Job Description Job Summary Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the
Multi-Specialty Medical group is seeking a strong candidate, responsible for ensuring the continuity of care in both the inpatient and outpatient setting. Responsible for utilizing the appropriate resources within the parameters of contracts and patients health plan
Summary Prepares for and performs institutional audits to assess appropriate provider billing and to identify any aberrant billings that may have an impact on reimbursement. Responsible for reviewing all aspects of claim processing to include fraudulent
Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on
Anticipated End Date:2026-10-31 Position Title:LTSS Service Coordinator – Clinician (LSW, LCSW, LPN) Eastern Ohio Job Description: LTSS Service Coordinator – Clinician Candidates should be located in one of the following counties: Ashtabula, Columbiana, Mahoning, Richland, Marion, Franklin,
Anticipated End Date:2026-10-31 Position Title:LTSS Service Coordinator – Clinician (LSW, LCSW, LPN) Western Ohio Job Description: LTSS Service Coordinator – Clinician Candidates should be located in one of the following counties: Butler, Warren, Clinton, Clermont, Hamilton, Montgomery,
Title: Nursing Instructor - LPN Salary Range: $57,000.00 - $59,000.00 Contract Term Length: 10 Months Standard Hours: 37.50 Work Location: Hybrid FLSA Status: Exempt College: Jefferson Community & Technical College Campus Location: Jefferson Community College Department: Nursing Total
Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on
Empowering lives, healing hearts, embracing future Are you ready to make a lasting impact in specialty care? We’re seeking a dedicated and dynamic Bilingual Field Reimbursement Specialist - RN/LPN to join our Patient Support Programs at BioScript
Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track
Review Nurse This is a contract assignment that will start right away and end on April 30th 2024 Summary Description: The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data
Job DetailsLevel: ExperiencedJob Location: Involuntary Remote TMC - Remote, SC 29486Position Type: Full TimeEducation Level: High School Diploma or GEDSalary Range: $85,000.00 - $92,000.00 Salary/yearTravel Percentage: NoneJob Shift: DayJob Category: Admin - ClericalPOSITION SUMMARY: The medical
Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the
Become a part of our caring community The LTSS Care Coordinator (Care Coach 1) employs a variety of strategies, approaches, and techniques to manage a members health issues. The LTSS Care Coordinator (Care Coach 1) understands
JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports (LTSS)-specific activities. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to
Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the
Anticipated End Date:2026-09-11 Position Title:LTSS Svc Coordinator-Clinician Job Description: LTSS Svc Coordinator-Clinician Location: This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with
Anticipated End Date:2026-09-18 Position Title:LTSS Service Coordinator - RN Clinician (Plainview Texas) Job Description: LTSS Service Coordinator - RN Clinician The candidate should reside in Plainview, Texas and must be open to travel up to 1
Anticipated End Date:2026-10-05 Position Title:LTSS Svc Coordinator- RN Clinician Job Description: LTSS Svc Coordinator- RN Clinician Location: This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as
This is a remote position. What We Do At Outsource Access, we help Nurse Partners, a premier healthcare staffing agency, match qualified nursing professionals to individualized care assignments across the Greater Philadelphia area. We dont just