• Senior Grievance & Appeals

    Banner Health (Tucson, AZ)
    …by including remote and hybrid opportunities. In the role of Senior Grievance & Appeals Coordinator , you will utilize your expertise in Grievance & Appeals ... **Primary City/State:** Arizona, Arizona **Department Name:** Grievances & Appeals **Work Shift:** Day **Job Category:** General Operations Great careers are built… more
    Banner Health (11/16/24)
    - Save Job - Related Jobs - Block Source
  • Grievance & Appeals Coordinator

    Elevance Health (Atlanta, GA)
    **Grievance & Appeals Coordinator ** **Location** : This is a fully remote role. Candidates must reside in the state of **Georgia** to be considered. Ideal ... location in Atlanta, Augusta, Savannah and/or Columbus, GA. The **Grievance & Appeals Coordinator ** is responsible for investigating and reviewing customer… more
    Elevance Health (11/13/24)
    - Save Job - Related Jobs - Block Source
  • Senior Coordinator Complaint Appeals

    CVS Health (Harrisburg, PA)
    …issues and may require coordination of responses from multiple business units. Appeals are typically more complex and may require outreach and deviation from ... outside plan sponsors or regulators. + Research and resolves incoming electronic appeals as appropriate as a "single-point-of-contact" based on type of appeal. +… more
    CVS Health (11/15/24)
    - Save Job - Related Jobs - Block Source
  • Exclusive Posting for Community Health Team…

    University of Virginia (Haymarket, VA)
    …minimum loss of revenue and maximum payment for services. Utilizing persuasive clinical arguments and tenacious communication skills, both oral and written, creates ... problem solving methodology to discern trends in payor behaviors and/or our clinical documentation/practice that need to be communicated back to departments or… more
    University of Virginia (11/16/24)
    - Save Job - Related Jobs - Block Source
  • Appeals & Grievance Specialist

    Commonwealth Care Alliance (Boston, MA)
    …, operations, pharmacy, dental, reporting, and member services. - Supports the Senior Appeals & Grievance Coordinator and A/G Coordinator in day-to-day ... **Why This Role is Important to Us:** Appeals and Grievances Representative supports the Operations Department...strict deadlines. - When necessary collaborate with care teams, clinical staff, family members, and other involved in providing… more
    Commonwealth Care Alliance (09/07/24)
    - Save Job - Related Jobs - Block Source
  • Medical Appeals Coding Specialist SR

    University of Utah (Salt Lake City, UT)
    …PRN40045B **Job Title** Outpatient/Provider Coder Level 3 **Working Title** Medical Appeals Coding Specialist SR **Job Grade** E **FLSA Code** Nonexempt **Patient ... or other specialty certification indicated by the department, AND 3 years coding, clinical , or billing experience or equivalency (one year of education can be… more
    University of Utah (10/09/24)
    - Save Job - Related Jobs - Block Source
  • Medicare Pharmacy Coordinator

    Medical Mutual of Ohio (OH)
    …D experience is highly sought after._** **Responsibilities** **Medicare Pharmacy Coordinator I** Working under general supervision, administers standardized to ... outbound calls to members, providers, and pharmacies to initiate coverage determinations/ appeals , prescription refills, and switch members to lower cost therapeutic… more
    Medical Mutual of Ohio (09/20/24)
    - Save Job - Related Jobs - Block Source
  • Clinical Program Coordinator RN,…

    Providence (WA)
    …the best people, we must empower them.** **Providence Health Plan is calling a Clinical Program Coordinator RN who will:** + Provide care coordination services ... + This posting is for multiple openings of a Clinical Care Coordinator RN + This position...Management Experience (EX. Concurrent Review, Prior Authorization, Medical Audits, Appeals or Delegation) + Experience working in a health… more
    Providence (11/15/24)
    - Save Job - Related Jobs - Block Source
  • Clinical Program Coordinator RN…

    Providence (OR)
    …the best people, we must empower them.** **Providence Health Plan is calling a Clinical Program Coordinator RN who will:** + Support the commercial insurance ... + This posting is for multiple openings of a Clinical Care Coordinator RN + This position...Management Experience (EX. Concurrent Review, Prior Authorization, Medical Audits, Appeals or Delegation) + Experience working in a health… more
    Providence (11/04/24)
    - Save Job - Related Jobs - Block Source
  • Clinical Program Coordinator RN,…

    Providence (Beaverton, OR)
    …the best people, we must empower them.** **Providence Health Plan is calling a Clinical Program Coordinator RN, Maternity / Pediatrics who will:** + Support the ... + This posting is for multiple openings of a Clinical Care Coordinator RN, Maternity / Pediatrics...Management Experience (EX. Concurrent Review, Prior Authorization, Medical Audits, Appeals or Delegation) + Experience working in a health… more
    Providence (10/15/24)
    - Save Job - Related Jobs - Block Source
  • Clinical Resource Coordinator Per…

