The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and timely return to work. This involves assessing treatment plans, communicating with physicians, and coordinating care delivery such as negotiating durable medical equipment.
Remote Full Time Jobs in United States (117,028)
Remote in = United States
Job type = Full Time
The Nurse Practitioner will conduct comprehensive annual wellness exams for patients both in-home and virtually, delivering personalized, compassionate medical care primarily to individuals with CKD and/or ESRD/ESKD. Responsibilities also include documenting patient information, coordinating care with other providers, prescribing medications, ordering tests, and ensuring timely completion of all required paperwork.
The role involves leading the design and technical execution of the Enterprise Performance Management (EPM) ecosystem, acting as the primary authority on the OneStream unified platform. Key duties include defining architectural strategy, overseeing multi-cube design, and hands-on development of complex business rules and data integrations.
The Advanced Practice Provider will conduct comprehensive annual wellness exams for patients in-home or virtually, delivering personalized, compassionate medical care primarily to individuals with CKD and/or ESRD/ESKD. Responsibilities also include coordinating care with other providers, maintaining accurate records, educating patients and families, and prescribing medications while collaborating with the Monogram physician.
CA WC Senior Claims Specialist (SIP, 4850)
CorVel Corporation
·
Full Time
·
12 Weeks Ago
CorVel Corporation
The Senior Claims Specialist manages complex Workers' Compensation claims by confirming coverage, determining compensability through investigation, and establishing reserves and authorizing payments. This role involves developing action plans with case managers to reduce claim costs, coordinating return-to-work efforts, and managing subrogation and potential recoveries.
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The Implementation Manager is responsible for product enhancement and development while managing the implementation process from prospect presentation through conclusion for new and existing clients. This role facilitates the transition of client programs to field operations and account management personnel for ongoing service.
Oil & Gas HBP Landman
Paramount Field Services, LLC
·
Full Time
·
12 Weeks Ago
Paramount Field Services, LLC
The primary responsibilities involve managing and analyzing Held By Production (HBP) assets across Texas and New Mexico by reviewing leases, drilling clauses, production data, and title to determine HBP status. This role also requires clear communication of findings to clients and teams while maintaining organized, client-ready documentation.
CA WC Senior Claims Specialist (Floater)
CorVel Corporation
·
Full Time
·
12 Weeks Ago
CorVel Corporation
The Senior Claims Specialist manages complex Workers' Compensation claims by confirming coverage, determining compensability through investigation, establishing reserves, and authorizing payments within authority limits. This role involves developing action plans with case managers to reduce claim costs, coordinating return-to-work efforts, managing subrogation and litigation, and communicating claim status to customers and claimants.
The Medical Case Manager provides in-person and telephonic case management to injured workers, involving various stakeholders to facilitate recovery. Responsibilities include assessing treatment plans for appropriateness and necessity, attending provider visits, and coordinating care elements like durable medical equipment.
The coder reverse codes previously coded medical bills to verify coding accuracy and is responsible for making claim-related recommendations. This role involves processing claims based on state rules, determining validity, and communicating claim status to relevant stakeholders.
Advanced Practice Provider - Cedar Rapids, IA
Monogram Health
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Full Time
·
12 Weeks Ago
Monogram Health
The Advanced Practice Provider will conduct comprehensive annual wellness exams for patients primarily dealing with CKD and/or ESRD/ESKD, both in-home and virtually, while delivering personalized, evidence-based care to reduce hospitalizations. Responsibilities also include maintaining accurate patient records, coordinating care with other providers, educating patients and families, and participating in integrated care team meetings.
The Advanced Practitioner will deliver personalized, compassionate medical care primarily to individuals with CKD and/or ESRD/ESKD, conducting comprehensive annual wellness exams both in-home and virtually. Responsibilities also include coordinating care with other providers, maintaining accurate patient records, and participating in integrated care team meetings to improve patient outcomes and quality of life.
The RTW Coordinator facilitates safe, timely, and appropriate return-to-work outcomes for injured employees by coordinating activities with clients, employees, and healthcare providers to identify RTW potential. Responsibilities include actively working with physicians to clarify medical restrictions and coordinating job function modifications with client locations.
Senior Claims Specialist - New England
CorVel Corporation
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Full Time
·
12 Weeks Ago
CorVel Corporation
The Senior Claims Specialist manages complex Workers' Compensation claims, ensuring adherence to company standards, coordinating with case managers and attorneys, and handling subrogation and settlement negotiations. Responsibilities include confirming coverage, determining compensability, establishing reserves, authorizing payments, and developing action plans to reduce claim costs.
