Clinical Case Manager - Cost Optimization & Claims Analysis
ullico inc.
Ullico Inc. is actively recruiting a Case Manager for the Silver Spring, MD office. The role involves analyzing claims for potential financial exposure, gathering clinical information, and providing recommendations. Ideal candidates will possess a BSN and RN license with at least 5 years of clinical experience. Benefits include health insurance, a pension plan, and a 401K. The company has been a proud partner of the labor movement for over 95 years, ensuring protection for its customers. #J-18808-Ljbffr ullico inc.
$76.68k - $115k
Ullico is hiring a Case Manager for their Silver Spring, MD office. In this role, you will analyze claims and provide clinical insights to inform policy pricing. The ideal candidate holds a BSN and an active RN license, with at least five years of clinical experience, preferably...ClaimsWork at office- ...Insurance RN Field Case Manager This Field Case Manager... ...Apply your medical/clinical or rehabilitation... ...used in a timely and cost-effective manner in order... ...troubleshooting, problem solving, analysis, and discretion;... ...'s leading risk and claims administration partner...ClaimsLive inWork at officeRemote workWork from homeFlexible hours
- ...Registered Nurse (RN) Case Manager to work the Directorate... ...promote quality and cost-effective outcomes, across... ...care. Serves as a clinical case manager and... ...monitoring, evaluation and analysis of cases. Screen... ...Address services needed to optimize current health, psycho...SuggestedFull timeContract workTemporary workWork at officeLocal areaMonday to FridayShift workWeekday work
$76.68k - $115k
...Company is actively recruiting a Case Manager for our Silver Spring, MD... ...trigger reports” and high dollar claim referrals to identify... ...physician charges, specialty drug costs, usage and provide potential... ...alternatives. Gather and analyze clinical information and medical...ClaimsWork at office$108k - $145k
...Overview As a Senior Cost Manager at Linesight, you will work with highly experienced, culturally... ...tender/bid documentation through analysis and reporting Manage the change management... ...accounts, including the handling of any claims to ensure the client gets best value from...ClaimsContract work$186.49k - $278.88k
...with the Senior Director of Clinical Management, the Director is responsible... ...dossier. • Contributes to final analysis and interpretation including... ...in assigned therapy area to optimize scientific quality/... ...application processing fee, even if claimed you will be reimbursed, this...ClaimsContract workTemporary workLocal areaFlexible hours- We are seeking a Cost Estimator to support large-scale capital construction... ...cost estimating, change management, and the development of standardized... ...and performing what-if cost analysis Participate in and support change order and claims negotiations with contractors Facilitate...ClaimsFull timeFor contractors
- ...and development, manage national laboratories... ..., full‑time Nurse Case Manager to join... ...which is dedicated to optimizing and sustaining the... ...principles and clinical expertise to analyze... ...appropriate and cost‑effective treatment... ..., rendering, and analysis Ability to design...Full timeWork at officeLocal areaRemote workFlexible hours
$45k - $70k
The Utilization Management Nurse Reviewer plays a... ...companies, and patients to optimize healthcare delivery, control costs, and maintain... ...requires strong clinical knowledge, critical... ...final approval on cases for release to the... ...200,000 insurance claims annually for leading...ClaimsRemote jobTemporary workWork at officeWork from home- ...provide exceptional claims support, customized coverage... ...and relevant risk management resources. At UE, you... ...through process optimization, technology solutions... ...documentation, business cases, cost-benefit analyses, and... ...mapping, workflow analysis, business requirements...ClaimsHourly payWork experience placementWork at officeFlexible hours
- ...Alexandria, VA (Hybrid) Strategic Management is seeking a highly motivated... .... Conducts research and analysis on federal and state healthcare... ...Anti-Kickback Statute, False Claims Act, Stark Law, HIPAA and CMS... ...protections, and optimize the overall efficiency of their...ClaimsFull timeInterim roleWork at office
$89.07k - $162.8k
...Case Management Nurse Serves as a member of the Case Management... ...Team and applies RN clinical expertise and medical... ...delivery of quality cost effective patient-... ...and works to achieve optimal clinical and resource... ...service surveys LOS data analysis charge/discharge data...Temporary work$60k - $85k
Senior Cost Segregation Associate $60,000 - $85,000 per year |... ...clients identify, document, and claim valuable tax credits and... ...approach emphasizes thorough analysis, precise documentation, and compliance... ...in engineering, construction management, architecture, or a related...ClaimsPermanent employmentWork at officeLocal areaRemote workNight shift$73.8k - $130.18k
...Risk Management Analyst Lockheed Martin is seeking candidates desiring new skillsets, willing... ...the reporting and handling of insurance claims, including internal and external... ...requisition posting date in order to receive optimal consideration. Pay rate: The annual...ClaimsFull timeTemporary workPart timeWork experience placementWork at officeRemote workRelocationFlexible hours2 days per week3 days per week- ...the DC Office of Risk Management (ORM). ORM provides risk... ...can minimize the total cost of risk, resulting in improved... ...program, and claims for unliquidated damages... ...is responsible for the clinical oversight, administration... ...workers’ compensation nurse case management services for...ClaimsWork at officeRemote workMonday to Friday
$79k - $90k
