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.
$74.8k - $112.2k
...Behavioral Health Case Mgr - CT08IE We... ...service and superb claim outcomes! The... ...Behavioral Health Case Managers who are... ...assessments and interpret clinical information. They... ...roundtables to ensure optimal outcomes.... ...primarily based on analysis of similar positions...ClaimsTemporary workWork experience placementWork at officeRemote work3 days per week$50 per hour
...specifically in the Cognitus Incurred Cost Claim (ICC) arena.Your Mission:In... ...multiple project teams to optimize end-to-end processes. You... ...processes• Performing gap analysis and system re-engineering of... ...• Established program management skills (traditional and/or agile...ClaimsFull timeTemporary workWork experience placementCasual workFlexible hours- ...participating in complex case reviews and... ...role, you will manage a small team of... ...Repricing Optimization System Mastery... ...CCI edits, and clinical validation... ...and UCR value analysis. Technical Expertise... ...coverage at no cost. Our generous... ...,000 insurance claims annually for leading...ClaimsContract workTemporary workRemote work
- ...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
$82k - $99k
...MBP is looking for a Cost Estimator in the U.S. Northern Virginia area, with experience... ...general contracting, construction management, CPM scheduling, value engineering, risk management, constructability review, claims analysis, and/or contract administration. Occasional...ClaimsFull timeContract workFor contractorsWork at officeNight shift- 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
$73.8k - $130.18k
...Risk Management AnalystLockheed 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 base...ClaimsFull timeTemporary workPart timeWork experience placementWork at officeRemote workFlexible hours2 days per week- ...Job Description Job title: Cost Estimator Location: Seattle... ...services consist of project management, construction management,... ...contractor pricing for changes, claims, and other project impacts. You... ...estimating, cost analysis, engineering, cost tracking systems...ClaimsFull timeContract workFor contractorsFor subcontractorWork at office
- ...Nurse Case ManagerBattelle delivers when... ...and development, manage national laboratories... ...is dedicated to optimizing and sustaining the... ...nursing principles and clinical expertise to... ...ensuring appropriate and cost-effective... ...generated outcome analysis information to provide...Full timeWork at officeLocal areaRemote workFlexible hours
$89.07k - $162.8k
...Serves as a member of the Case Management Team and applies RN clinical expertise and medical... ...the delivery of quality cost effective patient-centered... ...resources and works to achieve optimal clinical and resource... ...service surveys LOS data analysis charge/discharge data comparison...Temporary work$66.9k - $117.1k
...cash application, and denial management processes. You will hypothesize... .... Through data-driven analysis and manual review, you will identify... ...to revenue leakage, claim denials, and operational inefficiencies... ...controllership at the lowest cost to the company. We provide...ClaimsFlexible hours$76.6k - $127.6k
...development, and configuration management. Collaborate with... ...law enforcement, and case teams to gather,... ...Analyze health insurance claims data, open source, and... ...fraudulent behavior. Conduct analysis of open source and... ...advantage by optimizing “heart of the business...ClaimsLocal area- ...Financial/Actuarial Associate Manager As a Healthcare Financial/Actuarial... ...and measurement and financial analysis of the full spectrum of... ...plan analysis, design, cost avoidance, risk and funding strategies... ...accurate and reliable claim reporting and financial modeling...ClaimsTemporary workWork at officeLocal areaRemote workFlexible hours
- ...assessment, and dependency analysis of existing... ...SQL Database, Azure SQL Managed Instance)Perform database... ...database performance and optimize queries, indexing, and... ...environmentsAssist in cloud cost optimization related to... ...sensitive member and claims dataAutomation, Documentation...Claims
$80.3k - $133.9k
...covering valuation modeling, cost optimization, restructuring, government... ...You’ll Do We are seeking a Claims Data Consultant to join our... ...Translating research questions into analysis-ready definitions, including... ...and circumstances of each case. A reasonable estimate of...ClaimsLocal area- ...Description Job Description Job Title: Case Manager Location: Tysons - VA About Us:... ...and Letters of Protection (LOPs), file claims, and ensure timely case documentation in... ...providers to verify balances and reduce costs for clients. Case Resolution: Collaborate...ClaimsRemote work
