Senior Clinical Appeals Manager
Health Business Solutions LLC
A healthcare solutions company seeks a Manager of Clinical Appeals in New York. The role involves overseeing clinical appeals operations with commercial and government payers, leading a team, and ensuring compliance with payer guidelines. Ideal candidates should have significant experience in clinical appeals and team leadership, particularly in managing remote teams. The position requires strong writing skills and a thorough understanding of medical coding and payer processes. Competitive salary and benefits offered. #J-18808-Ljbffr Health Business Solutions LLC
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...groups, and members as needed. Utilizes clinical knowledge and experience to support value... ...Leadership Skills: Project planning and management Core Skills: Strategy Develops,... ...utilization management, case management, PA, appeals) Healthcare programs (disease management...- ...member, provider, client, and broker issues. Monitor complaints, appeals, grievances, and service trends to identify opportunities for... ..., inventory, turnaround times, quality metrics, and backlog management. Coordinate cross-functional teams to resolve complex claims processing...Senior
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...Provides behavioral health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs... ...behavioral health clinical reviews, peer reviews and appeals. Supports behavioral health committees for...Work experience placementWork at officeLocal area- Complexity of Work: Requires critical thinking skills, effective communications skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Required Work Experience: Two (2) years...Work experience placement
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Position Summary The Senior Principal Trainer is an individual contributor responsible for leading clinical application training in support of enterprise initiatives, system implementations, and workflow optimization. This role provides functional expertise, supports training...SeniorHourly payFull timeTemporary workLocal area- ...The People Of: Professional Services seeks a Senior Corporate Attorney with 5–10 years of capital markets experience to join its Corporate... ...teams. Florida Bar admission preferred; JD from ABA-accredited school; strong drafting and deal-management skills are #J-18808-Ljbffr...Senior
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