Clinical appeals reviewer jobs in Dover, DE

 ...inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You’ll Be Doing: As an Initial Clinical Reviewer, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in... 

 ...our caring community and help us put health first The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals Nurse 2 work assignments...  ...appropriate courses of action. The Appeals Nurse 2 reviews documentation and interprets data obtained from clinical... 

 ...available for this opportunity. Requisition #: 73054 The Role at a Glance We are excited to bring on an Appeals Specialist to join our Appeal Review Department in a fully remote environment. Appeal Specialists conduct reviews, investigation, and analysis of an... 

 ...you motivated by driving business outcomes and interested in partnering closely with the business leadership in Income Tax Audit and Appeals within Lumen? Does working in a fast-paced environment with agility sound exciting? We are seeking a Senior Tax Manager to lead... 

 ...at Humana in Dover, Delaware, United States Become a part of our caring community and help us put health first The Claims Review Representative 3 adjudicates claims in Humana’s legacy systems and Pareo upon making appropriate claim decisions. Decisions are made... 

Job Description \n\t\n\t\tCodebeautify.org Text to HTML Converter\n\t\n\t\n\t\t Summary\n \nCorrections professionals who foster a humane and secure environment and ensure public safety by preparing individuals for successful reentry into our communities. Our highly...

 ...Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of...  ...communication skills + 5 years of established clinical experience + Knowledge of the managed care industry... 

 ...-depth evaluation of variable factors. Humana MarketPoint is seeking a Senior Compliance Professional with a focus on Marketing Review who will work within the business to develop and maintain key relationships with internal and external business partners to evaluate... 

 ...Horizons is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support the coordination, documentation and...  ...to take about 15 to 30 minutes. Your recorded screen will be reviewed, and you will subsequently be informed if you will be moving forward... 

 ...practice of your own, we’re excited to support you in reaching your goals! Wage: Between $84 - $131 an hour Are you a licensed Clinical Psychologist looking to launch a private practice, or grow your existing practice? Headway supports thousands of mental health... 

 ...practice of your own, we’re excited to support you in reaching your goals! Wage: Between $84 - $131 an hour Are you a licensed Clinical Social Worker looking to launch a private practice, or grow your existing practice? Headway supports thousands of mental health... 

 ...Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support the coordination, documentation and communication...  ...interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving... 

 ...Duties WHAT ARE THE APPEALS, CRIMINAL INVESTIGATION, AND TRANSFORMATION & STRATEGY OFFICE DIVISIONS? A description of the business...  ...by Direct Deposit/Electronic Funds Transfer. * Undergo a review of prior performance/conduct and an income tax verification. Refer... 

 ...deploy war-winning capabilities for the United States Air Force. The Air Force Civilian Service (AFCS) is looking for a Full-Time Clinical Social Worker (GS-0185-12) to work at the 436 Security Forces Squadron (SFS) on Dover AFB in Dover, DE. The primary purpose of... 

 ...based, training and development programs including new employee orientation, preceptor training, facility specific in- services, and clinical, quality, and customer service training programs to promote quality patient care, and achieve Area, Regional and/or Enterprise... 

 ...+ Apply judgment within defined parameters + Receive general guidance and additional detailed instruction on new projects + Review work for sound reasoning and accuracy + Occasional travel to the office for training/meetings as needed Responsibilities + Execute... 

 ...our Airmen and their families face may feel overwhelming or difficult to overcome. Concentrating on the social aspects of health, Clinical Social Workers help individuals improve the quality of their lives. From diagnosing various issues to offering guidance and counseling... 

Job Information Humana VP, Clinical Operations in Dover Delaware Description VP, Clinical Operations and Chief Clinical Officer of Kindred at Home, you will be responsible for planning and creating the ongoing strategic, operational, and service design to achieve the mission... 

 ...working to create vitality for life. We're currently seeking a Clinical Admissions Director - Hospital Liaison (focused on Referral...  ...Are you energized by the fast-pace and complexities of patient review? * Do you want to make a meaningful impact by matching... 

 ...Work® Most Loved Workplace® Forbes Best-in-State Employer Clinical Manager This manager will have to be able to work the PST...  ..., and high quality delivery of case management and utilization review services to clients by managing and training either a dedicated...