Under the direction of the Branch Manager or Field Leader, the Mobile Examiner's primary responsibility is to provide coverage in the field ensuring that mobile exams are completed accurately and on time. Maintain a safe and professional environment for applicants, clients, and employees, perform with confidence all aspects of an insurance exam, including specimen collect

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 Nurse Consultant will report to the Manager of Care Management for the Population Health Management Medi Cal Team. In this role, you will ensure that services are provided based on

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

Load, process, and summarize various data types and files using MATLAB or similar program. Further organize, clean, sort, and analyze data using SPSS, R, SAS, or related data analysis programs and interpret meaningful findings in tables, graphs, and written form. Conduct casualty assessment using currently available high rate blast data and published computational models.

Must have High school diploma, GED or equivalent required, Two year degree preferred. Minimum of 3 years previous experience working for a Health Plan, IPA, or other Managed Care Organization. Minimum of 2 years previous direct experience that included verifying and maintaining provider information and provider contract configuration in a managed care transaction system .

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 M

Analyzes, configures, develops, tests, implements, supports and maintains Epic revenue cycle applications, solutions and business processes to meet operational and technical requirements. Obtains and maintains in depth knowledge of software functionality and acquires as well as utilizes knowledge of operational workflows to be implemented. Areas of responsibility may be H

Providence caregivers are not simply valued they're invaluable. Join our team and thrive in our culture of patient focused, whole person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence is calling a Senior Claims Insurance Manager Medical Profe

Accountable for a full range of provider relations including engagement with and development of prospective providers Design and implement strategies to increase the membership of providers in the network Create and execute a marketing plan to build and nurture provider network Identify needs in provider network, incorporating potential gaps related to composition, servic

Analyzes, configures, develops, tests, implements, supports and maintains Epic revenue cycle applications, solutions and business processes to meet operational and technical requirements. Obtains and maintains in depth knowledge of software functionality and acquires as well as utilizes knowledge of operational workflows to be implemented. Areas of responsibility may be H

The Senior Claims Specialist is responsible for the processing of complex institutional claims (stop loss, contracted, non contracted, per diem, case rate etc.) and adjudication and claims research when necessary. Senior Claims Specialist must have knowledge of compliance issues as they relate to claims processing and ability to identify and address non contracted provide

The Senior Claims Specialist is responsible for the processing of complex institutional claims (stop loss, contracted, non contracted, per diem, case rate etc.) and adjudication and claims research when necessary. Senior Claims Specialist must have knowledge of compliance issues as they relate to claims processing and ability to identify and address non contracted provide

Apply if looking for Flexibility and Financial Freedom

Incumbent is responsible for obtaining all necessary authorizations in accordance with established guidelines. Verifies eligibility, obtains benefit information, and generates letters for authorizations. Responds to Member Services and Call Center inquiries and resolves any identified authorization issues which arise. The essential functions listed below are not intended