• Supervisor , Appeals

    LA Care Health Plan (Los Angeles, CA)
    Supervisor , Appeals and Grievances Clinical Operations RN Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, ... required to achieve that purpose. Job Summary The Supervisor of Appeals and Grievances Clinical Operations (A&G) RN is responsible for executing the… more
    LA Care Health Plan (03/27/24)
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  • Behavioral Health Supervisor

    State of Colorado (Pueblo, CO)
    Behavioral Health Supervisor - Pueblo Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4500403) Apply  Behavioral Health Supervisor - Pueblo ... CAA HP V SCCF 9359 5/2024 Department Department of Corrections Division Clinical and Correctional Services Opening Date 05/16/2024 Closing Date 5/30/2024 4:00 PM… more
    State of Colorado (05/17/24)
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  • Clinical Director - Summit Youth Services…

    State of Colorado (Golden, CO)
    Clinical Director - Summit Youth Services Center in Golden Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4490587) Apply  Clinical ... evaluations if credentialed; Neuropsychological screenings and evaluations if credentialed; clinical consultation with Behavioral Health Specialists, Client Managers and… more
    State of Colorado (05/22/24)
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  • Occupational Therapist Supervisor

    State of Colorado (Pueblo, CO)
    Occupational Therapist Supervisor - Therapist IV Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4506134) Apply  Occupational Therapist ... Supervisor - Therapist IV Salary $98,000.00 Annually Location Pueblo,...care in groups or individualized treatment sessions + Provide clinical and administrative supervision to OT staff providing OT… more
    State of Colorado (05/24/24)
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  • Correctional, Youth, Or Clinical Security…

    State of Colorado (Pueblo, CO)
    CORRECTIONAL, YOUTH, OR CLINICAL SECURITY OFFICER I - Pueblo Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4514229) Apply  CORRECTIONAL, ... YOUTH, OR CLINICAL SECURITY OFFICER I - Pueblo Salary $2,104.62 Biweekly...in accordance with the living unit master schedule, shift supervisor and/or other administrative direction. Provide corrective cognitive, emotional… more
    State of Colorado (05/21/24)
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  • Case Management Analyst-3

    The Cigna Group (Bloomfield, CT)
    …, administrative and regulatory criteria for reviewing and making decisions on all non- clinical appeals and validating the accuracy of all received information + ... regarding Medicare appeals and related issues, implications and decisions. The Appeals Reviewer reports to the Supervisor /Manager of Appeals and… more
    The Cigna Group (05/01/24)
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  • Supervisor Care Management - Utilization…

    Hackensack Meridian Health (Hackensack, NJ)
    …functions and performance improvement activities for the case managers. The Supervisor Case Management is accountable for the department's designated staff caseload ... case management process, including LOS, throughput, patient flow and denials and appeals follow up. i. Responsible for staff productivity and ongoing education. j.… more
    Hackensack Meridian Health (05/07/24)
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  • Supervisor , Care Management Coordinator

    LA Care Health Plan (Los Angeles, CA)
    Supervisor , Care Management Coordinator Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... net required to achieve that purpose. Job Summary The Supervisor of Care Management Coordinator is responsible for direct...in Managed Care preferably in Customer Service, Care Management, Appeals and Grievances and/or Claims. Participated in… more
    LA Care Health Plan (05/23/24)
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  • Clinical Operations Executive

    LA Care Health Plan (Los Angeles, CA)
    …closely with the Chief Operating Officer (COO) to allow for integration with claims, appeals and grievances , and our customer service center. The COE ensures ... Clinical Operations Executive Job Category: Management/Executive Department: Utilization...all HIPAA requirements. Actively identifies and makes recommendations to supervisor , ideas to improve the quality effectiveness and efficiency… more
    LA Care Health Plan (03/10/24)
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  • CDOC Health Service Administrator

    State of Colorado (Pueblo, CO)
    …Job This position provides operational and supervisory oversight of multi-disciplinary clinical services staff working at the San Carlos Correctional Facility. This ... position is an Administrative Supervisor with direct field of influence and accountability on...and completing performance evaluations per CDOC regulations, and resolves complaints/ grievances at the informal level; + Ensures staff compliance… more
    State of Colorado (05/17/24)
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  • Lead Mid Level Provider - Gilliam Youth Services…

    State of Colorado (Denver, CO)
    …+ 1 - 2 years + Less than a year 03 How many years of experience do you have as clinical supervisor ? + 2 or more years + 1 - 2 years + Less than a year 04 How ... and has primary oversight and supervision of the clinic. Job Duties: Clinical Management: Functions as the facility medical authority (RHA). Ensuring that health… more
    State of Colorado (04/30/24)
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  • Provider Relations Specialist Lead

    CareOregon (Portland, OR)
    …following areas: Provider relations, managed care operations (eg, claims, appeals , grievances , customer service), medical/behavioral health clinic operations, ... Status Exempt Requisition # 24293 Direct Reports n/a Manager Title Provider Relations Supervisor Pay & Benefits Estimated hiring range $ 70,310 - $85,075 / year,… more
    CareOregon (05/23/24)
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  • Provider Relations Specialist I

    CareOregon (Medford, OR)
    …the following areas: Provider relations, managed care operations (eg claims, appeals , grievances , customer service), medical/behavioral health clinic operations, ... # 24280 Direct Reports n/a Manager Title Provider Relations Supervisor Pay & Benefits Estimated hiring range $ 56,730...partner in the resolution of issues. + Participate in Clinical Advisory Panel (CAP) meetings. Contract Initiation + Identify… more
    CareOregon (05/18/24)
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  • Provider Relations Specialist II

    CareOregon (Portland, OR)
    …following areas: Provider relations, managed care operations (eg, claims, appeals , grievances , customer service), medical/behavioral health clinic operations, ... Exemption Status Exempt Department Provider Relations Manager Title Provider Relations Supervisor Direct Reports n/a Requisition # 24285 Pay and Benefits Estimated… more
    CareOregon (05/15/24)
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  • Data Entry Pharmacy Technician Mail Order

    Beth Israel Lahey Health (Westwood, MA)
    …information. Escalates calls to pharmacists for clinical inquiries and escalates grievances to supervisor . 7. Maintains new and existing patient profiles and ... Support health care providers with required prior authorization and required appeals . Manage all mail/delivery of Rx orders including addressing problems/issues with… more
    Beth Israel Lahey Health (05/14/24)
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