    Rush University Medical Center (Chicago, IL)
    …less than 0.5) **Shift:** **Shift 1** **Work Schedule:** 8 Hr **Summary:** The Clinical resource coordinator (CRC) applies a collaborative approach in working ... disability, veteran status, and other legally protected characteristics.** **Position** Clinical Resource Coordinator Per Diem **Location** US:IL:Chicago **Req… more
    Rush University Medical Center (09/15/24)
    - Save Job - Related Jobs - Block Source
  • Youth Corrections Medical Operations…

    State of Colorado (Denver, CO)
    Youth Corrections Medical Operations Coordinator (Nurse V) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4573875) Apply  Youth Corrections ... Medical Operations Coordinator (Nurse V) Salary $108,540.00 - $151,968.00 Annually Location...clinic operations + Respond to case escalations + Provide clinical coverage as needed + Review and approve the… more
    State of Colorado (10/19/24)
    - Save Job - Related Jobs - Block Source
  • Case Management Coordinator

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Case Management (CM) Coordinator position is a proficient CM representative that provides technical, clerical and data management support ... and other community resources and transportation. In addition, the CM Coordinator position anticipates independent actions necessary to provide competent and… more
    Houston Methodist (10/11/24)
    - Save Job - Related Jobs - Block Source
  • Coordinator -RAC TPE - HS Revenue Audit…

    Baptist Memorial (Memphis, TN)
    Summary Medicare / Medicaid Appeals Registered Nurse reviews and evaluates medical documentation to support billing compliance and external regulatory requirements. ... Responsibilities + Abstracts pertinent information from the medical record to create appeals for cases denied by governmental payors. + Educates department staff to… more
    Baptist Memorial (09/05/24)
    - Save Job - Related Jobs - Block Source
  • RN - MDS Coordinator

    Elderwood (Wheatfield, NY)
    Salary Pay: $72,150 - $87,750 / year Overview Sign on bonus for MDS Coordinator $10,000 for full-time (paid over 12 months) What makes Elderwood at Wheatfield ... We want to talk with you! RN - MDS Coordinator Position Overview: + Oversees, reviews and/or completes the...of Benefits Program + Increased Tuition Reimbursement Program for Clinical Tracks + Shift Differentials + Full Benefits Package… more
    Elderwood (10/24/24)
    - Save Job - Related Jobs - Block Source
  • Registered Nurse - Care Coordinator

    CareOregon (Medford, OR)
    …must comply with all federal laws. Job Title Registered Nurse - Care Coordinator (Community) Exemption Status Exempt Department Clinical Services Manager Title ... to achieve optimal health and wellness outcomes. Registered Nurse - Care Coordinator is part of an innovative multi-disciplinary care coordination team addressing… more
    CareOregon (09/27/24)
    - Save Job - Related Jobs - Block Source
  • Development Coordinator , The Institute…

    Johns Hopkins University (Baltimore, MD)
    …team supporting the entities that comprise Johns Hopkins Medicine (JHM), including clinical departments, hospitals, satellite clinics, and the School of Medicine. We ... JHM's work to advance medicine and improve the human condition. The Development Coordinator for the Institute for Basic and Behavioral Sciences is an integral member… more
    Johns Hopkins University (11/01/24)
    - Save Job - Related Jobs - Block Source
  • LTSS Concierge Coordinator - Kansas

    Elevance Health (Overland Park, KS)
    …to, potential for high-risk complications). + Engages the primary service coordinator and other clinical healthcare management and interdisciplinary teams ... candidates must be located in the state of Kansas.** The **LTSS CONCIERGE COORDINATOR ** is responsible for supporting the LTSS Coordinator (or contracted… more
    Elevance Health (09/11/24)
    - Save Job - Related Jobs - Block Source
  • Community Care Coordinator DEHS

    State of Colorado (Denver, CO)
    Community Care Coordinator DEHS - FAA02655 Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4714715) Apply  Community Care Coordinator DEHS ... the process . + Previous experience working in a pediatric or family medicine clinical setting as a registered nurse or a practice manager, knowledge of clinical more
    State of Colorado (11/09/24)
    - Save Job - Related Jobs - Block Source
  • Care Coordinator , Utilization Management

    Hackensack Meridian Health (Neptune, NJ)
    …and serve as a leader of positive change. The **Care Management, Care Coordinator , Utilization Management** is a member of the healthcare team and is responsible ... for coordinating, communicating, and facilitating the clinical progression of the patient's treatment. Accountable for a designated patient caseload; the Care … more
    Hackensack Meridian Health (11/15/24)
    - Save Job - Related Jobs - Block Source