Your Role 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 Registered Nurse Case Manager will report to the FEP Department Ma

Your Role The Federal Employee Program (FEP) Care Management team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with their care including a multidisciplinary team and the member's treating physicians. The Registered Nurse Case Managemen

Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination o

Claims Manager TPA Remote Job Locations US CA LOS ANGELES Job ID 2024 3803 Category Claims Type Regular Division Surplus & Specialty Crum & Forster Company Overview Crum & Forster (C&F) with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial

Gather data and File third party property damage claims, third party injury claims, automobile accident claims, property claims, and workers compensation claims with the carrier. Attend all claims reviews, track action items and provide follow up reports. Work with director of risk, claims manager, and legal counsel on litigated claims. Maintain a temporary disability log

Apply if looking for Flexibility and Financial Freedom

Apply if looking for Flexibility and Financial Freedom

Apply if looking for Flexibility and Financial Freedom

Apply if looking for Flexibility and Financial Freedom

Apply if looking for Flexibility and Financial Freedom

Assist in efforts to enhance ease of use of physician portal and future services enhancements Assist providers and members with basic inquiries about claims, authorizations, benefits, and other issues Fostering and maintaining proactive, positive relations throughout the provider network by communicating with provider offices through face to face visits, emails, telephone

Must have High school diploma, GED or equivalent required, Two year degree preferred. Minimum of 3 years previous experience working for a Health Plan, IPA, or other Managed Care Organization. Minimum of 2 years previous direct experience that included verifying and maintaining provider information and provider contract configuration in a managed care transaction system .

Senior Claim Examiner Workers Compensation (CA) Requisition ID 2024 25313 Job Locations US CA Brea Position Type Regular Full Time Category Claims Business Unit BUS_TPA US Excellence In Everything We Touch Position Summary GREAT WORK FROM HOME CAREER OPPORTUNITY! Seeking candidates with experience managing CA WC claims! SIP is a requirement! Bonus Opportunities! Multiple

Senior Claim Examiner Workers Compensation (CA) Requisition ID 2024 25333 Job Locations US CA Brea Position Type Regular Full Time Category Claims Business Unit BUS_TPA US Excellence In Everything We Touch Position Summary GREAT WORK FROM HOME CAREER OPPORTUNITY! Seeking candidates with experience managing CA WC claims! SIP is a requirement! Bonus Opportunities! Multiple

Take on an important role within an award winning health organization. Help ensure the efficient operation of a complex health system. Take your career to the next level. You can do all this and more at UCLA Health. You will receive urgent, routine, pre service, and retro authorization requests, as well as process prior authorization requests with accuracy and timeliness.