Your Role The Federal Employee Program (FEP) team performs 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 Registered Nurse Case Manager will report to the FEP Department Ma

Your Role The Federal Employee Program (FEP) Care Management team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with their care including a multidisciplinary team and the member's treating physicians. The Registered Nurse Case Managemen

Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination o

Your Role The Case Management team performs and case management (CM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members care including clinical nurses and treating MDs.. The Case Management Nurse, Senior will report to the Manager, Care Management. In this role you will determine, develop and imp

Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position. Responsible for managing patient account balances including accurate claim submission, compliance will all

Steptoe LLP, seeks an associate with 1 to 4 years of experience to join the Firm's Intellectual Property ("IP") practice group in its Chicago, Los Angeles, New York, San Francisco or Washington, DC office. Ideal candidates will have litigation, trade secret and other soft IP experience. A bachelor's degree and/or an advanced degree in electrical engineering or computer sci

To learn more about Arkansas Blue Cross and Blue Shield Hiring Policies, please click here. Applicants must be eligible to begin work on the date of hire. Applicants must be currently authorized to work in the United States on a full time basis. ARKANSAS BLUE CROSS BLUE SHIELD will NOT sponsor applicants for work visas in this position. Arkansas Blue Cross is only seeking

Responsible in the provider enrollment process to review, research, analyze, and process provider enrollment applications. Ensures provider file integrity and that suppliers are in compliance with established standards and guidelines. Description What You'll Do May perform any or all of the following in the enrollment of providers determines the acceptability of provider

Provides leadership to the proposal technical team and project team upon award of a contract Identifies differentiating factors concerning approach, design, and constructability during bid, proposal and execution phases Coordinates meetings between potential clients and individual internal specialists Provides EPC Project Management support to the Business Development gro

Be aware of, understand, and effectively carry out all delegated health, safety, and environmental responsibilities. Actively promote a health and safety culture to achieve targets of no lost time injuries or environmental incidents; all incidents are reported and accurately recorded, and all persons are suitably trained or supervised in their work. Key advisor to the Reg

Manages Maryland and District of Columbia member and provider medical appeals, Maryland complaints and grievances. Responsible for member advocate functions. Interacts directly with members, staff, physicians, and others on the telephone to resolve issues. Acts as a resource and documents all information as it relates to medical appeals/complaints and grievances. Assists w

At American Family Insurance Claims Services (AFICS, Inc.), we're embarking on a transformation of our claims capabilities that will put customers at the center of what we do best protecting and restoring their dreams when they need us most. We're leveraging our expertise, technology, and new ways of working to actively reinvent one of America's largest industries creating

Develops and maintains corporate payment policies, and works collaboratively with the Clinical Editing Manager to ensure consistency with the Plan's adjudication system(s) Monitors DHHS, EOHHS, and CMS websites, listservs and other sources to identify existing payment practice and upcoming changes Determine the scope and impact of the change on Plan operations and seek to

Senior/Executive Claims Specialist Environmental Remote Job Locations US NJ MORRISTOWN Job ID 2024 3775 Category Claims Type Regular Division Surplus & Specialty Crum & Forster Company Overview Crum & Forster (C&F) with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance compa

Claims Manager TPA Remote Job Locations US CA LOS ANGELES Job ID 2024 3803 Category Claims Type Regular Division Surplus & Specialty Crum & Forster Company Overview Crum & Forster (C&F) with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial