- Association-American Cancer Institute (Atlanta, GA)
- …institutional compliance decisions, nationally recognized guidelines, and/or information from denials management records. Performs related responsibilities as ... Cancer Institute of Emory University November 18, 2025 Senior Director , Clinical Trials CLICK HERE TO APPLY...Office (CTO) to include the National Cancer Institute (NCI)-designated Clinical Protocol and Data Management operations. Provides… more
- Kaiser Permanente (Vallejo, CA)
- …the responsibilities listed above, this position is also responsible for directing clinical quality and patient safety management programs including budgets, ... education initiatives, measurement of outcomes, and improvement strategies related to clinical , accreditation, regulatory and licensing (AR&L), risk management ,… more
- Allen Spolden (Nashville, TN)
- …Leverage data-mining and reimbursement modeling tools to review and identify underpayments/ denials which are due for additional reimbursement from the payer Identify ... goals clearly and expectations to team members and communicate results to MRI Management . Customer-service orientation with the ability to interact with a range of… more
- UnitedHealth Group (Nashville, TN)
- …The Medical Director 's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on ... optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Clinical Coverage Review Medical Director is a key member of the Optum… more
- Phipps Pharmacy (Jackson, TN)
- …The Medical Director 's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on ... optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Clinical Coverage Review Medical Director is a key member of the Optum… more
- UnitedHealth Group (Nashville, TN)
- …The Medical Director 's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on ... optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Clinical Coverage Review Medical Director is a key member of the Optum… more
- Commonwealth of Massachusetts (Boston, MA)
- …business administration, business management , public administration, public management , clinical administration or clinical management of which (B) ... Director of Pharmacy Benefit Manager Oversight (2500064V) Job...Insurance values inclusiveness and diversity within their employee and management teams. Within our community we strive to create… more
- Children's National Medical Center (Silver Spring, MD)
- …current with industry changes. Coding Denial Management - Lead the coding denials management strategy, working closely with denials , CDI, and revenue ... Coding Audits & Education - 250003C0 - will work under the direction of the Director of Health Information Management , Coding and Audit to provide strategic and… more
- Magnus Medical, Inc. (Burlingame, CA)
- …Area: Reimbursement and Market Access Department: Commercial Reports to: Senior Director , Market Access Location: US Remote (Preferred: Western US, and close ... reimbursement lifecycle including prior authorization, claims submission, appeals, and denial management . They work closely with internal and external teams to align… more
- NHS Management (Prattville, AL)
- …to the facility Administrator, Director of Nursing, Regional Administrator, Director of Medicare and Rehabilitation and MDS/ Clinical Information Consultant. ... to the Administrator, Director of Nursing, Regional Administrator, Director of Medicare and Rehabilitation, and MDS/ Clinical Information Consultant.… more
- Direct Jobs (Old Bridge, NJ)
- …the Rutgers Cancer Institute of New Jersey (RCINJ) Network. Work with the case management team to address denials by the managed care companies regarding ... be subject to the direction of the Regional Medical Director and the Chief Medical Officer(s) and include, but...and include, but not be limited to the following: Clinical Responsibilities Physician shall devote all of the time,… more
- CHRISTUS Health (San Antonio, TX)
- …and or/ Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate ... CHRISTUS Health departments, including but not limited to the HIM and Clinical Documentation Specialists, to ensure accurate and complete physician documentation to… more
- Huron Consulting Group Inc. (Chicago, IL)
- …closely with internal SME functional leaders (eg, coding, billing, patient access, clinical denials /CDI) to support consistent and expert service delivery.* ... and financial goals.* Lead a globally integrated delivery model, including management of onshore and offshore resources.* Collaborate with SME functional leadership,… more
- Neon Health (San Francisco, CA)
- …facing $30,000 monthly costs. Marcus's autoimmune condition worsened while battling insurance denials . Over 50% of critical prescriptions are abandoned due to: Cost ... most. Help us ensure that access to medicine is determined by clinical need-not bureaucracy or financial constraint. When Neon succeeds, patients access life‑saving… more
- Neon Health (San Francisco, CA)
- …facing $30,000 monthly costs. Marcus's autoimmune condition worsened while battling insurance denials . Over 50% of critical prescriptions are abandoned due to: Cost ... most. Help us ensure that access to medicine is determined by clinical need-not bureaucracy or financial constraint. When Neon succeeds, patients access life‑saving… more
- R1 RCM (Chicago, IL)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Denials Director ** , you will act as a strategic leader ... , improve revenue recovery, and enhance overall financial performance. The Denials Director will collaborate with senior leadership and cross-functional… more
- University of Southern California (Los Angeles, CA)
- …federal & state coding compliance regulations and guidelines, the HIM Coding Denials Management Specialist" analyze, investigate, mitigate, and resolve all ... denials , triage denied claims to distinguish coding-related denials versus clinical -related denials , evaluating...tools that effectively measure and monitor processes throughout the denials management process in order to support… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The Denials & Appeals Coordinator is responsible for managing, tracking, and resolving denials and appeals to ensure timely reimbursement. This ... HMS, Hyland, BARRT) to ensure all follow-up dates are current. + Analyzes denials to determine appropriate actions, completes appeals, or routes cases for … more
- Community Health Systems (Franklin, TN)
- …on reason for the denial and appeal status. + Consults with Coordinator and/or Director , Coding Denials and Appeals during any audit discrepancies. + Attends ... with periodic quality monitoring and evaluation of work products by the Coordinator and/or Director , Coding Denials and Appeals. + Partners with peers and … more
- Rochester Regional Health (Rochester, NY)
- Job Title: Director , CDI Department: Clinical Documentation ImprovementLocation: Riedman CampusHours Per Week: 40Schedule: Monday - Friday, 8am - 4:30pmSUMMARY ... The Clinical Documentation Improvement Director provides a key...+ Provides direct managerial oversight to CDI Team in management of CDI processes CDI projects, barriers and education… more