The Medical Only Claims Specialist manages non-complex, medical-only workers’ compensation claims under close supervision, supporting departmental goals. Key duties include receiving claims, confirming coverage, determining compensability, establishing reserves, and communicating claim status to all relevant parties.
The Advanced Practitioner will deliver personalized, compassionate medical care, primarily to individuals with CKD and/or ESRD/ESKD, conducting comprehensive annual wellness exams both in-home and virtually. Responsibilities also include documenting patient records, coordinating care with other providers, and delivering evidence-based care to reduce hospitalizations and maximize quality of life.
The Advanced Practitioner will deliver personalized, compassionate medical care, primarily to patients with CKD and/or ESRD/ESKD, conducting comprehensive annual wellness exams both in-home and virtually. Responsibilities also include coordinating care with other providers, maintaining accurate records, and delivering timely care to reduce hospitalizations and maximize patient quality of life.
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The manager is responsible for driving business results by achieving revenue goals, developing regional sales plans, and promoting the company's value proposition through active prospecting and customer engagement. This includes utilizing CRM tools, submitting required reporting, and providing accurate 12-month sales forecasts.
The Indemnity Claims Specialist manages lower-level, non-complex workers’ compensation claims within delegated authority, aiming for the best possible outcome under senior supervision. Essential functions include receiving claims, confirming coverage, determining validity, establishing reserves, authorizing payments, and communicating claim status to relevant parties.
The analyst will provide front-line technical support for proprietary government software applications via phone, email, and remote access, focusing on timely issue resolution. Key duties include building client relationships, troubleshooting application problems, documenting issues, and deploying software updates or training new clients.
The Quality Assurance Nurse develops, implements, and provides ongoing quality assurance calibration of processes and case management mentoring at the operational level. Responsibilities include educating operations staff with measurement tools, providing national account and regulatory quality oversight, and ensuring adherence to company standards.
The Medical Case Manager provides in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing, planning, implementing, and evaluating patient progress while ensuring treatment plans are appropriate, medically necessary, and cost-effective.
The specialist manages lower-level, non-complex workers’ compensation claims within delegated authority, ensuring the best possible outcome under senior supervision. Key duties include receiving claims, confirming coverage, determining validity, establishing reserves, authorizing payments, and communicating claim status to relevant parties.
Auto and General Liability Claims Specialist
CorVel Corporation
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Full Time
·
12 Weeks Ago
CorVel Corporation
The specialist will manage low to mid-level complex auto and general liability claims, including bodily injury and property damage, while confirming policy coverage and establishing reserves. Responsibilities also include communicating claim status to all relevant parties and adhering to client and carrier guidelines.
Auto and General Liability Claims Specialist
CorVel Corporation
·
Full Time
·
12 Weeks Ago
CorVel Corporation
The specialist will manage low to mid-level complex auto and general liability claims, including bodily injury and property damage, focusing on achieving optimal outcomes. Essential functions include receiving claims, confirming coverage, investigating, establishing reserves, authorizing payments, and communicating claim status to all relevant parties.
Customer Service Representative I - Workers' Compensation Call Center
CorVel Corporation
·
Full Time
·
12 Weeks Ago
CorVel Corporation
The Customer Service Representative manages inbound and outbound calls for the Workers’ Compensation department, providing service to claimants and internal teams. Responsibilities include reviewing claim history, clarifying details with adjusters, resolving inquiries, and accurately documenting all interactions.
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The Medical Case Manager provides in-person and telephonic case management to injured workers, involving various stakeholders like physicians and employers, utilizing nursing knowledge to discuss and evaluate treatment plans for appropriateness and cost-effectiveness. Responsibilities also include attending provider visits, facility discharge planning, conducting home evaluations, and negotiating care implementation such as durable medical equipment.
The Medical Case Manager provides in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include utilizing nursing knowledge to discuss and evaluate treatment plans for appropriateness, medical necessity, and cost-effectiveness, often requiring significant local travel.
The Account Manager is responsible for executive-level customer interaction, acting as a client extension to understand and communicate expectations, and increasing market share by delivering service that meets or exceeds customer goals. Key duties include managing accounts with significant revenue thresholds, conducting client stewardship, handling collections, and driving revenue growth with existing accounts.
The Medical Case Manager provides in-person and telephonic case management to injured workers, involving various stakeholders to facilitate recovery. Responsibilities include assessing, planning, implementing, and evaluating patient progress while discussing and evaluating treatment plans for appropriateness and cost-effectiveness.
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