• Utilization Review Specialist

    Sanford Health (SD)
    …to the work of health and healing across our broad footprint.** **Facility:** Remote SD (Central Time) **Location:** Remote , SD **Address:** **Job Schedule:** ... Summary** Provides clinical support to the MCHS revenue cycle for denial management and clinical workflows within the patient financial service department. Will be… more
    Sanford Health (03/19/25)
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  • Utilization Review (UR) Specialist

    Spectrum Billing Solutions (Skokie, IL)
    …cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Specialist to our growing team. The UR Specialist ... in working in a cohesive and rewarding environment. This is a remote or office/home hybrid position. Responsibilities include: + Review patient admission and… more
    Spectrum Billing Solutions (02/05/25)
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  • Denials Management RN Specialist

    AdventHealth (Altamonte Springs, FL)
    …cause and bring about the best opportunity for fair reimbursement. The Clinical Denial Management Specialist will adhere to the AHS Compliance Plan and to all ... rebilling. . Collaborates with pre-access, patient financial services, revenue integrity, utilization management and clinical department staff to obtain further… more
    AdventHealth (01/27/25)
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  • Specialist , Vendor Management

    Lincoln Financial Group (Radnor, PA)
    …#:** 74191 **The Role at a Glance** We are excited to onboard a Specialist , Supplier Management to our Procurement Strategic Relationship Management (SRM) ... Center of Excellence. This position would be remote or hybrid remote to Radnor, PA....to Radnor, PA. Lincoln's procurement organization is adding a Specialist , Supplier Management to collaborate with… more
    Lincoln Financial Group (03/15/25)
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  • Denials Management Specialist (RN…

    St. Luke's University Health Network (Allentown, PA)
    …serve, regardless of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical ... billing with information needed to obtain payment of claims. Remote within local geography after orientation. JOB DUTIES AND...+ Prefer minimum of 2-5 years' experience in case management and/or utilization management . +… more
    St. Luke's University Health Network (02/12/25)
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  • Utilization Management Coordinator…

    Sanford Health (SD)
    …**Department Details** Opportunity to work remote . **Job Summary** Monitors the utilization of resources, risk management and quality of care for patients ... to the work of health and healing across our broad footprint.** **Facility:** Remote SD (Central Time) **Location:** Remote , SD **Address:** **Shift:** Day **Job… more
    Sanford Health (03/14/25)
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  • BCBA Utilization Review

    Intermountain Health (Murray, UT)
    …role that combines the expertise of a Licensed and Masters Prepared Behavior Health Specialist with Utilization and Care management . This role is essential ... in care management /navigation or closely related field including: Utilization Management , discharge planning, managed care, health promotion, health… more
    Intermountain Health (02/06/25)
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  • Utilization Review Spec Sr

    BayCare Health System (Clearwater, FL)
    …foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + Functions ... necessity of outpatient observation and inpatient stays and the utilization of ancillary services + Perform other duties as...start for up to 6 months, then eligible for remote ) + **On Call:** No **Certifications and Licensures:** +… more
    BayCare Health System (12/31/24)
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  • Sr NGS Sales Specialist , Remote (IL…

    ThermoFisher Scientific (Mount Prospect, IL)
    …Conditions** Office **Job Description** **Next Generation Sequencing Technical Sales Specialist , Clinical Sequencing** **Locations:** This is an outside sales ... will you make an impact?** The Next Generation Sequencing (NGS) Sales Specialist will have strong sales, technical and product expertise. Primary responsibilities… more
    ThermoFisher Scientific (03/11/25)
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  • Senior Coding Specialist , Pediatrics…

    Vanderbilt University Medical Center (Nashville, TN)
    …**Responsibilities:** **Certifications:** Certified Coding Associate - American Health Information Management Association, Certified Coding Specialist - American ... Health Information Management Association, Certified Coding Specialist - Physician - American Health Information Management Association, Certified Outpatient… more
    Vanderbilt University Medical Center (03/13/25)
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  • Clinical Pharmacist Specialist

