- Sedgwick (Norfolk, 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
- BrightSpring Health Services (Forest, VA)
- …expenses and repairs, vehicle expenses, personnel costs, consultant services* Monitors worker 's compensation and unemployment claims for assigned service ... Community Living Overview The Qualified Intellectual Disabilities Professional (QIDP) Manager oversees delivery of consumer support services for assigned location.… 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
- Post Holdings Inc. (Winchester, VA)
- …implementation. Supervise site incident and injury reporting, investigation, and recordkeeping; and worker 's compensation claims and site Return to Work program. ... Operations Administrative **Locations:** Winchester, Virginia **Position Type:** Regular Full-Time ** Remote Eligible:** No **Req ID:** 24263 **Job Description** **Business… more
- Elevance Health (Richmond, VA)
- **Anticipated End Date:** 2024-09-17 **Position Title:** Account Service Manager **Job Description:** **Account Service Manager ** **Location: Must be within 50 ... miles of any location listed; position has both office/ remote expectations.** AmeriBen is a proud member of the Elevance Health family of companies. We are a… more
- Elevance Health (Roanoke, 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
- BrightSpring Health Services (Martinsville, VA)
- …financial documentation + Ensures a safe work environment to minimize worker 's compensation injuries and financial expenditures. Responsible for timely reporting of ... all service site injuries and assist with the management of claims + Monitors service site expenses relative to budgets + Trains staff on financial and… more
- Elevance Health (Norfolk, 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 (Norfolk, 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)
- …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 (Norfolk, 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 (Roanoke, VA)
- …**Senior Investigator (Investigator Sr)** _Location: This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles of one ... 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 (Roanoke, 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 (Ashburn, 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 (Norfolk, 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 (Norfolk, 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)
- …Title:** RN Nurse Case Mgr I **Job Description:** **LOCATION** **: This is a remote position for our Central region. You must reside within 50 miles of our ... treatment plans. + Assists in problem solving with providers, claims or service issues. + Functions as preceptor for...staff. + Works on special projects as assigned by manager . + Other duties as assigned. **Required Qualifications** +… more
- Elevance Health (Norfolk, VA)
- …**Associate Research Director** **Location:** This position will work a hybrid model ( remote and office). The Ideal candidate will live within 50 miles of ... + Extensive experience conducting research using healthcare databases (ie administrative claims data) strongly preferred + Expertise in data science and analytic… more