- Elevance Health (Latham, NY)
- **Nurse Case Manager II ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... from 11:30 AM to 8:00 PM EST. The **Nurse Case Manager II ** is responsible...as applicable. + Assists in problem solving with providers, claims or service issues. Assists with development of utilization/care… more
- Elevance Health (Grand Prairie, TX)
- **Telephonic Nurse Case Manager II ** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... 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. + Assists with development of… more
- Elevance Health (Atlanta, GA)
- **Telephonic Nurse Case Manager II ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... 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. + Assists with development of… more
- Elevance Health (Washington, DC)
- **Nurse Case Manager II ** **Location:** **Washington, DC.** This role requires associates to be in-office 4 days per week, fostering collaboration and ... accommodation is granted as required by law. The **Nurse Case Manager II ** will be...as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
- State of Colorado (Denver, CO)
- Claims Manager - Workers' Compensation Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5185970) Apply Claims Manager - Workers' ... Job Type Full Time Job Number KAA 3261 CIS II 1.26 Department Department of Labor and Employment Division...medical providers, and employers in processing their workers' compensation claims by interpreting and explaining case law,… more
- AO Smith (Lebanon, TN)
- Regional Field Service Manager II Date: Jan 2, 2026 Location(s): Lebanon, TN, US, 37090 Company: A. O. Smith Corporation Hybrid, Onsite or Remote: Remote PRIMARY ... SCOPE OF RESPONSIBILITY: Position reports to the Field Service Engineering Manager SPECIFIC DUTIES/ACCOUNTABILITIES(List in order of importance) + Aligned with… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …policies and procedures and related health plan functions such as member services, claims , and the referral process. As well as functions related to legislative and ... the Health Plan Essential Accountabilities: Level I + Review / prep clinical case for clinical staff. + Navigates and utilizes corporate applications; core claims… more
- State of Massachusetts (Boston, MA)
- …or suitability is questionable or difficult to determine. 7. Prepare accurate case notations within claims management system which contain accurate, specific, ... * Claims Examiner/Job Service Representative I| Department of Family...Examiner/Job Service Representative I, who reports to the Senior Manager of Benefit Operations & Program Integrity is based… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …compliance and regulatory requirements. Primary activities include substantiating referrals, case planning and research, conducting onsite or desk audits, clinical ... in a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned,… more
- State of Colorado (Denver, CO)
- Senior Paralegal (Legal Assistant II ) - Workers' Compensation Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5187993) Apply Senior Paralegal ... (Legal Assistant II ) - Workers' Compensation Salary $71,893.50 - $88,560.00 Annually...from inception through hearings and appeals, including fully contested claims , challenges to specific disability and medical benefits, penalty… more
- Sutter Health (Modesto, 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)
- …Social Worker; current and unrestricted California License. Licenses/Certifications Preferred Certified Case Manager (CCM) Accredited Case Manager ... 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
- ZOLL Medical Corporation (Houston, TX)
- …Hospitalists, CT Surgeons etc.), Nurse Practitioners, Physician Assistants, nurses, case managers and administrators. Other duties include selling the value ... intake and reimbursement to ensure appropriate and timely filing of billing claims + Maintain credentialing/access to all assigned accounts at all times… more
- State of Arkansas (Little Rock, AR)
- ATTORNEY II Date: Jan 6, 2026 Req ID: 55025 Location: Little Rock, AR, US, 72202 Category: STATE INSURANCE DEPARTMENT Anticipated Starting Salary: $85,943.10 ... Position Summary Department. Attorney II provides legal support to the Arkansas Insurance Department...the Arkansas Administrative Procedure Act, the Arkansas Pharmacy Benefits Manager Licensure Act, and the Arkansas Freedom of Information… more
- Elevance Health (Indianapolis, IN)
- **eCOB Specialist II ** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... 8:00 am - 4:30 pm EST. The **eCOB Specialist II ** is responsible for researching and investigating other coverage...when they are entitled. + Determines primacy on each case using a complex set of Primacy Rules as… 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
- Elevance Health (Indianapolis, IN)
- …Saturday and Sunday) as well as 3 consecutive week days. The **Transplant Nurse II ** will be responsible for providing case and/or medical management for members ... **Transplant Nurse II ** **Location:** Virtual: This role enables associates to...preparation for advancement to the senior level. Within the case management role will within the scope of licensure… 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
- The County of Los Angeles (Los Angeles, CA)
- MANAGER , AUTOPSY OPERATIONS AND SUPPORT SERVICES Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4670156) Apply MANAGER , AUTOPSY ... Forensic Technician (https://www.governmentjobs.com/careers/lacounty/classspecs/1065384?keywords=Supervising%20Forensic%20Technician%20&pagetype=classSpecifications) for Los Angeles County. Option II : Four years of experience assisting pathologists in… more
- PPL Corporation (Allentown, PA)
- …build and maintain strong, diverse communities today. Overview The **Associate Project Manager ** position is the single point of accountability for small to routine ... typically be sought by the Project Leader for complicated projects. The **Project Manager ** position is the single point of accountability for large PPL Electric… more