• Specialist - Quality

    Baptist Memorial (Memphis, TN)
    Summary The Denial Mitigation Specialist - Denial Escalation Quality Assurance evaluates the adequacy and effectiveness of internal and operational ... processing including federal and state regulations and guidelines. The Quality Assurance Specialist will be...+ Employee referral program Job Summary: Position: 19873 - Supervisor- Quality Assurance Denial Escalation Facility:… more
    Baptist Memorial (10/16/24)
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  • Program Specialist 1 Cannabis (NY Helps)…

    New York State Civil Service (Albany, NY)
    …or corporate officials, or individuals; policy analysis and research; surveillance; quality assurance that included evaluating whether projects met/are meeting ... NY HELP Yes Agency Office of Cannabis Management Title Program Specialist 1 Cannabis (NY HELPS) - VID 172994 Occupational Category Other Professional Careers Salary… more
    New York State Civil Service (11/16/24)
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  • Ops-UM Training Specialist

    Integra Partners (Troy, MI)
    …compliance knowledge training. + Oversees all lesson plans for each application by ensuring quality assurance checks are in place and that training captures both ... Training & Development team as an Operations UM Training Specialist , specializing in Utilization Management (UM) processes. The ideal...key processes to use feedback from training assessments, the quality assurance team and leaders to design… more
    Integra Partners (10/09/24)
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  • Sr. Classified Cybersecurity Specialist

    Zantech (MD)
    …impact. + Resolve complex problems using technical knowledge. + Complete software assurance evaluations and make approval/ denial decisions based on residual ... join our team! Zantech is looking for a talented Classified Senior Cybersecurity Specialist to provide the Cyber Security Office with support and technical guidance… more
    Zantech (10/12/24)
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  • HFMG Revenue Cycle Specialist - Patient…

    Health First (Rockledge, FL)
    …understanding insurance payments, denials and correspondences. * Maintain established quality assurance and productivity benchmarks while utilizing best ... *POSITION SUMMARY* The Revenue Cycle Specialist will be responsible for the review, analyzation,...correspondences to include explanation of benefits, remittance advices and denial letters. * Advanced understanding and ability to navigate… more
    Health First (11/22/24)
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  • Utilization Management Nurse Specialist RN…

    LA Care Health Plan (Los Angeles, CA)
    …verbal and written communication skills. Preferred: Knowledge of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care ... Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization...Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and… more
    LA Care Health Plan (11/09/24)
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  • Outpatient Administrative Specialist

    SUNY Upstate Medical University (Syracuse, NY)
    …processes; identify retraining opportunities, and participate in clinic and quality assurance meetings. Minimum Qualifications: Associate's degree and ... Job Summary: Reporting to the Business Manager, the Outpatient Administrative Specialist is responsible for obtaining insurance referrals and authorizations for… more
    SUNY Upstate Medical University (10/16/24)
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  • Senior Director, Revenue Cycle

    Scripps Health (San Diego, CA)
    …coding and CDI performance indicators and metrics. . Develops and oversees a comprehensive quality assurance and productivity program for coding and CDI staff. . ... responsible for hospital and professional fee coding and CDI, ensuring quality documentation and clinical consistency. This individual position is responsible for… more
    Scripps Health (08/28/24)
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  • RN Manager-Post Acute Services

    Ascension Health (Baltimore, MD)
    …Formulation, Stakeholder Engagement and Community Outreach, Data Management and Reporting, Quality Assurance and Compliance** **Benefits** Paid time off (PTO) ... limited to: Access Authorization and pre-certification, utilization review and denial management, CareCoordination, Collaborative treatment planning and core measures,… more
    Ascension Health (11/06/24)
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  • Licensing Analyst 1-3

    Louisiana Department of State Civil Service (Baton Rouge, LA)
    …continuing education programs, and conducts annual continuing education audits. Assists in quality assurance review activities. Assists in the preparation and ... For further information about this vacancy contact: YaVonya Kelley, Human Resources Specialist PO Box 94095 Baton Rouge, LA 70804-9095 ###@OFI.LA.GOV ### Minimum… more
    Louisiana Department of State Civil Service (11/09/24)
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