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Results based on filters ( 2 jobs found )

Clinical Appeals Nurse

CareFirst BlueCross BlueShield
Located in Ohio
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Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes ...
Details
Summary
About the job:
research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The Clinical Appeals Nurse utilizes clinical skills and knowledge of all applicable State and Federal rules and regulations that govern the appeal process for Commercial and lines of business in order to formulate a professional response to the appeal request. We are looking for an experienced professional to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Clinical Nurse Specialists
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Himalayas
Certifications / Licenses:
Certified Case Manager
Legal Nurse Consultant, Certified
Certified Registered Nurse
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Senior Business Intel Analyst - Value-Based Care (Hybrid)

CareFirst BlueCross BlueShield
Located in Ohio
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Resp & Qualifications PURPOSE: Utilizes data analytics and contributes to a ...
Details
Summary
About the job:
set of business initiatives designed to help business partners extract value from information. Develops data visualizations for analysis, problem-solving, and business solutions. We are not looking for generalists who may have an IT background and various credentials like Scrum, Agile, etc. We are looking for an experienced professional in the greater Baltimore/Washington metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Business Intelligence Analysts
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Himalayas
Certifications / Licenses:
Certified Business Intelligence Professional
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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Company Name: CareFirst BlueCross BlueShield
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