- Franklin Energy (Pittsburgh, PA)
- …and how it affects utility consumption and demand, to help build a business case to prioritize recommendations and how they affect savings and first costEnter data ... in building design, "green" construction and sustainable design - PreferredCertified Energy Manager and the LEED AP credentials - PreferredCEM or VPI certification -… more
- 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
- Walmart (Bentonville, AR)
- …denial of the claim; and reserving file for payments that exceed authority for manager and serious case review. + Minimizes legal exposure by securing services ... in the claim/image management system. + Handles monetary aspects of assigned claims by establishing reserves within approval level; notifying store managers of… more
- 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 (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 (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
- 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 (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
- 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
- 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
- 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
- WellSpan Health (York, PA)
- Patient Financial Services Representative II Location: WellSpan Health, York, PA Schedule: Full Time Sign-On Bonus Eligible Remote/Hybrid Regular Apply Now See More ... Cycle functions including, submitting electronic and / or manual insurance claims , resolves claim edits, performs insurance account follow-up, researches claim… more
- 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
- State of Colorado (Greeley, CO)
- Employee Relations Specialist (Administrator II ) - Greeley Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4488772) Apply Employee Relations ... Specialist (Administrator II ) - Greeley Salary $48,396.00 - $55,644.00 Annually Location...is provided based upon multiple and complex federal laws, case law, regulations, state personnel system rules, as well… more
- 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
- LA Care Health Plan (Los Angeles, CA)
- Authorization Technician II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: ... net required to achieve that purpose. Job Summary The Authorization Technician II supports the Utilization Management (UM) Specialist by handling all administrative… 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
- Marriott Vacations Worldwide (Orlando, FL)
- …established Service Level Agreement (SLA) levels for resolution. The HR Generalist II , Associate Services, reports to the Manager , Leave Administration. Follows ... **Position Summary** The HR Generalist II , Leave Administration (HR Generalist), is responsible for...Leverages company policies to respond to inquiries by phone, case /e-mail, and in-person. All inquiries are to be documented… more
