- Catholic Health Services (Melville, NY)
- …communicate and manage project scope; Assist in work plan development and management ; contributes to completion of project status reports. Lead meetings with staff ... planning, organizing, and managing resources) and all phases of the project management life cycle for a variety of initiatives Actively responds to questions… more
- Elevance Health (Richmond, VA)
- **Title: Grievance/ Appeals Analyst II** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of ... one of our PulsePoint locations. The **Grievance/ Appeals Analyst II** will be responsible for...customer expectations and responses. + Responsibilities exclude conducting any utilization or medical management review activities which… more
- Elevance Health (Los Angeles, CA)
- **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 our PulsePoint locations. The **Grievance/ Appeals Analyst I** is an entry level...to convey the determination. + Responsibilities exclude conducting any utilization or medical management review activities which… more
- Henry Ford Health System (Troy, MI)
- …experience . + Minimum of two (2) years of experience working on utilization management platform-processing authorizations. + Minimum of two (2) years of ... prompt and thorough investigation of medical, transportation, and pharmacy member appeals and grievances for Health Alliance Plan's (HAP's): Commercial, Medicare… more
- The Cigna Group (Bloomfield, CT)
- …for providers, members and patient client advocates within the Prior Authorization/ Utilization Management department. Identify and track trends for analytics ... Nurse Case Management Lead Analyst -Nurse Clinician - Accredo...years of experience is preferred in prior authorization or utilization review and appeals + Demonstrated proficiency… more
- MSys Inc. (Harrisburg, PA)
- …of healthcare operations to include: enrollment, claims, customer service and appeals . + Demonstrated project management experience. + Applied analytical ... Job summary: Title: Healthcare Data Analyst -Hybrid Location: Harrisburg, PA, United States Length...healthcare operations to include: enrollment, claims, customer service and appeals . + Experience in Healthcare Quality measures, utilization… more
- The Cigna Group (Bloomfield, CT)
- …shifts with every other weekend (Tuesday ALT Day).** + Must have experience in Medicare Appeals , Utilization Case Management or Compliance in Medicare Part C ... + Ability to differentiate different types of requests Appeals , Grievances, coverage determination and Organization Determinations in order to ensure the correct… more
- City and County of San Francisco (San Francisco, CA)
- …customers regarding electronic system development, implementation, issues, and recommendations and utilization of best practices; + Work with the EHR implementation ... requirements; + Evaluate workflows and recommend re-engineering of processes around utilization of computerized applications, including the new EHR to improve the… more
- Clark County, NV (Las Vegas, NV)
- SENIOR ENTERPRISE SYSTEMS ANALYST Print (https://www.governmentjobs.com/careers/clarkcounty/jobs/newprint/4647253) Apply SENIOR ENTERPRISE SYSTEMS ANALYST ... seeking qualified candidates to join our team as a Senior Enterprise Systems Analyst located within the Enterprise Resource Planning (ERP) office. We are looking for… more
- City and County of San Francisco (San Francisco, CA)
- …external customers regarding electronic system development, implementation, issues, recommendations, and utilization of best practices + As a member of a ... good working relations with department personnel, staff, vendors, peers, and management + Maintaining all system configuration and build parameters for application… more