• Appeals Case Manager

    Guardian Life (Bethlehem, PA)
    …Group Disability claims experience to join our dynamic Appeals Team. The ** Appeals Case Manager II ** (ACM 2) is responsible for adjudicating assigned ... role supports Group Short-Term Disability, Long-Term Disability and Life Waiver of Premium appeals . You are A highly motivated and reliable individual who can work… more
    Guardian Life (01/24/25)
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  • Case Manager II -Transition…

    Sharp HealthCare (San Diego, CA)
    …Status** Regular **Shift** Day **FTE** 1 **Shift Start Time** **Shift End Time** Accredited Case Manager (ACM) - American Case Management Association (ACMA); ... Nurse (RN) - CA Board of Registered Nursing; Certified Case Manager (CCM) - Commission for ...in the electronic medical record (EMR) and other supporting case management software.The RN CM II will… more
    Sharp HealthCare (01/25/25)
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  • Assistant Commonwealth Attorney I, II ,…

    City of Norfolk, Virginia (Norfolk, VA)
    Assistant Commonwealth Attorney I, II , and III Print (https://www.governmentjobs.com/careers/norfolk/jobs/newprint/2506461) Apply  Assistant Commonwealth Attorney ... I, II , and III Salary See Position Description Location Norfolk,...Attorney I: + Prepares cases for trial by reviewing case reports, identifying the relevant facts of the … more
    City of Norfolk, Virginia (01/22/25)
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  • Cpw Phy/SCI/Researcher Scientist II

    State of Colorado (Morgan County, CO)
    CPW PHY/SCI/RESEARCHER SCIENTIST II / Microbiologist II (Brush, CO) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4798126) Apply  CPW ... PHY/SCI/RESEARCHER SCIENTIST II / Microbiologist II (Brush, CO) Salary $74,604.00...(virology, bacteriology, parasitology, and molecular); (d) assist with accessioning case history paperwork, create, develop, or modify forms and… more
    State of Colorado (01/22/25)
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  • Behavioral Health Specialist, Social…

    State of Colorado (Golden, CO)
    Behavioral Health Specialist, Social Work/Counselor II - Betty K. Marler Youth Services Center Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4812548) Apply  Behavioral Health Specialist, Social Work/Counselor II - Betty K. Marler Youth Services Center Salary… more
    State of Colorado (01/31/25)
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  • Authorization Technician II

    LA Care Health Plan (Los Angeles, CA)
    …log and keep track all due dates for each file. Inform nurses of a new case received from Grievance and Appeals Specialist.; submit all Grievances and Appeals ... Authorization Technician II Job Category: Clinical Department: Utilization Management Location:...required by clinical staff to render decisions, assists the Manager and Director of the Utilization Management department in… more
    LA Care Health Plan (01/16/25)
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  • Administrative Assistant II - Mviu (Hybrid)

    State of Colorado (Lakewood, CO)
    Administrative Assistant II - MVIU (Hybrid) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4814699) Apply  Administrative Assistant II - ... customer service oriented individual to be our Administrative Assistant II in our MVIU! You'll be answering calls from...then this job may be for you! Primary Duties: Case Intake Management - + Reviews all case more
    State of Colorado (02/04/25)
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  • Social Work/Counselor II

    State of Colorado (Pueblo, CO)
    SOCIAL WORK/COUNSELOR II Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4800337) Apply  SOCIAL WORK/COUNSELOR II Salary $73,464.00 - ... and part time Colorado Mental Health Hospital in Pueblo (CMHHIP) Social Work/ Counselor II Full Time As a cornerstone of the Pueblo community for over a century,… more
    State of Colorado (01/22/25)
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  • CPW Marketing & Communications Specialist…

    State of Colorado (Adams County, CO)
    CPW Marketing & Communications Specialist II - CORA Records Assistant (Denver, CO) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4813678) ... Apply  CPW Marketing & Communications Specialist II - CORA Records Assistant (Denver, CO) Salary $49,848.00...The CORA Records Assistant will support the CORA Records Manager in the processing of Colorado Open Records Act… more
    State of Colorado (02/01/25)
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  • Patient Financial Services Representative…

