USRN- Case Manager

The Case Manager must be highly organized, empathetic, compassionate, nonjudgmental, and eager to support a growing management team. Case Manager Requirements and QualificationsPossesses superb written and spoken communication skillsExcellent interpersonal skills with colleagues, applicants, employers and attorneysExcellent time management skills; organized...

The Senior Case Manager must be highly organized, empathetic, compassionate, nonjudgmental, and eager to support a growing management team. Senior Case Manager Requirements and QualificationsPossesses superb written and spoken communication skillsExcellent interpersonal skills with colleagues, applicants, employers and attorneysExcellent time management...

Key Responsibilities Manage and audit medical bills and records. Validate coding (ICD/PT/DRG) and apply fee schedules. Negotiate provider fees and leverage costsaving opportunities. Provide clinical support and training to Medical Services Representatives. Contribute to the development of the Clinical Bill Review program.Qualifications Must have an Active...

We are hiring for USRN - Utilization Review Author Rewarding Sign On Bonus Awaits You- Get as much as TWICE your monthly basic salary If interested, you may now apply using this Workday link below: Qualifications:Bachelor of Science in NursingMust have an active USRN Mainland LicenseAt least 2 years of recent hospital-based Utilization Review experience or...

ResponsibilitiesAdjudicate disability for eligibility of short and long-term benefits. This includes reviewing and analyzing contractual, medical, functional and occupational information. Coordinate appropriate interventions including, but not limited to: Independent Medical Evaluations, Functional Capacity Evaluations, Ergonomic assessments, Medical...

Responsible for collaborating with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources. Ensures medically appropriate, high-quality, cost-effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and diagnostic...

Exciting Opportunities for our REGISTERED NURSES (PHRN) You will be responsible in assisting clients with the services, medications and coverage of their insurance. Available opening:Nurse Associate - At least 1 year of hospital bedside experienceUtilization Management Review - At least 1 year of clinical appeals and denials or utilization reviewUSRN Academy...

About the roleAs an Information Governance Specialist - AI, you will play a crucial role in ensuring the effective management and governance of information and data within the Firm. In this role you will have primary responsibility for the engagement and execution of our projects using AI, to ensure the risks, controls and obligations across our data and...

Qualifications NCLEX-RN certified nurses with 3-5 years of recent Telephone Triage experience/ Call Center Experience Licensure in at least one US state is required. Nurses registered in the state of Illinois are highly preferred Preferred candidate with minimum 2 years of clinical experience in a physician office, one or more specialties, home health,...

Qualifications5+ years of experience in clinical settings, clinical administrative services, and revenue cycle, of which a minimum of 2 years should be in an Assistant Manager and above role.Preferably with 5 years managing project and operational improvement efforts within RCM (Coding and Clinical Administrative Services including CDI).Deep expertise in...

We are seeking a Licensure Specialist to work with their multinational team. We are seeking someone that is highly organized, detailed-oriented, has excellent communication skills, and interpersonal skills. Do you want to be a part of a team that helps change the lives for hundreds of immigrants and their families early? Do you enjoy problem solving?...

Job Responsibilities:In-charge of the service center's routine operation and development of operating targets.Generation of ASP Daily Pending casesData gathering and analyzing daily pending. Communicating pending cases and updatesAnalysis on the ASP pending cases, assess TAT and impose penalties for case management Handling incoming escalations coming from...

Responsibilities:Responsible for training A&G clinical staff on processes, policies, and systemsParticipate & lead in the development, implementation, and updating of training manuals to reflect new approaches to training, departmental and/or system process changes and MCG criteria updates as neededOversee and mentor new employees during the initial training...

Management of the end-to-end project management life cycle. Manage all programs and projects from ideation / business case / inception, delivery (implementation and deployment) to closure (PIR). Supporting across the lifecycle of project delivery and benefits realization.Definition – clearly define project scope, deliverables and timelines which achieve...

You are as unique as your background, experience and point of view. Here, you'll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll...

Lead group planning and coordinate with various stakeholders for project design, implementation, and turnoverAssist General Manager in designing and monitoring overall business plans for the project/s including financial, technical permits, and marketing requirementsMonitor status of construction activities and coordinate with construction team to ensure...

About the OpportunityAre you looking to join a world-class marketing team, fine-tune your creative marketing skills, and make a positive difference in the lives of disadvantaged children around the world? Then this is the place for youAs a Manager in the Creative Service team for the Marketing team, you will be responsible for creating compelling ways to...

You are as unique as your background, experience and point of view. Here, you'll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll...

Duties and Responsibilities:CDP (Customer Data Platform) integration and implementation into existing Home Credit Philippines environment Use cases implementation – member of working group for delivery of tangible results thru selected use cases implementation Data Mapping and Transformation – close cooperation with working group over ingested data...

We are looking for a highly motivated professional who is well versed in clinical knowledge, healthcare staffing, people leadership and compliance. This role will interview nurse applicants and provide clinical insight on items relating to traveler documentation as well as provide education and expert interpretation for internal and external customers.Job...