Healthcare Advocate Specialist
6 days ago
As a Healthcare Advocate Specialist at American Health Partners, you will play a critical role in ensuring the highest level of satisfaction for our Medicare Advantage members. Your primary responsibility will be to process, track, and follow up on all medical necessity and administrative denials and appeals within specified timeframes established by regulatory agencies or customer needs.
Job SummaryWe are seeking an experienced professional with excellent communication skills and a passion for delivering exceptional customer service to join our team. The ideal candidate will have a minimum of three years' experience in health plan operations, preferably in grievance and appeals, with knowledge of managed care, utilization management processes, and NCQA/HEDIS accreditation requirements.
Key Responsibilities:- Capture, investigate, and respond to all complaints regarding customer grievances and appeals involving provision of service and benefit coverage issues.
- Conduct pertinent research to evaluate, answer, and close appeals.
- Ensure appropriate resolution to inquiries, grievances, and appeals within specified timeframes established by regulatory agencies or customer needs.
In this role, you will work collaboratively with internal departments and external stakeholders to resolve member issues efficiently and effectively. You will also maintain privacy and confidentiality of records, conditions, and other information relating to residents, employees, and facilities.
Requirements:- Minimum three years' experience in health plan operations, preferably in grievance and appeals.
- Excellent communication skills and active listening.
- Positive, engaging customer service skills.
- Ability to work cooperatively with internal departments and external stakeholders.
- Knowledge of managed care, utilization management processes, and NCQA/HEDIS accreditation requirements.
We offer a competitive salary of $65,000 - $85,000 per year, depending on experience, plus a comprehensive benefits package that includes medical, dental, vision insurance options, generous paid time-off program, and 401K retirement accounts with company match.
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Healthcare Specialist
6 days ago
Kansas City, Kansas, United States Della Infotech, Inc. Full timeJob SummaryThis is an exciting opportunity to work as a skilled healthcare professional in the Acute Care department at Della Infotech, Inc. As a Healthcare Specialist, you will be responsible for delivering high-quality patient care and services.About the JobThe position involves working in a fast-paced environment with a heavy surgical population. You will...
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Clinical Healthcare Coordinator Specialist
7 days ago
Kansas City, Kansas, United States Della Infotech, Inc. Full timeWe are seeking a skilled Clinical Healthcare Coordinator Specialist to join our team at Della Infotech, Inc. in Kansas City, KS.The estimated salary for this role is $120-$150 per hour, based on industry standards and the location.About the RoleAs a Clinical Healthcare Coordinator Specialist, you will be responsible for supporting the head and neck patient...
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Kansas City, Kansas, United States Host Healthcare Full timeAbout Host HealthcareWe are an award-winning travel healthcare company with a strong presence in the industry. Our commitment to providing unparalleled service has made us the agency of choice for new and experienced travelers.Salary and BenefitsAs a Traveling Healthcare Professional for Speech Language Pathology, you can expect a competitive salary package...
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Travel Dialysis Healthcare Specialist
2 days ago
Kansas City, Kansas, United States HealthCare Support Full timeAbout HealthCare SupportWe are a leading healthcare staffing agency dedicated to providing exceptional care professionals for various medical facilities across the United States.Job OverviewThis 13-week assignment in Kansas City, KS offers a unique opportunity to work as a Travel Dialysis Technician with our team. You will be responsible for delivering...
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Surgical Nurse Specialist
7 days ago
Kansas City, Kansas, United States Providence Medical Center Full timeWe are seeking a highly skilled and experienced Surgical Nurse Specialist to join our team at Providence Medical Center. This is a unique opportunity for a talented healthcare professional to make a meaningful difference in the lives of our patients while advancing their career.About the RoleThis position involves working as a traveling healthcare...
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Radiology Imaging Specialist
4 weeks ago
Kansas City, Kansas, United States Summit Medical Staffing Allied Full timeAbout the JobWe are seeking an experienced Radiology Imaging Specialist to join our team at Summit Medical Staffing Allied.The successful candidate will be responsible for performing a variety of imaging procedures, including fluoroscopy and radiography. This is a travel assignment in Kansas City, Kansas, with a duration of 14 weeks.Job...
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Home Healthcare LPN Specialist
2 days ago
Kansas City, Kansas, United States Maxim Healthcare Services Full time**Experienced LPNs Wanted for Home Healthcare Roles in Kansas City**We are recruiting skilled Licensed Practical Nurses (LPNs) to provide expert patient care in the home setting through our esteemed organization, Maxim Healthcare Services.**Why Choose Us?**Excellent Compensation Package: Up to $65,000 per year, depending on qualifications and...
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Diagnostic Imaging Specialist
4 days ago
Kansas City, Kansas, United States Healthcare Support Full timeJob SummaryWe are seeking a skilled Diagnostic Imaging Specialist to fill a travel position in Kansas City. As a diagnostic imaging specialist, you will be responsible for operating MRI equipment to produce high-quality images of the body's internal structures.About the JobThis is a 13-week travel assignment working 36 hours per week with a shift schedule of...
