Clinical Appeals Manager Full time/Remote Salary: $88,000.00 - $110,000.00 per year Managed Resources is a leading... and would like to hear more about this opportunity with Managed Resources Inc.! Purpose The Clinical Appeals Manager will work...
SUMMARY: Coordinates and executes the appeal process for all AHS facilities clinical appeals and third party audits... level of care; Utilizes McKesson Interqual® clinical guidelines; refers questionable cases to the CM Manager or physician...
Anticipated End Date: 2025-01-27 Position Title: Manager II Grievances and Appeals (RN) Job Description: Manager...-Friday; 8am-5pm PST The Manager II Grievance/Appeals is responsible for management oversight of grievances and appeals...
will report to the Manager of the Appeals and Grievances team. In this role you will perform accurate and timely clinical review..., and nationally recognized clinical criteria. The successful RN candidate will review both medical and pharmacy member appeals...
and serves as a subject matter expert for appeals/grievances/quality of care issues and is a resource for clinical and non...Anticipated End Date: 2025-02-03 Position Title: Nurse Appeals (RN) CA Job Description: Nurse Appeals – Licensed...
City / Los Angeles, CA Case Manager (CM) - Full Time (on-site) Registered Nurse (RN) or Licensed Clinical Social Worker... with an interdisciplinary team. Patient at Cal Rehab have a high discharge to home rate. Benefits of working as a Case Manager...
Anticipated End Date: 2025-01-24 Position Title: Clinical Ops Associate Medical Director...; 8.5-hour shifts between 7am – 7pm CT (later shift hours preferred) The Clinical Operations Associate Medical Director...
as assigned by Senior Director of Clinical Services and Manager of Clinical Services Experience/ Education: Required Licensure... management. Job Duties: The Ambulatory Clinical Pharmacist (ACP) will help advance quality pharmacotherapy care by actively...
areas. This position requires the ability to combine clinical/quality considerations with regulatory/financial/utilization... a balance between individual clinical needs with the efficient and cost-effective utilization of resources while promoting...
treatment of NASH with compensated cirrhosis. Opportunity and Summary of Position: Access Reimbursement Manager The role... of the Access Reimbursement Manager (ARM) is to minimize access and reimbursement barriers for patients and providers related...
Job Title: Field Access Manager, Northwest Job Location: United States Job Location Type: Remote Job Contract..., WA; Portland, OR How will your role help us transform hope into reality? The newly created Field Access Manager...
Manager, Care Management (Medicare) Department: Care Management Office: Hybrid San Francisco Location: San... Francisco, CA Salary: $140000 - $154000 Per Year Reporting to the Director, Care Management, the Manager, Care Management...
Job Summary: The SLH Case Manager RN is responsible for providing comprehensive case management services to clients... and other documentation; contacts with payers conducting phone reviews and initiates denial appeals as needed. 3. Encourages patients...
Job Summary: The SLH Case Manager RN is responsible for providing comprehensive case management services to clients... and other documentation; contacts with payers conducting phone reviews and initiates denial appeals as needed. 3. Encourages patients...
and the ability to participate in multiple plans. Generous paid time off plans Role Overview:The Manager of Care... review process; actively appeals denied cases when necessary and assists physicians with appeals. Maintains minimal denial...
SUMMARY: The AHD Case Manager (RN) is responsible for providing comprehensive case management services to clients... denial appeals as needed. 4. Conducts discharge planning assessments in a timely and complete manner. Assessments...
Job Description: GLAUKOS - SR. MANAGER, MARKET ACCESS SYSTEMS (Aliso Viejo, CA) How will you make an impact...? Reporting to the Senior Director, Market Access Operations, the Senior Manager, Market Access Systems will be responsible...
Reporting to the Director, Care Management, the Manager, Care Management (Medicare) is responsible for the operation.... You will build a high-performing team of Clinical Supervisors, Nurses Care Managers and Coordinators committed to providing exemplary...
advisor for in-depth clinical education and to facilitate effective communication and problem-solving with attending... physicians. 9 Monitors the care managers’ involvement of the physician advisor for in-depth clinical education and to facilitate...
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 Regional...