Medical Policy Supervisor

Job SummaryThe University of California- Davis Health is seeking a skilled LVN Supervisor to join our team. As a key member of our healthcare team, you will be responsible for providing licensed medical support to medical care providers and supervising a group of employees. This is a critical position that requires strong leadership and communication skills,...

Job DescriptionAs a Claims Supervisor at Prime Therapeutics, you will be responsible for managing a team of claims processors to ensure timely and accurate processing of medical claims. Your primary goal will be to meet or exceed customer requirements and business objectives.Key Responsibilities:Manage cross-functional team members to meet or exceed service...

Job SummaryAs a Pharmacy eFill Specialist with Dignity Health Medical Foundation, you will play a vital role in ensuring the smooth operation of our pharmacy services. This is a work-from-home position within California, requiring a valid CA Pharmacy Tech certification. Responsibilities- Gather information from medical records and other sources to process...

Job SummaryAs a Case Management Supervisor, you will oversee cases and manage the case management team for our program. This role requires strong clinical and organizational skills, as well as the ability to build rapport with a team.ResponsibilitiesSupervise cases within the assigned management team, providing direction, support, and counsel to team...

Job Summary:The Medical Coding Specialist at Dignity Health Medical Foundation plays a vital role in ensuring accurate and timely reimbursement for healthcare services. This position requires a strong understanding of coding principles, government regulatory standards, and payer-specific guidelines. The ideal candidate will have 2 years of professional fee...

Your RoleThe Medical Management team at Blue Shield of California is dedicated to ensuring that our organization is at the forefront of medical, medication, and payment policy to accelerate the emergence of a value-based healthcare system in California. As the Medical Director, Utilization Management (CalPERS), you will report to the Vice President, Medical...

About the RoleThe Medical Director, Utilization Management plays a critical role in ensuring the delivery of high-quality, cost-effective healthcare services to our members. As a key member of the Blue Shield of California Medical Management team, you will be responsible for reviewing and making determinations regarding member and provider requests for...

Job Summary:CommonSpirit Health is seeking a skilled Medical Office Coordinator to join our team. As a key member of our healthcare team, you will be responsible for coordinating transfer center activities for Dignity Health facilities.Key Responsibilities:Coordinate transfer center activities for Dignity Health facilities in collaboration with hospital...

Job OverviewCVHCare is seeking a highly organized and detail-oriented Medical Office Coordinator to join our team. The successful candidate will provide administrative support to our agency team, ensuring seamless communication and coordination of patient care services.Key Responsibilities:Provide administrative support to the agency team, including...

Job SummaryThe Medical Director, Utilization Management will serve as a key member of the Blue Shield of California Promise Health Plan's utilization management review team. This role reports to the VP, Medical Management or their designee.Key ResponsibilitiesReview and make determinations regarding all member and provider requests for service, including...

Job SummaryThe National Guard Employment Network is seeking a highly skilled Medical Claims Processor to join our team. As a Medical Claims Processor, you will be responsible for handling Personal and Business Insurance Auto Bodily Injury claims from the first notice of loss through resolution/settlement and payment process.Key ResponsibilitiesProvides...

Your RoleThe Medical Director, Operations (Behavioral Health) will report to the Senior Medical Director, Behavioral Health at Blue Shield of California. In this role, you will have core responsibilities in the areas of psychiatric inpatient concurrent review, pre- and post-service utilization review, and collaboration with Nurse Care Managers.Key...

Job OverviewAt LandCare, we're seeking a skilled Landscape Operations Manager to lead our production teams in delivering exceptional landscape services. This role is crucial in ensuring quality, efficiency, and safety while creating beautiful outdoor spaces for our clients.Key Responsibilities:Partner with account managers and clients to conduct landscape...

Job SummaryWe are seeking a highly motivated and detail-oriented Medical Record Coordinator to join our team at ExamWorks. As a Medical Record Coordinator, you will be responsible for servicing inquiries from clients, physicians, and nurses, while performing a wide range of data processing tasks, including data preparation, data entry, and documentation.Key...

Job Position Description:PuroClean, a leader in emergency property restoration services, helps families and businesses overcome the devastating setbacks caused by water, fire, mold, biohazard, and other conditions resulting in property damage. As a key member of our team, you will perform services as assigned while following PuroClean production guidelines....

Job Summary:We are seeking a highly motivated and customer-focused Customer Service Representative to join our team at Home Depot. As a Customer Service Representative, you will be responsible for providing exceptional customer service by actively seeking out customers to assess their needs and provide assistance.You will learn about our products using our...

Job Summary:As a Laborer Technician at PuroClean, you will play a vital role in our team's success. Your primary responsibility will be to perform services as assigned while following PuroClean production guidelines. This includes assisting your team and supervisors with all aspects of restoration work on residential and commercial jobsites, as well as...

Job DescriptionJob Title/Position: Nurse Care SpecialistReports To: Clinical Supervisor/Nursing SupervisorJOB DESCRIPTION SUMMARYThe nurse care specialist plans, organizes, and directs home care services, emphasizing community health education and experience. This professional builds from the resources of the community to plan and direct services to meet the...

Your Role at Blue Shield of CAThe Pharmacy Prior Authorization team provides efficient and accurate responses to external customers and internal team members for all outpatient pharmacy benefit inquiries. As a Pharmacy Technician, Intermediate, you will report to the Operations Supervisor and resolve outpatient pharmacy benefit coverage inquiries, including...

Job DescriptionBank of Marin is seeking a skilled ATM & Card Services Associate to join our Consumer Services team. This role will serve as the central resource for internal and external clients, providing expert guidance on ATM and Card services and exceptions.Key Responsibilities:Process and respond to customer inquiries and requests in a timely and...