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Advanced Diagnostic Imaging Specialist
7 days ago
Kansas City, Kansas, United States Springboard Healthcare Full timeSpringboard Healthcare Seeks Advanced Diagnostic Imaging SpecialistWe are seeking an experienced Advanced Diagnostic Imaging Specialist to join our team in Kansas City, Kansas. This 13-week contract position requires the ideal candidate to work a minimum of 40 hours per week.Job Requirements:Specialty: Interventional Radiology TechnologistDiscipline: Allied...
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Radiology Specialist in Kansas City
6 days ago
Kansas City, Kansas, United States Concentric Healthcare Staffing Full timeConcentric Healthcare Staffing is a leading staffing firm specializing in Radiology placements. Our team of experts is dedicated to connecting talented professionals with exciting opportunities in the Kansas City, KS area.We are currently seeking a skilled Radiology Specialist for a week-long contract. This position offers a unique chance to work with a...
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Diagnostic Imaging Specialist
2 days ago
Kansas City, Kansas, United States Healthcare Support Full timeHealthcare Support is a renowned provider of national healthcare and medical recruiting services, boasting an industry-leading approach that connects top healthcare professionals with esteemed organizations.The company's specific focus on healthcare recruiting has earned it a reputation as one of the country's top employment partners.About this JobWe are...
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Registered Nurse
2 days ago
Kansas City, Kansas, United States GHR Healthcare Full timeJob SummaryWe are seeking an experienced Registered Nurse to join our team as a Telemetry Specialist in Kansas City, Kansas. This is a 13-week local contract nursing job that offers a competitive pay package and the flexibility to work with different facilities.About the Role Salary: $52/hr (starting rate)This role requires a minimum of 1 year of experience...
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Healthcare Leadership Specialist
6 days ago
Kansas City, Kansas, United States CoreMedical Group Full timeJob Opportunity at CoreMedical GroupWe are seeking a highly skilled Healthcare Leadership Specialist to join our team in providing exceptional patient care and leadership in an acute care setting. About the Role:This position requires a minimum of 2 years of recent (within the last year) Acute Care Leadership experience with 5+ years of total RN...
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Diagnostic Imaging Specialist
2 days ago
Kansas City, Kansas, United States Host Healthcare Full timeExplore a rewarding opportunity with Host Healthcare, an award-winning travel healthcare company. We have an immediate opening for an MRI Technologist position in West Plains, MO.About Host HealthcareHost Healthcare is a reputable agency that has earned the trust of new and experienced travelers alike. Our dedicated team members prioritize transparency and...
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Nurse Recruitment Specialist
1 week ago
Kansas City, Kansas, United States GHR Healthcare Full timeMed Surg Travel Nurse Job OpportunityGHR Healthcare, a leading healthcare staffing agency with over 30 years of experience, is currently seeking a skilled Med Surg travel nurse for a 13-week contract in Kansas City, Kansas.About the Job:Duration: 13 weeksShift: 12 hours, nightsEmployment Type: TravelSpecialty: Med SurgDiscipline: RN36 hours per...
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Labor Delivery Nurse Specialist
7 days ago
Kansas City, Kansas, United States Healthcare Staffing Plus Full timeJob Title: Labor Delivery Nurse SpecialistAbout the Role:We are seeking a skilled Labor Delivery Nurse Specialist to join our team at Healthcare Staffing Plus. As a key member of our healthcare team, you will be responsible for providing high-quality patient care in a fast-paced labor and delivery environment.Key Responsibilities:Assess and coordinate...
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Insurance Coverage Specialist
7 days ago
Kansas City, Kansas, United States Diedre Moire Corp. Full timeJob SummaryWe are seeking a skilled Insurance Coverage Specialist to join our team at Diedre Moire Corp. in Kansas City, KS. As an Insurance Coverage Specialist, you will be responsible for underwriting general liability excess surplus coverage for contractors and construction companies.Key Responsibilities:- Manage a profitable book of new and renewal...
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Advanced Healthcare Professional
1 week ago
Kansas City, Kansas, United States HealthTrust Workforce Solutions Full timeExemplary Patient Care and Career Advancement OpportunitiesWe are seeking a skilled and compassionate Registered Nurse to join our healthcare team as an Intermediate Care specialist. As part of HealthTrust Workforce Solutions, you will have the opportunity to work in a hospital setting, providing top-notch care to patients and supporting their recovery...
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Travel Nurse PCU Specialist
1 week ago
Kansas City, Kansas, United States Genie Healthcare Full timeGenie Healthcare is a leading provider of travel nursing services. As a Travel Nurse PCU Specialist, you will be working in the Progressive Care Unit (PCU) at a facility in Wyandotte, Michigan.About Genie HealthcareWith over 4000 current travel RN contracts open, Genie Healthcare offers flexibility, support, top pay scale, housing, and multi-state health...
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Mobility Rehabilitation Specialist
2 days ago
Kansas City, Kansas, United States Go Healthcare Full timeAbout the RoleAt Go Healthcare, we are seeking a skilled Mobility Rehabilitation Specialist to join our team for a travel assignment in Kansas City.Job SummaryThis is a 12-week contract with a guaranteed 40 hours per week. The ideal candidate will have experience as a Physical Therapist and be licensed in their field.Key ResponsibilitiesAssess patients'...