Manager, Clinical Appeals jobs
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Featured Job Postings from the Web
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| May 20 | Clinical Appeals Reviewer - OT or RN | Umass Medical School | Shrewsbury, MA |
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the oversight and adjudication of appeals and grieveance cases/matters. This ... intake and reassessments to determine clinical eligibility and medical necessity... more |
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| May 19 | Tech II Prior Auth and Appeals | CVS Caremark | Richardson, TX |
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all approvals and denials, and transfers all clinical questions and judgement calls to the pharmacist. The rep maintains the incoming follow up and issues fax queues. The rep must... more |
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| May 19 | Clinical Manager Clinical Affairs | CVS Caremark | Northbrook, IL |
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The Manager of the CVS Caremark Clinical Program Oversight (CPO) Department in Clinical ... and Clinical Intervention programs. The Manager will coordinate and supervise the... more |
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| May 18 | Clinical Appeal Unit Manager(1300005281) | Corporate Service Center | Arizona |
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The Clinical Appeal Manager will be responsible for collaboratively working with all ... Relationship: * Reports to Director of Clinical Denial Improvement. Clinical... more |
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| May 18 | Clinical Registered Nurse RN Case Manager Behavioral HealthPart time | Barnabas Health | Newark, NJ |
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authorization, concurrent review, appeals using QuadraMed, MIDAS and Interqual. ... rounds and records accurate and timely clinical documentation. Assists in code... more |
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| May 17 | Appeals Coordinator | Lifespan | Providence, RI |
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The Appeals Coordinator working in the Appeals Coordination Unit reports to the ... involved with Recovery Audits and Appeals to answer questions and give... more |
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| May 17 | Clinical Appeals Reviewer - OT or RN - #20440 | Commonwealth of Massachusetts | Shrewsbury, MA |
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Clinical Appeals Reviewer - OT or RN - #20440Clinical Appeals Reviewer - OT or RN - #20440 ... Medical School Official Title: Clinical Appeals Reviewer - OT or RN - #20440... more |
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| May 16 | Clinical Appeals Mananger | HCA Physician Services | Nashville, TN |
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Directors & Managers The Clinical Appeals Manager manages all activities related to ... * Perform Q/A for Clinical Appeals function * Screen, interview, and hire new employees *... more |
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| May 16 | Corp Clinical Appeals Cnsltnt | Intermountain Healthcare | Ogden, UT |
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act as the corporate consultant for clinical Appeals and Audits for Intermountain ... Healthcare. The Corporate Clinical Appeals Consultant will execute clinical... more |
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| May 16 | Clinical Appeals Specialist RN Team Lead ATL WFH (Parallon) | Parallon Business Solutions | Norcross, GA |
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SUMMARY OF DUTIES - Assists Clinical Appeals Manager with training of the appeals ... SUPERVISOR - Clinical Appeals Manager SUPERVISES - N/A DUTIES INCLUDE BUT ARE NOT LIMITED... more |
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| May 16 | Clinical Appeals Mananger | HCA Physician Services US | Nashville, TN |
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Directors & Managers The Clinical Appeals Manager manages all activities related to ... Perform Q/A for Clinical Appeals function Screen, interview, and hire new employees Arrang... more |
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| May 09 | HOLD-Clinical Appeals / Compliance Coordinator (SUPERIOR HEALTH PLAN) | Centene | Austin, TX |
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HOLD-Clinical Appeals / Compliance Coordinator (SUPERIOR HEALTH PLAN) Job Title: HOLD-Clin ... degree in nursing or equivalent. 3+ years of clinical nursing or case management... more |
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| May 07 | Clinical Appeals Nurse | UnitedHealth Group | Baltimore, MD |
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Clinical Appeals Nurse- Baltimore, MD Clinical Appeals Nurse- Baltimore, MD Bookmark and ... The chosen Clinical Appeals Nurse would be responsible for reviewing appeals and grievanc... more |
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| May 07 | Review RN, Appeals(175254) | Kaiser Permanente | Brooklyn Heights, OH |
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Provides clinical guidance and benefit interpretation as it relates to clinical scenarios ... Nursing Licensed Public Department Name : Appeals Unit Travel : No Job Eligible for... more |
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| May 07 | Manager, Appeal and Grievances | Healthfirst | New York, NY |
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non-clinical and clinical matters. The A&G Manager supervises the day-to-day activities ... include supervising the A&G clinical and non-clinical staff as well as implementing,... more |
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| May 02 | Clinical Audit and Appeals Coordinator | AnMed Health | Anderson, SC |
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Clinical Audit and Appeals Coordinator Department: Resource Management Schedule: Full-time ... daily oversight of the Clinical Audit and Appeals efforts for AnMed Health. Provides... more |
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| Apr 30 | Clinical Appeals Coord | Independence Blue Cross | Philadelphia, PA |
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we serve. Job Summary Serves as a clinical resource and provides support and ... Pennsylvania RN with a minimum of 5 years clinical experience. Excellent interpersonal... more |
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| Apr 26 | Clinical Appeal Unit Manager | Dignity Health | Phoenix, AZ |
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Job Summary: The Clinical Appeal Manager will be responsible for collaboratively working ... RELATIONSHIP: * Reports to Director of Clinical Denial Improvement. Clinical... more |
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| Apr 22 | Clinical Appeals and Coding RN Work at Home | UnitedHealth Group | Bloomington, MN |
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Clinical Appeals and Coding RN Work at Home Clinical Appeals and Coding RN Work at ... The chosen Clinical Appeals & Coding Nurse would be responsible for reviewing appeals an... more |
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| Apr 20 | Patient Financial Clinical Denials RN | Central Florida Health Alliance | Leesburg, FL |
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clinical experience with an understanding of clinical documentation, case management, and ... experience preferred. Experience in clinical documentation, ICD9 coding, hospital... more |
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| Apr 17 | Clinical Appeals Coordinator | Centene | Baton Rouge, LA |
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license. Position Responsibilities: * Review clinical information for all appeals ... information regarding member and provider clinical appeals, including information... more |
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| Apr 12 | Clinical Appeals Reviewer - OT or RN | University of Massachusetts Medical School | Shrewsbury, MA |
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Clinical Appeals Reviewer - OT or RN Requisition Number 2012-20440 # of Openings 1 Job ... the oversight and adjudication of appeals and grieveance cases/matters. This... more |
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| Apr 07 | Denials and Appeals Specialist | Cancer Treatment Centers of America | Zion, IL |
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with the Clinical Appeals Program Manager to initiate the appeals process, and ... The Denials and Appeals Specialists report directly to the Manager of Denials and Appeals. more |
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| Feb 13 | Clinical Cardiology - Physician Advisor | DEBORAH Heart and Lung Center | Browns Mills, NJ |
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third-party firms for its outstanding clinical outcomes. Qualified candidates ... or InterQual preferred), third-party appeals processes, and developing and... more |
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| Jan 22 | Sr. Grievance & Appeals Administrator | Kaiser Permanente | Portland, OR |
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Sr. Grievance & Appeals Administrator( Job Number: 167791) At Kaiser Permanente ... resolving complaints, grievances and appeals region-wide in compliance with... more |
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