Thank you for your interest in joining Solventum. Solventum is a new healthcare company with a long legacy of solving big challenges that improve lives and help healthcare professionals perform at their best. At Solventum, people
Summary We are currently hiring for a Payment Integrity Nurse – Medicare Advantage to join BlueCross BlueShield of South Carolina. In this role as an Payment Integrity Nurse, you will monitor/implement quality improvement/management activities, conduct specific
Summary Performs medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices.
Job Description SummaryResponsible for providing quality nursing care while maintaining accountability for the coordination of patient care. EntityCarolina Family Care, Inc. (CFC) Worker TypeEmployee Worker Sub-TypeRegular Cost CenterCC005453 MHP In-Basket Team Pay Rate TypeHourly Pay GradeHealth-27 Scheduled
Work Location Type: Hybrid Req Number 333991 About Grainger W.W. Grainger, Inc. is a leading broad line distributor with operations primarily in North America and Japan. At Grainger, We Keep the World Working® by serving more
Work Flexibility: Field-based The Field Clinical Specialist works using independent judgement, partners with local Account Managers to increase clinical support, education resulting in increased clinical acumen. Responsibilities Educate physicians on device handling, implantation and troubleshooting techniques
Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but weve been part of the national landscape for more than seven decades, with our roots firmly
Summary We are currently hiring for an RN Behavioral Health Concierge Care Manager to join BlueCross BlueShield of South Carolina. In this role as an RN Behavioral Health Concierge Care Manager, you will provide care management
Summary We are currently hiring for an RN Appeals Analyst to join BlueCross BlueShield of South Carolina. In this role as an RN Appeals Analyst, you will research the substance of complex appeal or retrospective review
Summary We are currently hiring for a Senior Medical Reviewer to join BlueCross BlueShield of South Carolina. In this role as a Senior Medical Reviewer, you will act as Team Lead for specialty programs, medical review,
Business Analyst - Clinical Analyst & Coding Specialist Sunshine Enterprise USA is retained by our valued client to search and recruit for the following executive opening: Business Analyst - Clinical Analyst & Coding Specialist Location: Fully
Regional Payor Contracting Associate Fundamental Clinical & Operational Services, LLC is searching for an experienced Regional Payor Contracting Associate to focus on MCO and payor contracting for multiple client skilled nursing facilities and Behavioral Health Hospital located
Materials Coordinator Aiken Regional Medical Centers, located in Aiken, South Carolina, is a 273-bed acute care facility providing top quality and safe healthcare to the residents of Aiken and surrounding communities since 1917. Aiken Regional Medical
Essential Duties and Responsibilities: - Responsible for completing medical and/or behavioral health assessments within contract requirements - Conducts on-site, video call and/or telephonic assessments to determine an individuals needs for services and supports, eligibility, level of
Essential Duties and Responsibilities: - Provides advanced clinical inquiry responses (verbal and written) to health-related inquiries from consumers, educators or medical/health professionals. - Provides medical subject matter expertise. - Performs advanced database searches. - Composes documents,
Essential Duties and Responsibilities: - Provides advanced clinical inquiry responses (verbal and written) to health-related inquiries from consumers, educators or medical/health professionals. - Provides medical subject matter expertise. - Performs advanced database searches. - Composes documents,
Essential Duties and Responsibilities: - Responsible for reviewing favorable and partially favorable determinations in accordance with applicable regulations. - Render determinations for cases assigned. - Resolve all other technical issues within reconsideration assigned. - Review cases
Essential Duties and Responsibilities: - Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations. - Render medical necessity determinations for Medicare State East cases assigned. - Resolve all other technical issues within
Essential Duties and Responsibilities: - Supervise a designated team of unit staff - Responsible for the training and development of unit staff - Monitor the activities, schedules, productivity and work product results of the assigned unit
JOB DESCRIPTION Job Description Description Become a Medical Scribe First Scribe-X offers unparalleled clinical experience and preparation for medical school. * Receive extensive paid training that will help you master EMR systems and patient documentation procedures.