    WellSpan Health (York, PA)
    Patient Financial Services Representative II - Govt Billing - Days Location: WellSpan Health, York, PA Schedule: Full Time General Summary Completes assigned revenue ... researches claim denial for resolution and submits disputes and appeals . Represents the System in a professional manner while...within 1 year Required or + Certified Patient Accounts Manager within 1 year Required or + Certified Coding… more
    WellSpan Health (01/23/25)
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  • Job Service Rep II

    State of Massachusetts (Boston, MA)
    …to parties in accordance with Massachusetts Employment Security Law. Assist unit manager in the operations of the department. This position requires a combination ... stating the conclusion, and the effect of the determination *3. *Conducts regular case reviews and discussions with staff to develop and enhance their capacity and… more
    State of Massachusetts (12/12/24)
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  • Investigation Specialist II - 1

    MyFlorida (Tallahassee, FL)
    INVESTIGATION SPECIALIST II - 41500119 1 Date: Jan 30, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... No: 845880 Agency: Florida Gaming Control Commission Working Title: INVESTIGATION SPECIALIST II - 41500119 1 Pay Plan: Career Service Position Number: 41500119… more
    MyFlorida (01/31/25)
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  • Operating Permit Unit Supervisor - PE II

    State of Colorado (Denver, CO)
    Operating Permit Unit Supervisor - PE II - HYBRID Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4813961) Apply  Operating Permit Unit ... Supervisor - PE II - HYBRID Salary $8,748.00 - $12,922.00 Monthly Location...legislation, rules and requirements. Coordinate with the Permitting Program Manager and other Operating Permit Supervisor(s) on all management… more
    State of Colorado (02/01/25)
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  • Medicare Pharmacy Coordinator

    Medical Mutual of Ohio (OH)
    …outbound calls to members, providers, and pharmacies to initiate coverage determinations/ appeals , prescription refills, and switch members to lower cost therapeutic ... with a strong focus on member experience. Conducts outreach to Pharmacy Benefit Manager (PBM) for refills, claim reprocessing and to members to provide status of… more
    Medical Mutual of Ohio (12/20/24)
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  • Family Mediation Specialist I

    Clark County, NV (Las Vegas, NV)
    …is seeking qualified candidates for the position of Family Mediation Specialist I/ II . The Family Mediation Specialist I/ II provides professional services to ... This class is alternately staffed with Family Mediation Specialist II and incumbents may advance to a higher level...duties. This class is distinguished from the Family Mediation Manager in that the latter supervises and manages all… more
    Clark County, NV (02/01/25)
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  • Physician Utilization Review Specialist Per Diem…

    Hackensack Meridian Health (Hackensack, NJ)
    …d. Clarifying ambiguous or conflicting documentation e. Target DRGs Reviews f. Use of case manager as a resource + Uses guidelines to evaluate patient status ... not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of care, as outlined in...reduce clinical denials by: I. Peer-to Peer (P2P) Concurrent appeals ii . Written Concurrent appeals more
    Hackensack Meridian Health (11/18/24)
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  • Sr Utilization Review Spec FT Humc

    Hackensack Meridian Health (Hackensack, NJ)
    …iii. Clarifying ambiguous or conflicting documentation iv. Target DRGs Reviews v. Use of case manager as a resource 4. Uses guidelines to evaluate patient status ... but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of care, as outlined in the responsibilities… more
    Hackensack Meridian Health (02/01/25)
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  • Executive Assistant to the Office of the General…

    State of Massachusetts (Boston, MA)
    …The Executive Assistant will supervise the Docket Clerk in the Hearing and Appeals Unit. *Duties and Responsibilities:*(these duties are a general summary and not ... working in a professional Legal or Government setting as an Office Manager , Paralegal or Executive Assistant or other administrative position. * Superior… more
    State of Massachusetts (12/18/24)
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