- Sedgwick (Richmond, VA)
- …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
- Sedgwick (Richmond, VA)
- …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 (Richmond, VA)
- …member benefits, and managed care products preferred. + Certification as a Case Manager is preferred. + Previous work from home/ remote experience is very ... **Anticipated End Date:** 2024-09-19 **Position Title:** RN Transplant Case Manager II (Telephonic) **Job Description:** **LOCATION** **: This is a remote … more
- Elevance Health (Richmond, VA)
- **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 (Richmond, VA)
- …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 (Richmond, VA)
- …**Title: Grievance/Appeals Analyst I** **Location:** This position will work a hybrid model ( remote and office). Ideal candidates will live within 50 miles of one of ... with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable… more
- Elevance Health (Richmond, VA)
- …Grievance/Appeals Representative I** **Location:** This position will work a hybrid model ( remote and office). Ideal candidates will live within 50 miles of one ... Representative I** is responsible for reviewing, analyzing and processing claims in accordance with policies and claims ...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Richmond, VA)
- …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 (Richmond, VA)
- …**Provider Contract Analyst Senior** **Location:** This position will work a hybrid model ( remote and office). The Ideal candidate will live within 50 miles of one ... 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 (Richmond, VA)
- …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 (Richmond, VA)
- …**Pharmacy Internal Auditor** **Location:** This position will work a hybrid model ( remote and office). Ideal candidates will live within 50 miles of one ... processes and processes related to enrollment and billing and claims processing, as well as customer service written and...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Richmond, VA)
- …2024-09-27 **Position Title:** Mgr I Cust Care - Multi (US) **Job Description:** ** Manager I Customer Care - Multi** **Location:** This position will work a hybrid ... model ( remote and office). The Ideal candidate will live within...of one of our Elevance Health PulsePoint locations. The ** Manager I Customer Care - Multi** will be responsible… more
- Elevance Health (Richmond, VA)
- …Contract/Cost of Care Consultant** **Location:** This position will work a hybrid model ( remote and office). Ideal candidates will live within 50 miles of one of ... 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 (Richmond, VA)
- …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 (Richmond, VA)
- …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 (Richmond, VA)
- …in-office) with PulsePoint sites used for collaboration, community, and connection. This includes remote work and 1-2 days in office per week. Candidates must reside ... + Responsible for recommendations on pricing, marketing, product design, claims , premium and enrollment administration of business unit. **Minimum Requirements:**… more
- Elevance Health (Richmond, VA)
- …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 (Richmond, VA)
- …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 (Richmond, VA)
- …**Business Information Consultant** **Location:** This position will work a hybrid model ( remote and office). Ideal candidates will live within 50 miles of one ... procedures. * Develops and analyzes business performance reports (eg for claims data, provider data, utilization data) and provides notations of performance… more
- Elevance Health (Richmond, VA)
- …in-office) with PulsePoint sites used for collaboration, community, and connection. This includes remote work and 1-2 days in office per week. Candidates must reside ... increments or decrement. + Communicates with sales, administration and claims to assess the rating and administrative impact or...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more