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Results based on filters ( 18 jobs found )

RN Senior Medical Reviewer - ALJ Clinician *(Read position purpose)

CGS Administrators LLC
Nashville, TN
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CGS Administrators LLC life insurance, paid time off, 401(k), remote work ...
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About the job:
United States, Tennessee, Nashville Jan 20, 2026 Summary Acts as Team Lead for specialty programs, medical review, utilization management, and case management areas by providing assistance and support to unit supervisor/manager by giving direction/guidance/training to staff. Ensures appropriate levels of healthcare services are provided. Description Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Compliance Officers
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Diversityjobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

IT Business Systems Analyst II (Medicare/Medicaid)- CGS Administrators, LLC

CGS Administrators, LLC
Nashville, TN
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Summary Working at CGS Administrators CGS Administrators, LLC (CGS) is part ...
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About the job:
of BCBSSC&trade's Celerian Group of companies and provides a variety of services for Medicare beneficiaries, healthcare providers, and medical equipment suppliers in 38 states, supporting the needs of over 8.7 million Medicare beneficiaries and 103,000 healthcare professionals nationwide. This is an onsite full-time position located at 26 Century Blvd., Ste. ST610 Nashville, TN 37214-3685. If you have IT Business Analysis Healthcare experience and leadership capabilities, this could be the perfect role for you. Join a...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Project Management Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Diversity.com
Certifications / Licenses:
Certified Business Analysis Professional
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Consultant, Sr Provider Education

CGS Administrators LLC
Tennessee
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
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About the job:
Tennessee Dec 20, 2025 Summary Provides education to medical providers as warranted. Description Logistics: CGS (cgsadmin.com) - one of BlueCross BlueShield's South Carolina subsidiary companies. Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. Location: This a remote position. You will work an 8-hour shift scheduled during our normal business hours of 8:00 a.m.-5:00 p.m. Monday - Friday . What You'll Do: - Communicates/educates...
Location:
Tennessee
Job Type:
Full-Time
Permanent
Occupation:
Licensed Practical and Licensed Vocational Nurses
Career Level / Education:
Postsecondary nondegree award
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Diversityjobs
Certifications / Licenses:
Security clearance
Licensed Practical Nurse
Certified Registered Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Medical Review Director - CGS Administrators, LLC

CGS Administrators LLC
Nashville, TN
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CGS Administrators LLC $76,546.00 $113,900.50 $151,255.00Pay Transparency ...
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About the job:
Statement: Please note that this range represents the pay range for this and other positions that fall into this pay grade. Compensation decisions within the range will be dependent upon a variety of f life insurance, paid time off, 401(k) United States, Tennessee, Nashville Jan 14, 2026 Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we've been part of the national landscape, with our roots firmly embedded in the...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Diversityjobs
Certifications / Licenses:
Security clearance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Summer Student Intern- Accounting

CGS Administrators LLC
Springfield, IL
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
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About the job:
Illinois, Springfield 3021 Montvale Drive ( Show on map ) Jan 13, 2026 Summary We have a job opening for the position of Summer Student Intern Accounting position at CGS one of BlueCross BlueShield of South Carolina subsidiary companies. The Intern position is utilized for training an active high school or college student towards an entry level role. The responsibilities vary and are based upon the needs of the area and the experience of the incumbent at the time of employment. The incumbent will work under direct...
Location:
Springfield, IL
Job Type:
Full-Time
Internship
Occupation:
Equal Opportunity Representatives and Officers
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Diversityjobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Physical Medicine and Rehabilitation Medical Director

CGS Administrators, LLC
Grove City, OH
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85617542 293085448 Internal Reference Number: R1047244 Summary As member of ...
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About the job:
the senior management team, provides administrative oversight to the medical staff, analyzes medical review utilization data, researches new medical procedures or technology, and acts as a resource to providers and internal staff on issues concerning medical policies. May also write and revise medical policies.Description Logistics: Palmetto GBA, - one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-time (40-hours/week) Monday-Friday working REMOTE in the United States or...
Location:
Job Type:
Occupation:
Career Level / Education:
Salary:
From:
OhioMeansJobs.com
Certifications / Licenses:
Workkeys
Applied Math
5
Graphic Literacy
6
Workplace Documents
5
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Detailed Job Information

Medicare Auditing Supervisor (Cost Reporting)

CGS Administrators, LLC
Darbydale, OH
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85161147_1 293084592 Internal Reference Number: R1047424 Summary Responsible ...
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About the job:
for supervising the receipt, review, and settlement of the Medicare cost report, ensuring all Centers for Medicare and Medicaid Services (CMS) requirements are met throughout the process.Description The Government Audit Supervisor is a full-time remote position working 8:00-5:00pm.What You'll Do: Performs supervisory review of all audit work papers completed by the team to ensure all work conforms to CMS and other government auditing standards. Performs supervisory review of all cost report acceptances and desk...
Location:
Job Type:
Occupation:
Career Level / Education:
Salary:
From:
OhioMeansJobs.com
Certifications / Licenses:
Workkeys
Applied Math
5
Graphic Literacy
6
Workplace Documents
6
apply
Detailed Job Information

Claims Processor II

CGS Administrators, LLC
Darbydale, OH
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85923821 293076700 Internal Reference Number: R1048695 Summary Reviews and ...
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About the job:
adjudicates complex or specialty claims. Determines whether to return, deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members.Description Logistics: CGS (cgsadmin.com) - one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-time (40-hours/week) Monday-Friday from 8:00am-4:30pm and will be fully remote. What You'll Do: Examines and processes complex or specialty claims according to business/contract regulations,...
Location:
Job Type:
Occupation:
Career Level / Education:
Salary:
From:
OhioMeansJobs.com
Certifications / Licenses:
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
3
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Detailed Job Information

Medical Review Director - CGS Administrators, LLC

CGS Administrators LLC
Columbia, SC
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
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Summary
About the job:
South Carolina, Columbia Dec 05, 2025 Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we've been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the...
Location:
Columbia, SC
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Diversityjobs
Certifications / Licenses:
Security clearance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Medical Review Director - CGS Administrators, LLC

CGS Administrators LLC
Springfield, IL
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CGS Administrators LLC life insurance, paid time off, 401(k) United States, ...
Details
Summary
About the job:
Illinois, Springfield 3021 Montvale Drive ( Show on map ) Dec 05, 2025 Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we've been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated...
Location:
Springfield, IL
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Diversityjobs
Certifications / Licenses:
Security clearance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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