    Beth Israel Lahey Health (Cambridge, MA)
    …people's lives.** Based out of (Burlington, MA.) Job Summary: The Clinical Pharmacy Specialist serves as a leader in clinical pharmacy practice in a specific ... by hospital needs. Specialists provide comprehensive clinical and distributive medication management services and will utilize their advanced clinical skills in the… more
    Beth Israel Lahey Health (03/04/25)
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  • HPS Provider Svc Specialist ( Remote

    Parkview Health (Fort Wayne, IN)
    …years of comprehensive experience in managed healthcare, provider relations, project management , medical informatics, utilization management or physician ... of contract issues. Responsible for verbal and written communication to Contract Specialist and Manager, as well as to the provider network. Delivers outstanding… more
    Parkview Health (03/08/25)
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  • Appeals Specialist II ( Remote )

    CareFirst (Baltimore, MD)
    …Degree + Knowledge of CareFirst systems, Member/Provider Service, Claims or Utilization Management experience a plus. Managed care experience. **Knowledge, ... will support government programs lines of business. The Appeals Specialist II will be responsible for the initial analysis...and works on special projects with Appeals Nurse or Management . + Interacts regularly with and responds to internal… more
    CareFirst (02/15/25)
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  • Commercial Sales Specialist - Central…

    Anywhere Real Estate (Louisville, KY)
    The **Commercial** **Sales Specialist ** participates in and supports sales management efforts, by assisting the **Commercial Director** in a range of agent ... and detail-oriented + Must be proficient with technology tools and teaching agents on utilization of tools + Must have a valid Real Estate or Broker's license This… more
    Anywhere Real Estate (03/12/25)
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  • RN Clinical Documentation Specialist

    Guthrie (Sayre, PA)
    …acute clinical experience in a hospital setting required. Critical care, utilization review or coding experience required. Requires excellent communication skills ... with physicians to finalize diagnoses and quality measures. * Assists with management of CDMPTrak� and reporting as designated. * Assists with special projects… more
    Guthrie (03/19/25)
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  • Billing Specialist II - Host Unbilled…

    Community Health Systems (Antioch, TN)
    Processing of claims, via electronic claims management system, by reviewing identified errors or rejections and resolving these issues appropriately. Also ... knowledge of third party billing regulations, as well as the utilization of applicable automated resources for assigned area of responsibility.Reviews related… more
    Community Health Systems (03/04/25)
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  • Facility Management Specialist

    State of Massachusetts (Boston, MA)
    *_Executive Office of Housing and Livable Communities (EOHLC) is seeking a Facilities Management Specialist in the Division of Public Housing & Rental ... residents and reducing and preventing homelessness. *_OVERVIEW:_* The Facilities Management Specialist (FMS) providestechnicalassistance,performance-basedmonitoringoversight,andserveasprimaryEOHLCpointof contact on maintenance… more
    State of Massachusetts (02/21/25)
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  • Facilities Management Specialist

    Censeo Consulting Group (Washington, DC)
    Facilities Management Specialist - Department of State The Position: We are looking for eager, driven candidates with experience in people management , ... solutions for our Federal clients at the Department of State. The Facilities Management Specialist is responsible for overseeing and managing the physical… more
    Censeo Consulting Group (03/09/25)
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  • Medical Management Specialist I

    Elevance Health (New Hyde Park, NY)
    **Medical Management Specialist I** **Location** : **New York** . This position will work a hybrid model ( remote and office). The ideal candidate will live ... PulsePoint location in Lake Success, New York. The **Medical Management Specialist I** is responsible for providing...and determines appropriate area to refer or assign case ( utilization management , case management , QI,… more
    Elevance Health (03/15/25)
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  • Salesforce Change Management

    TE Connectivity (PA)
    Salesforce Change Management Specialist (Contractor) **At TE, you will unleash your potential working with people from diverse backgrounds and industries to ... **Job Overview** **Job Type:** 6 month contractor role **Location:** Remote - US (EST or CST time zone) **Job...We are seeking a highly skilled and experienced Change Management Expert with a specialization in Training and Communications… more
    TE Connectivity (03/06/25)
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