitute(s) abuse of discretion by the Human Resources Director . Appeals must be submitted directly to… more
- City and County of San Francisco (San Francisco, CA)
- …service examination process is subject to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or the Civil Service ... reason(s) why the cited item(s) constitute(s) abuse of discretion by the Human Resources Director . Appeals must be submitted directly to the Executive Officer of… more
- City and County of San Francisco (San Francisco, CA)
- …service examination process is subject to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or the Civil Service ... divisions in the Water Enterprise serving 2.7 million residential, commercial , and industrial customers in the Bay Area, the...item(s) constitute(s) abuse of discretion by the Human Resources Director . Appeals must be submitted directly to… more
- City and County of San Francisco (San Francisco, CA)
- …service examination process is subject to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or the Civil Service ... reason(s) why the cited item(s) constitute(s) abuse of discretion by the Human Resources Director . Appeals must be submitted directly to the Executive Officer of… more
- State of Colorado (Greeley, CO)
- …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... in public safety. Full benefits are provided. Apprentices will earn their Commercial Driver's License and the requirements to qualify for a Highway Maintenance… more
- State of Colorado (Sterling, CO)
- …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... Officers" and are eligible for increased PERA benefits. + Medical and dental health plans. + Short and long...purposes. Four (4) years of employment experience in a commercial , institutional or industrial setting (such as hospital, hotel,… more
- Sacramento County (Sacramento, CA)
- …Building Inspector series review construction plans, and/or inspects all residential, commercial , industrial buildings, and other structures in Sacramento County to ... duties which have included reviewing construction plans and inspecting residential, commercial , and/or industrial buildings to determine compliance with local, state… more
- State of Colorado (Durango, CO)
- …Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, ... traveling public? Are you interested in obtaining a Colorado Commercial Driver's License Class A or B? If so,...keeping them safe. The State of Colorado offers competitive medical , dental and vision insurance, life and disability insurance,… more
- City and County of San Francisco (San Francisco, CA)
- …reason(s) why the cited item(s) constitute(s) abuse of discretion by the Human Resources Director . Appeals must be submitted directly to the Executive Officer of ... of way. + Knowledge of San Francisco Municipal Codes + Knowledge of Commercial Inspection Services. VERIFICATION: Please make sure your application is complete and… more
- State of Colorado (Park County, CO)
- …Colorado Code of Regulations (CCR) 801-1,State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and ... biweekly pay periods in a year. Why CDOT? + Medical and Dental benefits after a 30-day sign-up timeframe,...information section. + Must possess and maintain a valid Commercial Driver's License Class A or B with no… more
- State of Colorado (Summit County, CO)
- …Colorado Code of Regulations (CCR) 801-1,State Personnel Board Rules and Personnel Director 's Administrative Procedures, Chapter 8, Resolution of Appeals and ... keeping them safe. The State of Colorado offers competitive medical , dental and vision insurance, life and disability insurance,...to operate CDOT vehicles + Required to obtain a Commercial Driver's License Class A or B with no… more