...combine innovative technology, clinical expertise, and human... ...hands‑on workers’ compensation case management training. Join our compassionate... ...appropriately, ensure appropriate and cost‑effective healthcare services... ...recovery and return to an optimal level of work and functioning...Full timePart timeLocal areaHome officeFlexible hours- ...process. Medical Office Manager Full Time Managers... ...overseeing and supporting daily clinic operations while... ...clinical leadership to optimize provider schedules, maximize... ..., registration, and claim‑related issues associated... ...adequate stock levels, cost‑effective utilization...ClaimsFull timeWork at officeLocal area
$195k - $315k
...distribution, underwriting, policy management, billing and collection, claims management, renewals and... ...priorities; data analysis; internal risk and... ...emerging risks, control optimization, or strategic opportunities... ...achievement of objectives, cost‑effectiveness, and sustainability...ClaimsHourly payWork experience placementWork at officeLocal areaFlexible hoursShift work3 days per week- Trilogy Federal is seeking a skilled Business Analyst - ClaimsXM/ECAMS Support to join our Washington team. This role focuses on claims data analysis, process improvements, and stakeholder engagement to enhance the efficiency of claims processes. The ideal candidate will...ClaimsWork experience placement
$106.1k - $187.11k
...Property Risk Manager Lockheed Martin is seeking a seasoned Risk... ..., including renewals, claims management, and policy compliance... ...including contract review, risk analysis, and bid and proposal support... ...date in order to receive optimal consideration. Pay rate:...ClaimsFull timeContract workTemporary workPart timeWork experience placementWork at officeRemote workRelocationFlexible hoursShift work2 days per week3 days per week$120.7k - $238.22k
...The Director of Case Management provides strategic and... ...plans under a centralized clinical operations model. The... ...standardizes, implements and optimizes care management... ...members utilizing high-cost or specialty medications... ...of care data, and ROI analysis. Expertise in...$70k - $130k
...mid-to-senior Scheduling and Cost Engineer to our team of multi-... ...cost baselines based on thorough analysis of project requirements.... ...analyses and prepare reports. Manage multiple project assignments,... ...Experience Builder’s risk insurance claims and/or construction contract...Contract workFor contractors$125k - $165k
...including utilization review, claims management, payer relations, reimbursement optimization, denial management, and... ..., PHP/IOP, and case management services. Establish... ...Reimbursement variance analysis Identify process... ...accurate submission of clinical documentation supporting...ClaimsFull timeContract workRemote work- ...and measurement and financial analysis of the full spectrum of... ...well as your financial, project management and communication skills by working... ...plan analysis, design, cost avoidance, risk and funding strategies... ...accurate and reliable claim reporting and financial modeling...ClaimsTemporary workWork at officeLocal areaRemote workVisa sponsorshipWork visaFlexible hours
- ...Hill, Washington, DC Hospital Case Manager – Be the Heart of Medically... ...and strong focus on teamwork Optimal staff-to-patient ratios to prevent... ...continuity of care and cost-effectiveness through the integration... ...Positions. Education Clinical – Degree in Nursing, BSN preferred...Hourly payDaily paidFull timePart timeReliefShift workDay shift
- ...regulations. The officer will work closely with management and employees to promote a culture of... ...safety regulations. Perform root cause analysis for incidents and accidents to prevent... ...of contact for workers' compensation claims and ensure compliance with relevant laws...ClaimsLocal area
$49.31 - $54.64 per hour
...Special Operations Case / Nurse Case Manager Part-Time (National Capitol... ..., and procedures in clinical settings in order to... ...appropriate, cost effective care to Department... ...in order to ensure optimal stewardship of resources... ..., rending, and analysis. Ability to design...Temporary workPart timeLocal areaRelocation packageFlexible hours- ...role involves leadership, clinical oversight, regulatory... ..., per year, at no cost. Work/Life Balance:... ...individualized treatment plans. Manages pain and other... ...Improvement: Works with DCPP to optimize the patient and family... ...· Skill in data analysis and interpretation · Ability...Relocation packageNight shiftWeekend work
- ...Solutions & Services, Rebate Management, Network Strategy, and Strategic... ...rebate performance. Network Analysis Analyze pharmacy network... ...maintain KPIs for network unit cost, effective rate, mix shifts,... ..., PBM analytics, or contract/claims analytics. Strong Excel skills...ClaimsContract workWork at officeHome officeShift work
$223.8k - $313.1k
...background and reviews health claims. The Medical Director... ...issues where the analysis of situations or data... ...care through clinical expertise and thoughtful... ...physicians who excel in case analysis, structured decision... ...-reasoned utilization management determinations....ClaimsBi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workWork from homeHome officeMonday to FridayWeekend work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Clinical Case Manager - Cost Optimization & Claims Analysis. Be the first to apply!
- healthcare consulting manager Bethesda, MD
- healthcare supervisor Bethesda, MD
- medicare medical director Bethesda, MD
- health economics manager Bethesda, MD
- senior clinical data manager Bethesda, MD
- director of health information management Bethesda, MD
- occupational health manager Bethesda, MD
- health insurance manager Bethesda, MD
- medical director oncology Bethesda, MD
- clinical nutrition manager Bethesda, MD

