(FEP) Correspondence Phone Support, Intermediate

Client: Health insurance industry Job Title: Quality FEP Business Analyst Location: Hybrid in Philadelphia, PA Duration: Contract to hire Job Description: Work in a production environment handling transactions required as well as business support to teams as needed. Handle claims production tasks such as written inquiries and reconsiderations and related...

Job Title: Quality FEP Business AnalystWe are seeking a skilled Quality FEP Business Analyst to work in a production environment handling transactions and providing business support to teams as needed.Key Responsibilities:Handle claims production tasks such as written inquiries and reconsiderations.Assess FEP procedures and regulations, and incorporate...

Key Responsibilities Review medical documents and apply clinical criteria to establish the most appropriate level of care. Conduct retrospective utilization reviews and first-level determination approvals for members using BSC evidenced-based guidelines, policies, and nationally recognized clinical criteria across lines of business or for a specific line of...

Your Role Work schedule is Mon-Fri 10am- 7pm The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members’ care including clinical nurses and treating physicians. The Regional...

Your Role Work schedule is Mon-Fri 10am- 7pm The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members’ care including clinical nurses and treating physicians. The Regional...

Duncan Solutions, a wholly owned subsidiary of Navient, is a full-service tolling and parking management company and a leading provider of business processing services to government clients, including citation processing, debt collection, and integrated parking and tolling customer service. We are currently seeking a Correspondence Specialist for retrieving,...

Duncan Solutions, a wholly owned subsidiary of Navient, is a full-service tolling and parking management company and a leading provider of business processing services to government clients, including citation processing, debt collection, and integrated parking and tolling customer service.We are currently seeking a Correspondence Specialist for retrieving,...

Duncan Solutions, a wholly owned subsidiary of Navient, is a full-service tolling and parking management company and a leading provider of business processing services to government clients, including citation processing, debt collection, and integrated parking and tolling customer service. We are currently seeking a Correspondence Specialist for...

Your Role Schedule is Mon-Fri 10am-7pm The Behavioral Health Registered Nurse Case Manager will report to the FEP Department Manager. In this role you will determine, develop, and implement a plan of care based on accurate and comprehensive assessment of the member's needs. The Federal Employee Program (FEP) team performs integrated case management (CM) and...

Schedule is Mon-Fri 10am-7pm The Behavioral Health Registered Nurse Case Manager will report to the FEP Department Manager. In this role you will determine, develop, and implement a plan of care based on accurate and comprehensive assessment of the member's needs. The Federal Employee Program (FEP) team performs integrated case management (CM) and disease...

Your Role The clinical services coordinator (CSC) will report directly to the supervisor of care management support operations and will serve as an initial point of contact for providers and members in the medical management process by telephone or correspondence. The CSC will interact telephonically with members as per established protocol or direction to...

Schedule is Mon-Fri 10am-7pm The Behavioral Health Registered Nurse Case Manager will report to the FEP Department Manager. In this role you will determine, develop, and implement a plan of care based on accurate and comprehensive assessment of the member’s needs. The Federal Employee Program (FEP) team performs integrated case management (CM) and disease...

Your Role Schedule is Mon-Fri 10am-7pm The Behavioral Health Registered Nurse Case Manager will report to the FEP Department Manager. In this role you will determine, develop, and implement a plan of care based on accurate and comprehensive assessment of the member's needs. The Federal Employee Program (FEP) team performs integrated case management (CM) and...

Schedule is Mon-Fri 10am-7pm The Behavioral Health Registered Nurse Case Manager will report to the FEP Department Manager. In this role you will determine, develop, and implement a plan of care based on accurate and comprehensive assessment of the member’s needs. The Federal Employee Program (FEP) team performs integrated case management (CM) and disease...

Your Role The clinical services coordinator (CSC) will report directly to the supervisor of care management support operations and will serve as an initial point of contact for providers and members in the medical management process by telephone or correspondence.  The CSC will interact telephonically with members as per established protocol or direction to...

Job SummaryThe Clinical Review Specialist, Senior at Blue Shield of California will lead retrospective utilization reviews and first-level determination approvals for members using BSC evidenced-based guidelines, policies, and nationally recognized clinical criteria across lines of business or for a specific line of business such as Medicare and FEP.Key...

Your Role Work schedule is Mon- Fri 10am-7pm The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members’ care including clinical nurses and treating physicians. The Triage...

Your Role Schedule is Mon-Fri 10am-7pm The Behavioral Health Registered Nurse Case Manager will report to the FEP Department Manager. In this role you will determine, develop, and implement a plan of care based on accurate and comprehensive assessment of the member’s needs. The Federal Employee Program (FEP) team performs integrated case management (CM)...

Schedule is Mon-Fri 10am-7pm The Behavioral Health Registered Nurse Case Manager will report to the FEP Department Manager. In this role you will determine, develop, and implement a plan of care based on accurate and comprehensive assessment of the member’s needs. The Federal Employee Program (FEP) team performs integrated case management (CM) and disease...

Case Management - Behavioral Health Nurse at Blue Shield of California summary: The Behavioral Health Registered Nurse Case Manager coordinates care for members by developing and implementing individualized treatment plans based on comprehensive assessments. This role involves collaborating with healthcare professionals to ensure quality, effective, and...