- Marriott (Costa Mesa, CA)
- …Full-Time **Located Remotely?** N **Relocation?** N **Position Type** Management **JOB SUMMARY** A Claims Adjuster II is responsible for the timely, good faith ... and complexity of Worker's Compensation and General Liability cases as determined by Claims Unit Manager .) **Expected Contributions** + Investigate claims … more
- Elevance Health (Atlanta, GA)
- **Telephonic Nurse Case Manager II ** **- $3000 Sign-On Bonus Offered** **Location: This is a virtual position, but you must reside in the State of Georgia.** ... of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II ** is responsible...as applicable. + Assists in problem solving with providers, claims or service issues. **Minimum Requirements:** + Requires a… more
- Elevance Health (Denver, CO)
- **Telephonic Nurse Case Manager II ** **Sign-on Bonus: $2000.** At **Federal Health Products and Services - FHPS** , a proud member of the Elevance Health, ... 10 am - 6:30 pm EST.** The **Telephonic** **Nurse Case Manager II ** is responsible...reimbursement, as applicable. + Assists in problem-solving with providers, claims , or service issues. + Assists with the development… more
- Houston Methodist (Nassau Bay, TX)
- At Houston Methodist, the Manager Case Mgmt Social Svcs position is responsible for functional and operational aspects of the Case Mgmt./Social Work ... corporate and hospital administrators, medical staff, and defined customers related to the Case Mgmt. system. The Manager Case Mgmt./Social Work position… more
- Southern Company (Atlanta, GA)
- …insurer, according to specified time frames. + Maintain reporting standards and present case reviews to the Large Claims Review Committee. + Subject matter ... and determine employee benefits related to Workers' Compensation and Short-Term Disability Claims . The incumbent is responsible for obtaining a timely and medically… more
- Sutter Health (San Francisco, CA)
- …patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely ... management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and… more
- Sutter Health (Modesto, CA)
- …RN-Registered Nurse of California Upon Hire **TYPICAL EXPERIENCE:** + 3 years of recent Case Manager experience in Acute Care preferred. **SHIFT:** + The shift ... 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 (Castro Valley, CA)
- …patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely ... management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and… more
- LA Care Health Plan (Los Angeles, CA)
- …Worker; current and unrestricted California License. Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements Light ... Care Management Specialist II Job Category: Clinical Department: Care Management Location:...skills and judgement. Management of the caseload assigned by Manager includes: coordinating health care benefits, providing education and… more
- Sutter Health (Burlingame, CA)
- …patient experience. This position works in collaboration with the Physician, Utilization Manager , Medical Social Worker and bedside RN to assure the timely ... management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and… more
- LA Care Health Plan (Los Angeles, CA)
- …to develop and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service ... Utilization Management Nurse Specialist LVN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full… more
- LA Care Health Plan (Los Angeles, CA)
- …Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical Requirements Light ... to develop and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service… more
- ThermoFisher Scientific (Tewksbury, MA)
- …**Region of coverage:** Global **Reports To:** Global Technical Support Manager **Group/Division:** Analytical Instruments Group (AIG) / Chemical Analysis Division ... (CAD) **Career Band:** Band 5 (Technical Support Specialist II ) **Product Line:** Product Inspection **Key Responsibilities:** + Responsible for providing technical… more
- CAMBA (Brooklyn, NY)
- …the ability to recognize, diffuse, and/or avoid violent situations. Position: Supervisor II Reports To: Program Manager Location: 955 Flatbush Avenue, Brooklyn, ... clients with assistance is processing Crime Victims Board Compensation Claims ; individual and group counseling' support groups, housing assistance,...NY 11226 What The Supervisor II Does: + Provide individual counseling to victims of… more
- Trinity Health (Troy, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** Patient Access Concierge II - St. Mary's Hospital - FT - Days Greets patients and family ... authorizations (pre-certifications, third-party authorizations, referrals) and contacts physicians and Case Management/Utilization Review personnel, as needed. Obtains and verifies… more
- Intrepid USA (Albany, GA)
- …Reporting . Outstanding Orders Reporting . Past Due Tasks Reporting . QA Manager Reporting . Visit Exception Reporting + Maintaining the patient's electronic medical ... requests for authorization to Authorization Department and/or obtains pre-authorization from case managers, state and county billers as needed. + Obtaining timely… more
- US Tech Solutions (Chesapeake, VA)
- …all levels to enable decision making at most appropriate level **Duties:** + Nurse Case Manager is responsible for face to face and telephonically assessing, ... and multiple diagnoses that impact functionality. + Reviews prior claims to address potential impact on current case... claims to address potential impact on current case management and eligibility. Assessments include the member's level… more
- PPL Corporation (Louisville, KY)
- …remediation of easement encroachments with property owners. With oversight settles damage claims with landowners resulting from the use of rights of way and ... Company storm restoration efforts. Performs other duties as directed by Manager Real Estate & Right of Way. Qualifications EDUCATIONAL_EXPERIENCE-Bachelor's degree… more
- Envista Holdings Corporation (Brea, CA)
- …personal protective equipment. + With minimal guidance, manages workers' compensation claims and return-to-work programs in collaboration with human resources. + ... + Performs any other projects or duties assigned by Manager . **Job Requirements:** REQUIRED: + Bachelor's degree plus a...are dependent on the facts and circumstances of each case . The total compensation package for this position may… more
- Immigration and Customs Enforcement (IN)
- …Responsibilities DUTIES AND RESPONSIBILITIES: Serves in the capacity of Regional Utilization Manager and subject matter expert in the oversight of program activities ... (MedPARs) for select reimbursable health care services and medical claims review. Ensures subordinate staff provide adequate coverage (eg,...is preferred. Incumbent must possess at minimum a Level II COR 40 hour course certificate or must obtain… more