Disability Case Manager Specialist

- Adjudicate 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 Consultant Opinions,...

What will you do?o Adjudicate disability for eligibility of short and long-term benefits. This includes reviewing and analyzing contractual, medical, functional and occupational informationo Coordinate appropriate interventions including, but not limited to: Independent Medical Evaluations, Functional Capacity Evaluations, Ergonomic assessments, Medical...

What will you do?o Adjudicate disability for eligibility of short and long-term benefits. This includes reviewing and analyzing contractual, medical, functional and occupational informationo Coordinate appropriate interventions including, but not limited to: Independent Medical Evaluations, Functional Capacity Evaluations, Ergonomic assessments, Medical...

Role OverviewWe are seeking an experienced and detail-oriented Short-Term Disability Claims Analyst to join our team. In this role, you will be responsible for analyzing and resolving complex disability claims in a fast-paced environment.Main ResponsibilitiesAnalyze medical, financial, and contractual information to make informed claim decisions.Communicate...

Roles and Responsibilities:• PH Registered nurses to review workers compensation claims with serious injury and that need surgery/lengthy treatments, create a return-to-work plan, work with various stakeholders (medical providers, injured worker, employer, attorney) to track the treatment plan and help bring the injured worker back to work.• Nurses have...

About the RoleThis position offers a unique opportunity to work in a collaborative environment where you will utilize your analytical and problem-solving skills to drive results. As a Short-Term Disability Claims Analyst, you will play a vital role in ensuring timely and accurate claim resolutions.ResponsibilitiesGather, review, and analyze medical,...

Join us as a Disability Case Manager and take on the challenging yet rewarding role of supporting individuals with disabilities to achieve their full potential.Job ResponsibilitiesAdjudicate disability for eligibility of short and long-term benefits, considering various factors such as contractual, medical, functional, and occupational information.Coordinate...

We are seeking a highly skilled Disability Case Manager to join our team at Recruiter PH. As a key member of our organization, you will play a critical role in ensuring that individuals with disabilities receive the support they need to achieve their goals.About the RoleThis position involves adjudicating disability claims, coordinating interventions, and...

Educational Background: B.S NursingQualifications: 8+ years of related experience or equivalent combination of education and experiencerequired to include 2+ years of direct clinical care OR 2+ years of casemanagement/utilization management required.  Bachelor's degree in nursing (BSN) from accredited college or university or equivalentwork experience...

Educational Background: B.S NursingQualifications: 8+ years of related experience or equivalent combination of education and experiencerequired to include 2+ years of direct clinical care OR 2+ years of casemanagement/utilization management required.  Bachelor's degree in nursing (BSN) from accredited college or university or equivalentwork experience...

Responsibilities:Carry out quality assurance oversight activities defined in the Client Managed Care National Best Practices and Quality Assurance StandardsConduct regular and systematic review of Managed Care internal and external claim files with focus towards validation of consistent evaluation of evidence-based medicine, comprehensive assessments,...

Responsibilities:Carry out quality assurance oversight activities defined in the Client Managed Care National Best Practices and Quality Assurance StandardsConduct regular and systematic review of Managed Care internal and external claim files with focus towards validation of consistent evaluation of evidence-based medicine, comprehensive assessments,...

Key skillsmanger operationsHealthcare domainHealthcare OperationPH HealthcareMinimum 2 years leadership role in BPO HealthcareHealthcare accountBPO Healthcare.Functional Title: Operations Manager.Educational Background: B.S NursingQualifications: 8+ years of related experience or equivalent combination of education and experience required to include 2+...

As a Workplace Conflict Resolution Specialist at 1Rotary Trading Corporation, you will play a critical role in maintaining a positive and productive work environment. Your primary responsibility will be to plan and execute employee engagement initiatives, including company events and activities.About the RoleThe successful candidate will have excellent...

OverviewSantaisabel is a leading healthcare provider offering a wide range of services. We are committed to delivering exceptional patient care and creating a positive impact in the lives of our clients.Job DescriptionThis Registered Nurse role involves coordinating department processes, performing telephonic authorizations, and monitoring patient...

Hunter's Hub Incorporated is seeking a highly skilled Quality Assurance Specialist to join our team. This role plays a critical part in ensuring the delivery of high-quality software solutions and business processes.Key ResponsibilitiesTest Planning and Design: Develop comprehensive test plans, test cases, and test scripts based on business requirements and...

Key skillsmanger operationsHealthcare domainHealthcare OperationPH HealthcareMinimum 2 years leadership role in BPO HealthcareHealthcare accountBPO Healthcare.Functional Title: Operations Manager.Educational Background: B.S NursingQualifications: 8+ years of related experience or equivalent combination of education and experience required to include 2+...

Job OverviewThe Business Analysis Specialist at Hunter's Hub Incorporated is responsible for helping the organization implement technology solutions by determining project requirements and communicating them clearly to stakeholders, facilitators, and partners. This role involves handling requirements analysis, definition, and documentation as well as User...

About the RoleAs a key member of our team, you will be responsible for evaluating the financial impact of projects and initiatives.Assist in reviewing business cases to ensure that financial sections are thoroughly addressed.Perform detailed reviews of business cases, validating cost treatment and assumptions.Endorse reviewed Business Cases with supporting...

Roles and Responsibilities:• PH Nurses to review treatment authorization request based on state guidelines and medical necessity and take decision to approve/deny. In case of denial send this to independent panel review to support the decision. Nurses will work with Claims adjuster on denial decision based on risk tolerance to ensure the denial doesn't...