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
$85.27k - $133.23k
Chapters Health System is seeking a Clinical Manager in Town of Florida, NY. The role involves overseeing clinical staff to ensure effective patient care delivery. The ideal candidate should have a Bachelor's degree in Nursing, a valid RN license, and significant nursing...Senior$67.9k - $182.55k
Position Overview The Senior Manager, Medical and Payment Policy Performance Research and Correct... ...and coding reviews by evaluating clinical and payment policies and identifying potential... ...(intake, edits, adjudication, denials, appeals, and adjustments) and to drive...SeniorHourly payFull timeTemporary workLocal area- Job Summary: We are seeking an experienced and highly organized Manager of Clinical Appeals to lead our clinical appeals operations across commercial and government payers. This role is responsible for overseeing day-to-day activities of clinical appeal specialists, managing...SuggestedRemote work
$18.5 - $35.29 per hour
Position Summary Responsible for managing to resolution complaint/appeal scenarios for all products, which may contain multiple issues and may require coordination of responses from multiple business units. Ensure timely, customer focused response to complaints/appeals....SeniorRemote jobHourly payFull timeLocal area$186.2k - $363.09k
Molina Healthcare is seeking a qualified Behavioral Health Medical Director in California. The ideal candidate will provide medical oversight for behavioral health services, ensure compliance with national standards, and assist with program implementation. A minimum of ...Senior$67.9k - $199.14k
The Hispanic Alliance for Career Enhancement is looking for a Senior Manager, Informatics to design and develop data solutions. The successful candidate will work alongside clinical and operational stakeholders, ensuring data accuracy and generating actionable insights....SeniorFull time$77.6k - $126.1k
...specialist for remote work with occasional office meetings in Florida. The role focuses on building relationships with clients and managing enrollment processes for large organizations. Qualifications include a bachelor’s degree, 5+ years of experience in the relevant...SeniorWork at officeRemote work- CONFLUENT MEDICAL TECHNOLOGIES INC. is seeking a Senior Staff Project Manager to join our team in Orange County, CA. The role involves overseeing medical device projects while managing budgets and ensuring effective communication across teams. Successful candidates will...Senior
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Transformcap is hiring a Clinical Supervisor in the Town of Florida, NY to oversee high-quality addiction treatment services. The role involves managing a team of counselors and ensuring clinical excellence as part of a comprehensive care model. Ideal candidates will have...SeniorMonday to Friday- Unified Women’s Healthcare is seeking a Senior Product Manager for Lucina, a maternal health platform. This role involves shaping product roadmaps based on market insights and customer feedback in a fully remote setting. Candidates should have 5-8+ years of product management...SeniorRemote jobFlexible hours
$100k - $150k
6AM City, LLC is seeking an experienced Senior Project Manager to lead large ground-up Healthcare builds. The ideal candidate will have over 7 years of experience, particularly in healthcare construction, and excel in fast-paced environments. The role involves overseeing...Senior- A healthcare institution in Florida is seeking an Office Manager III to lead and manage multiple clinics and staff operations. The ideal candidate should have significant supervisory and operational experience in a clinical outpatient setting. Responsibilities include overseeing...SeniorWork at office
$54.3k - $145.86k
The Hispanic Alliance for Career Enhancement is seeking a communicator based in Town of Florida, NY, to manage business communications initiatives for federal and postal health plans. This full-time role requires 5+ years in the health industry with a focus on strategic...SeniorFull time- ...private or public sector. Specialized experience must demonstrate the following: Performing safety and occupational health program management in complex industrial environments by conducting inspections and investigations, analyzing mishap trends, developing policies and...SeniorWork at office
- The Hispanic Alliance for Career Enhancement is seeking a Senior Manager - Digital Product Manager. This role will lead efforts to enhance customer experiences through high-quality software. Responsibilities include collaborating on product strategies, managing project...Senior
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...Town of Florida, NY. This role involves coordinating health services for children in care and developing policies for health record management. The position requires a Licensed Registered Nurse (RN) with at least one year of healthcare experience, strong communication...Senior- ...Florida is seeking a dedicated LPN CoCM Behavioral Health Care Manager to join their team in the Hollywood office. This role involves... ...administering behavioral health care planning, and engaging with the clinical team for chronic care management. Ideal candidates should...SeniorWork at office
- ...family and one community at a time. Position Summary: Aetna Medicaid Administrators, LLC, a CVS Health company, is hiring a Sr. Manager, Business Consultant to produce business intelligence by querying health care data and generating reports. Duties include: work with...SeniorHourly payFull timeTemporary workWork experience placementLocal area
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- SimiTree Talent Solutions is seeking an Administrator Home Health Operations in Florida to oversee clinical services and operations for a large facility near Orlando. Ideal candidates should have strong leadership in Home Health operations, be experts in Medicare regulations...Senior
- ...seeking a dedicated team leader for its dispensary operations in New York. This role focuses on ensuring premium patient care and managing all daily dispensary activities. Ideal candidates will have strong customer service skills, active optical licensure, and experience...Senior
- ...firm is seeking a Project Principal to oversee projects in Miami and Palm Beach. This role demands strong leadership and project management skills, ensuring successful client and architect experiences. Candidates must have a Bachelor's degree in construction management...Senior
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$115.88k - $261k
...to simplify health care one person, one family and one community at a time. Position Summary The Pharmacy Specialty Clinical Development Sr. Manager will be responsible for overseeing the development, maintenance, and execution of Pharmacy Specialty utilization management...SeniorHourly payFull timeTemporary workWork at officeLocal area- Prattwhitney is seeking a Sr. Principal Engineer, Lead Project Engineer in the Town of Florida, NY. This role involves managing technical execution for APU/Turbojet programs and providing mentorship to engineering teams. The ideal candidate will have a Bachelor’s degree...Senior
$132.4k - $251.6k
LRP Media Group is seeking a Sr. Principal Engineer to lead project engineering activities. Based in Florida, this role involves managing program activities, ensuring adherence to project management processes, and mentoring junior engineers. A Bachelor's degree in mechanical...SeniorRelocation packageFlexible hours- Northrop Grumman Corp. (JP) is seeking a Sr. Principal Quality Engineer to join their team in Apopka, FL. This role involves developing quality evaluation systems, partnering with engineering, and leading audits to ensure compliance and process improvement. The ideal candidate...Senior
- AMN Healthcare seeks a Senior Recruiter for Nursing & Allied in New York, focusing on sourcing and placing candidates in contract positions. This role emphasizes building positive relationships with candidates, understanding their career goals, and educating them on industry...SeniorContract work
- ...exhaustive and may be supplemented as necessary. Clinical Expertise and Consultation 30% Provide... ...teams (e.g., medical review staff, appeals teams) and external stakeholders.... ...years of clinical practice MBA, MHA, MS in Management, or formal accredited coursework in medical...Permanent employmentTemporary workFor contractorsWork experience placementWork at officeLocal areaImmediate startRemote work
$76.04k
Senior Trial Court Staff Attorney Location: TBD - Remote Eligible. The position also travels to other... ...position is to assist the judiciary with case management, pending litigation, processing of criminal and civil appeals, and various other issues. The work involves significant...SeniorFull timeImmediate startRemote work
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