Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care including clinical nurses and treating physicians . The Registered Nurse Case Manager will report to the FEP Department M

REQUIRED EXPERIENCE Take on a significant role within a world class health organization. Elevate the operational and financial effectiveness of a complex health system. Take your professional expertise to the next level. You will leverage your extensive theoretical revenue cycle knowledge as you take on a vast range of critical revenue issues. This will involve applying d

Your Role The Federal Employee Program (FEP) Care Management team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with their care including a multidisciplinary team and the member's treating physicians . The Registered Nurse Case Manageme

Providence caregivers are not simply valued they're invaluable. Join our team and thrive in our culture of patient focused, whole person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence is calling a Senior Claims Insurance Manager Medical Profe

Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination o

Your Role The Case Management team performs and case management (CM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members care including clinical nurses and treating MDs.. The Case Management Nurse, Senior will report to the Manager, Care Management. In this role you will determine, develop and imp

Must have High school diploma, GED or equivalent required, Two year degree preferred. Minimum of 3 years previous experience working for a Health Plan, IPA, or other Managed Care Organization. Minimum of 2 years previous direct experience that included verifying and maintaining provider information and provider contract configuration in a managed care transaction system .

Take on an important role within an award winning health organization. Help ensure the efficient operation of a complex health system. Take your career to the next level. You can do all this and more at UCLA Health. You will receive urgent, routine, pre service, and retro authorization requests, as well as process prior authorization requests with accuracy and timeliness.

Responsible for auditing and training claims staff on all Managed Care claims received from outside providers to ensure the Claims Examiners processed and adjudicated them accurately and consistently in accordance with outside Provider Contracts, State, Federal, CMS, DMHC and Health Plan contracts, internal departmental policies and procedures. Must maintain a productivit

Authorization Coordinator ENT Clinic Full Time 8 Hour Days (Non Exempt) (Non Union) Keck Medicine of USC Hospital Los Angeles, California The Authorization Coordinator coordinates communication with admitting, case management, patient financial services, and payers to ensure all inpatient services provided by the hospital are authorized by appropriate payer. He/She will f

Apply if looking for Flexibility and Financial Freedom

Aya Healthcare has an immediate opening for the following position Claims Examiner in Whittier, CA. This is a 13 week contract position that requires at least one year of Claims Examiner experience. Make $1040.67/week $1266.01/week. Want a job close to home? We've got you! We'll work with you to build the career of your dreams. Aya delivers Front of the line access to exc

Apply if looking for Flexibility and Financial Freedom

Apply if looking for Flexibility and Financial Freedom

Coding Compliance Auditor (HIM Inpatient) HIM Financial Full Time 8 Hour Days (Non Exempt) (Non Union) Keck Medicine of USC Hospital Alhambra, California In accordance with current federal & state coding compliance regulations and guidelines, the 'IP Coding Compliance Auditor" performs 2nd level reviews of previously coded inpatient accounts for MS DRG validation purposes