- ...design, development, and optimization of data pipelines using Databricks... .... Architect and manage Snowflake and BigQuery... ...performance, scalability, and cost-efficiency.... ...Perform advanced data analysis on healthcare datasets (claims, EMR, HL7, FHIR) to support...Claims
$115k - $165k
...Head of ClaimsJob Description:The Senior Manager, Claims & Risk Management leads HITT's... ...adequacy, litigation oversight, and total cost of risk while leading the claims organization... ...problem-solving skills.Proficiency in data analysis, Microsoft Excel, and translating...ClaimsFull timeFor subcontractorLocal area$140 - $155 per hour
...support the Research and Cost Trends (RCT) department... ...prepare the All-Payer Claims Database (APCD), advise... ...structural changes to case-mix and evaluate existing... ...Health Information and Analysis (CHIA). The SAS... ...report directly to the Manager of Research and Cost Trends...ClaimsHourly payContract workPart timeWork at officeRemote work$70k - $130k
...to apply for the Scheduling / Cost Engineer role at MKA International... ...And Duties Include Create/manage/analyze CPM schedules. Analyze... ...baselines based on thorough analysis of project requirements. Analyze... ...Builder’s risk insurance claims and/or construction contract dispute...Full timeContract workFor contractors$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- ...handling complex insurance claims disputes with a focus on excellence... ...to new business while managing cases from start to finish. This is... ...legal research and analysis to develop innovative strategies... ...seamless case management and optimal outcomes. ~ Execute strategies...ClaimsTemporary workLocal areaFlexible hours
$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$146k - $194k
...environmentsAnalyze and optimize algorithms for EO/IR... ...including Monte Carlo analysis, recorded sensor playback... ...requirements management, trade studies, and verification... ...at little to no cost to employees) ensures... ...or fraudulent outreach claiming to be from Anduril, please...ClaimsFull timeWork experience placementImmediate start$166k - $220k
...simulation including Monte Carlo analysis, recorded sensor playback,... ...to production C/C++ code optimized for real-time operational systemsSupport... ...(available at little to no cost to employees) ensures you’re... ...or fraudulent outreach claiming to be from Anduril, please report...ClaimsFull timeWork experience placementImmediate start- ...pushing the boundaries of how we manage and deliver projects. As... ...project progress, conducting an analysis of project documents and schedules... ...documentation, and Project costs. Perform inspections of Project... ...Risk Delay in Start-up (DSU) claims. Evaluate Project...ClaimsFor contractorsFlexible hours
$129k - $171k
...and SaaS applicationsBuild and optimize tailored detection signatures... ...in security monitoring, log analysis, and detection engineering... ...package (available at little to no cost to employees) ensures you’re... ...or fraudulent outreach claiming to be from Anduril, please report...ClaimsFull timeWork experience placementImmediate start$125k - $134k
...Resources and Benefits Manager (Falls Church)... ...to lead and optimize our people operations... ...optimize plan design and cost efficiency Ensure... ...administration, claims tracking, and... ...Background in compensation analysis and rewards... ...be determined on a case‑by‑case basis. In...ClaimsFull timeLocal areaRemote workWork from homeFlexible hours$118.34k - $177.51k
...Sequencing and proprietary data analysis, we can identify over 1,... ...their most challenging cases, with a future vision of accelerating clinical trials, discovering new... .... The Clinical Sales Manager is responsible for the... ..., where necessary or optimal, to memorialize long-term...Remote jobFull timeLocal areaImmediate startWorldwide$191k - $253k
...novel approaches and optimizations for complex operational... ...including Monte Carlo analysis, recorded sensor playback... ...engineers, program managers, and customersPREFERRED... ...at little to no cost to employees) ensures... ...or fraudulent outreach claiming to be from Anduril, please...ClaimsFull timeWork experience placementImmediate start
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