- Sedgwick (Concord, NH)
- …Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Claims Manager | VA Jurisdiction | Remote **PRIMARY PURPOSE** : To manage the ... + Establishes policy and procedure to assure compliance to best practices, claims management services standards, state regulations and client service requirements. +… more
- Elevance Health (Manchester, NH)
- **Anticipated End Date:** 2024-09-23 **Position Title:** Claims Analyst III- Overpayment Prevention **Job Description:** ** Claims Analyst III- Overpayment ... Prevention (Business Analyst III)** _Location: This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles of one of… more
- Sedgwick (Concord, NH)
- …and support systems. + Effectively communicates and builds relationships with the claims ' examiner, client, injured worker , attorney and supervisor. + Identifies ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Telephonic Case Manager **PRIMARY PURPOSE OF THE ROLE:** While partnering with the injured … more
- Elevance Health (Manchester, NH)
- **Anticipated End Date:** 2024-09-23 **Position Title:** CarelonRx Account Manager II **Job Description:** **CarelonRx Account Manager II** **Location:** This ... position will work a hybrid model ( remote and office). The ideal candidate must live within...PulsePoint locations listed on the requisition. The **CarelonRx Account Manager II** is responsible for retention and operational excellence… more
- Elevance Health (Manchester, NH)
- **Anticipated End Date:** 2024-09-12 **Position Title:** Account Service Manager - Pharmacy Account Management **Job Description:** **Account Service Manager - ... Pharmacy Account Management** **Location:** This position will work a hybrid model ( remote and office). The ideal candidate must live within 50 miles of one of our… more
- Elevance Health (Manchester, NH)
- …Payment Integrity line of business** _Location: This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles from our ... of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, and provider record review. **How you… more
- Elevance Health (Manchester, NH)
- …Group Clinical Validation Auditor** **Location:** This position will work a hybrid model ( remote and office). Ideal candidates will live within 50 miles of one of ... Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Manchester, NH)
- …any Elevance Health office location_ _**this position will work a hybrid model ( remote and office) which requires working in the nearest Elevance Health office 1-2 ... office**_ The **Provider Reimburse Admin** ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing… more
- Elevance Health (Manchester, NH)
- …Title:** eCOB Specialist I **Job Description:** **eCOB Specialist I** **Location** : Remote , within 50 miles of an Elevance Health pulse point. **Hours:** Monday ... identify the correct formulas in order to adjudicates impacted claims , using multiple COB Formulas for the various product...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Manchester, NH)
- …Payment Integrity line of business** _Location: This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles of one the ... to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Manchester, NH)
- …Investigator II **Job Description:** **Location:** This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles of one ... + Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to… more
- Elevance Health (Manchester, NH)
- …Consultant - Value-Based Care** **Location:** This position will work in a hybrid model ( remote and office). The Ideal candidate will live within 50 miles of one of ... procedures. + Develops and analyzes business performance reports (eg for claims data, provider data, utilization data) and provides notations of performance… more
- Elevance Health (Manchester, NH)
- …of Care Analyst Senior-Analytics** **Location:** This position will work a hybrid model ( remote and office). Must live within 50 miles/1 hour commute of an Elevance ... Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider… more
- Elevance Health (Manchester, NH)
- …and pricing mechanisms.. **Location:** This position will work in a hybrid model ( remote and office). The Ideal candidate will live within 50 miles of one ... + Provides analytic support during complex provider negotiations. + Analyzes claims experience to identify cost of care initiative opportunities. + Measuring… more