- J&J Family of Companies (Skillman, NJ)
- … Claims & Clinical Strategy, Essential Health** This position reports into the R&D Claims & Clinical Manager and is based at Skillman, NJ. **Who we ... in consumers hearts and homes. **Role reports to:** R&D Claims and Clinical Manager **Location:**... claims , formulate clinical strategies, perform clinical trial related activities, review and approve… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …provider call center, provider correspondence and appeals, clinical review , member correspondence and reconsiderations, enrollment, claims processing, ... is BCBSMA's single largest account Position Summary: The RN Clinical Provider Post Service Review Manager...by the FEP Association to ensure compliance and accurate case/ claims processing This leader must demonstrate the attributes and… more
- CenterWell (Atlanta, GA)
- …community and help us put health first** As an **Accounts Receivable Specialist/Healthcare Claims Denials Specialist** , you will: + Ensure the coordination of claim ... timely reimbursement of receivables. + Research, resolve, and prepare claims that have not passed the payer edits daily....Prepare input data forms to update computer system. + Review and communicate with agencies to educate them about… more
- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …Kettering Institute, scientists across MSK collaborate to conduct innovative translational and clinical research that is driving a revolution in our understanding of ... on to pursue our mission at MSK and around the globe. Please review important announcements about vaccination requirements and our upcoming EHR implementation by… more
- Robert Half Office Team (Oakland, CA)
- Description The Claims Analyst will ct as liaison for clinicians as it pertains to clinical documentation and meeting county requirements. + Become familiar with ... be involved in completing and distributing monthly QA chart review notifications to clinicians. + Will conduct quality reviews...other duties or projects as assigned by the QA Manager . Requirements + Master's degree, license or license eligible… more
- Guidehouse (Lewisville, TX)
- …from home._** **_Questions regarding this position, you may contact Chris Rivera ( Manager , Talent Acquisition) at ###._** The Patient Account Representative has an ... receivable follow-up, timely filing guidelines and the ability to effectively review remittance advices and electronic billing reports from payer to determine… more
- Memorial Sloan-Kettering Cancer Center (New York, NY)
- …more. Please note, this link is only accessible for MSK employees. Job Description Clinical Risk Manager - Quality & Safety Intriguing opportunity available. We ... are seeking a Clinical Risk Manager to join our Quality...its captive insurance program, and excess insurance carriers) on clinical risk and claims issues and will… more
- American Heart Association (Columbus, OH)
- …does your career. The American Heart Association has an excellent opportunity for a ** Clinical Data Manager ** in our **National Center** office. Location of the ... to be able to integrate data from different sources ( clinical , claims , patient-reported survey data, food vendors)....have a competitive base salary. That's why we regularly review the market value of jobs and make adjustments,… more
- Hackensack Meridian Health (Perth Amboy, NJ)
- …transform healthcare and serve as a leader of positive change. The ** Manager , Risk Management** provides basic and complex preventive risk management assessment of ... Bridge Medical Center. **Responsibilities** A day in the life of a ** Manager , Risk Management** at **Hackensack Meridian** **_Health_** includes: + Provide prompt… more
- Medtronic (Boulder, CO)
- …and problem solving + Understands the market and competitive space + Provides marketing material review for clinical evidence claims as needed + Post-market ... in the Life** In this exciting role as a Clinical Research Program Manager , you will have...(CDP) and remediation projects + Leverages competitive intelligence around clinical /regulatory pathways, indications and labeling, claims , … more
- SSM Health (St. Louis, MO)
- …a calling** MO-SSM Health Mission Hill **Worker Type:** Regular **Job Highlights:** RN- Clinical Auditor Manager , Care Transformation - Case Management and Social ... clinical audits within Care Transformation operations by supporting the Clinical Documentation Improvement, Utilization Management, Status Review , and Case… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Clinical Risk Manager reports to the Director of Risk Management and Patient Safety and is responsible for reviewing, summarizing, ... to day risk management activities the Mount Sinai Health System (MSHS)., The Clinical Risk Manager conducts investigations and prepares reports as required by… more
- Alight (IL)
- …disability, health case management, or utilization review . + 2+ years as a Clinical Case Manager + Have ability to work in hybrid environment . Office ... more at careers.alight.com. **About the Role** The Behavioral Health Clinical Case Manager provides clinical ...claims , if within the scope of licensure and clinical expertise. + Assisting in making informed choices via… more
- AdventHealth (Palm Coast, FL)
- …potential or have caused a serious injury or death. . Maintains and coordinates claims control. . Reviews, or provides for review , of records and documentation ... even better. **Shift** : FT Days **The role you'll contribute:** The Risk Manager plans, develops, and administers the system's Risk Management Program for loss… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations ... and internal and external regulatory and survey requirements. + The Utilization Review Manager collaborates with multiple professionals to support and coordinate… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Senior Clinical Risk Manager The Senior Clinical Risk Manager serves as a resource to staff to enhance patient safety, promote ... protect the assets of the facility. The Senior Risk Manager supports the Risk Management staff on how best...Cause Analysis investigations which include assessing need for focused review by departments, and/or clinical chairpersons for… more
- Mount Sinai Health System (New York, NY)
- …Ground breaking science. Advancing medicine. Healing made personal. **Job Title: Senior Clinical Risk Manager - Mount Sinai West** **Job Summary:** The ... Senior Clinical Risk Manager serves as a resource...Cause Analysis investigations which include assessing need for focused review by departments, and/or clinical chairpersons for… more
- Mount Sinai Health System (Astoria, NY)
- **Job Description** The Clinical Risk Manager in the Department of Risk Management is responsible for the day to day risk management activities at Mount Sinai ... of Health; and conducting risk management educational programs. The Clinical Risk Manager is responsible for the...Cause Analysis investigations, which includes assessing need for focused review by departments, and or clinical chairpersons… more
- TEKsystems (St. Louis, MO)
- …code, procedure analysis, X-ray, Hygiene, Clinical research, Customer service, Clinical trial, Dental claims , excel analysis, excel data entry, google ... Description: as an inclusive Education Manager . In this non-exempt role, you will play a vital part in advancing our values as outlined in our vision and mission… more
- Molina Healthcare (Florence, KY)
- …+ Maximizes use of information from multiple sources, including claims /encounters, pharmacy, utilization management, clinical indicators, industry benchmark, ... surveys and federal/state QI compliance activities. **Job Duties** + The Mgr, Clinical Data Acquisition uses knowledge, skills and technical expertise to manage the… more
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