- 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 ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Quality Auditing (QA) Specialist II...assisting the Appeal and Grievances Compliance, Training and QA Manager to develop a successful and cohesive unit with… more
- City of Norfolk, Virginia (Norfolk, VA)
- Assistant Commonwealth Attorney I, II , and III Print (https://www.governmentjobs.com/careers/norfolk/jobs/newprint/2506461) Apply Assistant Commonwealth Attorney ... I, II , and III Salary See Position Description Location Norfolk,...Attorney I: + Prepares cases for trial by reviewing case reports, identifying the relevant facts of the … more
- LA Care Health Plan (Los Angeles, CA)
- Technical Applications Manager II Job Category: Information Technology Department: IT Solutions Delivery Location: Los Angeles, CA, US, 90017 Position Type: Full ... the safety net required to achieve that purpose. Job Summary The Technical Application Manager II reports to the Senior Manager Information Technology IT… more
- Town of Gilbert (Gilbert, AZ)
- …The primary job duties of Planner II include: + Function as the case planner/project manager to facilitate and coordinate the planning review process with ... Planner II & Planner Senior Print (https://www.governmentjobs.com/careers/gilbert/jobs/newprint/5036814) Apply Planner II & Planner Senior Salary $72,775.00 -… more
- State of Colorado (Greeley, CO)
- Behavioral Health Specialist, Social Work/Counselor II - Platte Valley Youth Services Center Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5067786) Apply Behavioral Health Specialist, Social Work/Counselor II - Platte Valley Youth Services Center Salary $74,940.00… more
- LA Care Health Plan (Los Angeles, CA)
- …log and keep track all due dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist.; submit all Grievances and Appeals ... Authorization Technician II Job Category: Clinical Department: Utilization Management Location:...required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in… more
- State of Colorado (Denver, CO)
- Senior Paralegal (Legal Assistant II ) - Workers' Compensation Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5042905) Apply Senior Paralegal ... (Legal Assistant II ) - Workers' Compensation Salary $71,893.50 - $88,560.00 Annually...The Unit manages litigation from inception through hearings and appeals , including fully contested claims, challenges to specific disability… more
- State of Colorado (Denver, CO)
- Administrative Assistant II (State Services) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5054852) Apply Administrative Assistant II ... is looking for administrative professionals to join their team! These Administrative Assistant II positions will join a collaborative team with a wide range of… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …the Health Plan Essential Accountabilities: Level I + Review / prep clinical case for clinical staff. + Navigates and utilizes corporate applications; core claims ... assigned to non-care managers are monitored by the care manager + The care manager provides feedback...+ Performs other functions as assigned by management. Level II (in addition to Level I Accountabilities) + Prioritizes… more
- Highmark Health (Monroeville, PA)
- …BSN **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + ACM Certification (Accredited Case Manager ) - American Case Management Association - ... to employees. Forbes Hospital is a 315 bed, Level II trauma hospital located in the community of Monroeville....- American Board of Occupational Health Nurses (ABOHN) andCertified Case Manager (CCM) + Commission for … more
- State of Colorado (Denver, CO)
- Administrative Assistant II - Natural Resources & Environment Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5057017) Apply Administrative ... Assistant II - Natural Resources & Environment Salary $39,852.00 -...using SharePoint + Experience working with document management systems, case management systems, and document review systems + Experience… more
- State of Colorado (Denver, CO)
- …Surveillance Data Analyst - Statistical Analyst II Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5046504) Apply Syndromic Surveillance Data ... Analyst - Statistical Analyst II Salary $69,024.00 - $101,964.00 Annually Location Denver Metro,...through demonstrations, trainings, newsletters and/or annual meetings. + Defines case definitions and methods of data submission to enhance… more
- Covenant Health Inc. (Knoxville, TN)
- …in our region. Position Summary: Under the supervision of the clinic manager , coordinates the admission functions to therapy centers outpatient services. Monitors ... sent to medical records. + Participates in account audits and appeals . + Performs data collection, trending, and reporting of departmental statistics/information… more
- Covenant Health Inc. (Lenoir City, TN)
- …every time. Position Summary: Under the supervision of the clinic manager , coordinates the admission functions to therapy centers outpatient services. Monitors ... sent to medical records. + Participates in account audits and appeals . + Performs data collection, trending, and reporting of departmental statistics/information… more
- Veterans Affairs, Veterans Health Administration (Orlando, FL)
- …of VHA and industry best standards. Responsibilities Responsibilities of the RUR Nurse Manager (NM) include, but are not limited, to the following: RUR Nurse ... Manager is accountable to the Consolidated Patient Account Center...cases to validate related care for reimbursement. Conducts clinical appeals as required by the third-party payers to overturn… more
- City and County of San Francisco (San Francisco, CA)
- …the following duties: QUALITY CONTROL, INVESTIGATIONS, OVERPAYMENTS, AND/OR APPEALS SPECIALIST Under general supervision, the Quality Control, Investigations, ... Overpayments or Appeals Specialist performs investigations in support of human service...correspondence with the client + Reviews and analyzes client case records, case information, and other pertinent… more
- State of Colorado (Denver, CO)
- …sets of rules and regulations has been verified; investigates complaints concerning children in case of Stage II complaints and documents facts on licensees for ... to come into the office for business reasons, upon request by the hiring manager . **Please note - equipment provisioning and certain onboarding tasks will take place… more
- State of Colorado (Denver, CO)
- …is designed to train for the next higher level in the class series (EPS II ) and prepare the permit writer to be an individual contributor and carry out established ... Procedures, 4 CCR 801, for more information about the appeals process. The State Personnel Board Rules and Personnel...be invited to schedule an interview with the hiring manager . E-Verify: CDPHE uses e-Verify, an Internet-based system, to… more
- Baylor Scott & White Health (Dallas, TX)
- …on position type and/or level **Job Summary** + Under the Safe Choice Claims Manager , the Safe Choice Claims Specialist II reviews, studies, and processes ... efficient service while protecting the organization's assets. + The Claims Specialist II 's main duty involves using discretion and independent judgment on important… more
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