- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor directs and coordinates the accurate implementation of the clinical appeal process ... and serves as a resource for associates within the Clinical Appeals and Analysis unit. We are...who is willing and able to work in a hybrid model. The incumbent will be expected to work… more
- Centene Corporation (New York, NY)
- …appeals and grievances from a clinical perspective. Ensure that the clinical Appeals and Grievance department processes all cases in accordance with ... changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene...holidays, and a flexible approach to work with remote, hybrid , field or office work schedules. Actual pay will… more
- Centene Corporation (Sacramento, CA)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Supervisor of Appeals & Grievances is accountable for the recruitment, ... recruiting, hiring, promotion, and performance evaluation tasks and counsels non- clinical Grievance and Appeals staff. + Orients...holidays, and a flexible approach to work with remote, hybrid , field or office work schedules. Actual pay will… more
- LA Care Health Plan (Los Angeles, CA)
- …in Nursing for Registered Nurses Experience Required: At least 8 years of clinical appeals and grievances experience in a managed care, utilization management ... Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical...achieve regulatory standards. Acts as a back-up to the Supervisor in leading meetings and handling escalations as required.… more
- State of Colorado (Colorado Springs, CO)
- …Professional VI) - Therapeutic Community Program Manager ( Hybrid ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5154145) Apply CDOC (Health ... Professional VI) - Therapeutic Community Program Manager ( Hybrid ) Salary $7,971.00 - $11,159.00 Monthly Location Colorado Springs, CO Job Type Full Time Job Number… more
- State of Colorado (Denver, CO)
- PSYCHOLOGIST I - Forensic Evaluator - Statewide ( Hybrid ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5001467) Apply PSYCHOLOGIST I - ... Forensic Evaluator - Statewide ( Hybrid ) Salary $7,945.00 - $9,534.00 Monthly Location Denver, CO...to inform their opinion and seeks consultation from their supervisor or colleagues on difficult, complex, or ambiguous cases.… more
- Clark County, NV (Las Vegas, NV)
- …& Adult Intervention Supervisor . This position will be assigned to various Clinical Divisions to include the Mental Health Treatment Team within the Clark County ... Counselor (LCADC), or Clinical Psychologist (LCP). Professional licensing as a Clinical Alcohol and Drug Counselor Supervisor (LCADC-S), LCSW Supervisor … more
- Ventura County (Ventura, CA)
- Certified Coding Supervisor - Health Information Management Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4892159) Apply Certified Coding ... Supervisor - Health Information Management Salary $94,952.15 - $132,946.07...Information Management (HIM) department related to coding and CDI ( clinical documentation improvement). The ideal candidate will have a… more
- Corewell Health (Grand Rapids, MI)
- …State and Federal decisions are properly implemented. Assist the Lead, Supervisor and/or Manager in coordinating activities and in the development/collection of ... Essential Functions + Responsible for complex and thorough investigation of appeals , external complaints, and fair hearing reviews including: formulate action plan… more
- State of Colorado (Denver, CO)
- …As a Registered Nurse (RN) Health Professional III , you will use your clinical expertise to ensure quality of care, protect patient rights, and promote excellence ... with state and federal standards; + Assessing nursing and clinical services for adherence to accepted professional practice; +...Procedures, 4 CCR 801, for more information about the appeals process. The State Personnel Board Rules and Personnel… more
- Clark County, NV (Las Vegas, NV)
- …County - Las Vegas, NV Job Type PERMANENT Job Number 30476 Department Clinical Services Opening Date 12/02/2025 Closing Date 12/16/2025 5:01 PM Pacific + Description ... + Benefits + Questions ABOUT THE POSITION The Clark County Clinical & Community Services Department is seeking qualified candidates to apply for the position Senior… more
- State of Colorado (CO)
- …to receive text message updates on CDHS recruiting events! CDHSCareers Description of Job Hybrid Work: This position is required to report to the office at least 2x ... and competencies necessary to the position through continuing education, clinical supervision, literature review, and discipline and team development. This… more
- State of Colorado (CO)
- …and competencies necessary to the position through continuing education, clinical supervision, literature review, and discipline and team development. This ... Description of Job The current schedule will be a hybrid work arrangement (remote work and report on-site 2...to inform their opinion and seeks consultation from their supervisor or colleagues on difficult, complex, or ambiguous cases.… more
- Buffalo Hearing & Speech Center (Buffalo, NY)
- …updates from payers and shared within the Billing Department, Front Support Staff, Clinical Director, Audiology Supervisor , Speech Therapy Supervisor as ... Job Location North Street - Buffalo, NY Remote Type Hybrid Salary Range $21.97 - $27.50 Hourly Description Buffalo...done bi-monthly on assigned controls to include corrected claims, appeals , phone calls, or provider rep assistance to assure… more
- Johns Hopkins University (Baltimore, MD)
- …training courses. + Other duties may be assigned by the employee's immediate clinical supervisor , Assistant Administrator for the Division, or a healthcare ... receiving ongoing care. + Assist with medication prior authorizations and appeals . + Assist Medical Office Coordinators with procedure pre-authorizations as needed.… more
- Saint Francis Health System (Tulsa, OK)
- …**to login and apply.** Full Time Nights \#ALDIND **Shift: Nights; Hybrid after 6 months in the role. ** Job Summary: Provides ... administrative and clinical support to the hospital and treatment teams throughout...validate accurate level of care utilization. Investigates and prepares appeals for insurance companies when denial of reimbursement is… more
- Access Dubuque (Dubuque, IA)
- …able to meet productivity goals, this position has the **ability for a hybrid schedule** . In-person training is at Medical Associates West Campus (1500 Associates ... billing issues. Handling EOB's, submitting physician notes for protests and appeals , resubmitting corrected HCFA's, protesting denials and follow-up to ensure the… more
- State of Colorado (Denver, CO)
- …registered nurse member of the survey team , you will apply your clinical expertise to evaluate compliance with state and federal regulations, conduct medication ... and Personnel Director's Administrative Procedures, Chapter 8, Resolution of Appeals and Disputes, at spb.colorado.gov/board-rules . Supplemental Information A… more