• Claims Case Manager II

    Guardian Life (Columbus, OH)
    Grow your career with Guardian in our newly created opportunity as a **Claim Case Manager II , Supplemental Health** ! In a culture where "People Count," "We ... decisions via telephone and in writing. + Prioritize and review new claims to adhere to established departmental turnaround times. + Meet productivity requirements… more
    Guardian Life (04/11/24)
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  • Claims Adjuster II

    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
    Marriott (05/12/24)
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  • Telephonic Nurse Case Manager

    Elevance Health (Richmond, VA)
    **"Telephonic" Nurse Case Manager II ** **Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point ... 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 (05/10/24)
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  • Nurse Case Mgr II (US)

    Elevance Health (Indianapolis, IN)
    …proximity (1-hour commute and a 50-mile radius) to an Elevance Health Pulsepoint. The **Nurse Case Manager II ** is responsible for care management within the ... is providing services in multiple states. **Preferred Experience** Certification as a Case Manager is preferred. Discharge planning experience is a strong… more
    Elevance Health (05/08/24)
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  • Nurse Case Mgr II (US)

    Elevance Health (Indianapolis, IN)
    …report to a Pulsepoint once a week (subject to future change). The **Nurse Care Manager II ** is responsible for care management within the scope of licensure for ... as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of...services in multiple states. **Preferred Experience** Certification as a Case Manager is preferred. BS in a… more
    Elevance Health (05/24/24)
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  • Care Manager II , Acute (RN)

    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 (04/26/24)
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  • Care Manager II , Acute

    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
    Sutter Health (05/20/24)
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  • Care Management Specialist II

    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
    LA Care Health Plan (04/27/24)
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  • Care Manager II , Registered Nurse

    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
    Sutter Health (05/23/24)
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  • RN Case Manager

    HCA Healthcare (Lone Tree, CO)
    …in this role. The typical candidate is hired below midpoint of the range. **RN Case Manager ** **Thursday - Sunday Weekend Shift 8 and 10 hour shifts** ... any other healthcare provider. We are seeking a(an) RN Case Manager to join our healthcare family....acute care setting. + Performs telephonic clinical reviews with claims insurance personnel to facilitate reimbursement for the delivery… more
    HCA Healthcare (05/08/24)
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  • LTSS Provider Network Manager II

    BlueCross BlueShield of Tennessee (Knoxville, TN)
    …language and reimbursement methodologies, managed care business processes, case \-mix adjustment, medical terminology, utilization management and applications for ... claims payment, required\. _License_ + Valid Driver's License **Job Specific Requirements:** + Needs to be located in the Johnson City OR Knoxville area OR in… more
    BlueCross BlueShield of Tennessee (05/22/24)
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  • Utilization Management Nurse Specialist LVN…

    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 (05/22/24)
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  • Utilization Management Nurse Specialist RN…

    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
    LA Care Health Plan (05/07/24)
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  • HR Service Center Associate I / II | HR…

    Arizona Public Service (Phoenix, AZ)
    HR Service Center Associate I / II | HR Services/Operations Apply now " Date: May 17, 2024 Location: PHOENIX, AZ, US, 85004-3903 Company: APS Our present and future ... Other and Succeed Together. Summary HR Service Center Associate I/ II | HR Services/Operations - Join our dynamic team...with the goal of resolving at first contact. Owns case management process which includes opening, managing escalation and… more
    Arizona Public Service (05/18/24)
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  • Technical Support Specialist II

    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
    ThermoFisher Scientific (05/18/24)
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  • Supervisor II , Violence Prevention…

    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
    CAMBA (03/22/24)
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  • Patient Access Concierge II - St. Peter's…

    Trinity Health (Albany, NY)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** Patient Access Concierge II - St. Peter's Hospital - Full Time - 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
    Trinity Health (05/24/24)
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  • Support Specialist II

    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
    Intrepid USA (05/04/24)
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  • Healthcare Consultant II

    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
    US Tech Solutions (05/10/24)
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  • Ormco EH&S Specialist II (On-Site Pomona,…

    Envista Holdings Corporation (Pomona, 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 . + Travels up to 10% to Southern California...are dependent on the facts and circumstances of each case . The total compensation package for this position may… more
    Envista Holdings Corporation (05/24/24)
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