Appeals supervisor cypress ca jobs in the Healthcare Services industry in Irvine, California

Description: If you're interested in bringing your RN experience to a role that offers regular, Monday through Friday business hours and ample potential for advancement, apply to join us as one of our newest Senior Clinical Admin Nurses! Responsible for compiling medical information for provider appeals. Standard appeals must be completed within state regulations of 15-30 days. Review medical reco...
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Description: Position Description: The person in this function are responsible for providing general support to case coordinators and members resolving all types of appeals and grievances. Communicates with appropriate parties regarding appeals and grievance issues, implications and decisions. Analyzes and identifies trends for all appeals and grievances. May research and resolve written Departmen...
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Description: Position Description:Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.Primary Responsibilities:Foster and maintain a collaborative relationship with internal and external ...
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There's quite a distance between wondering and knowing. And for patients waiting for answers to important health questions, it's a road they want to travel as quickly as possible. At Quest Diagnostics Incorporated, we understand urgency. But more than speed, we focus our energies on accuracy. Currently, we have a challenging opportunity available for Manager, Cost Analysis at our Cypress, CA locat...
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Description: The Network Contractor develops the provider network (physicians and medical groups) yielding a geographically competitive, broad access, stable network that achieves objectives for unit cost performance and trend management, and produces an affordable and predictable product for customers and business partners. Network Contractors evaluate and negotiate contracts in compliance with c...
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Description: We are seeking an experienced IT Program and Project Manager to lead a team of PMs in our Cypress, CA office location. This group is dedicated to application services (ASG) project and programs in the Document Management Services domain. The ideal candidate will have human capital responsibility for 4-6 full time staff and a program budget in the $10-20MM range. The role summary is as...
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Description: We will put you in the driver's seat on vital projects that have strategic importance to our mission of helping people lead healthier lives. Yes, we share a mission that inspires. We need your organizational talents and business discipline to help fuel ours. It's the opportunity to do your life's best work.(sm) Use your Sharp Business Skills to assist in end-to-end business process ac...
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Description: Want to learn more before applying for this role? Click here to view the Realistic Job Preview: UHC_Telephonic_UM_Nurse.pdf UnitedHealthcare currently has multiple opportunities available for Utilization Management Nurses in our Cypress, CA office. The successful candidates will be responsible for applying new medical necessity guidelines to Prior Authorization Requests and responding...
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Description: Great account management is result of strong purpose, conviction and pride - pride in your ability and your product. UnitedHealth Group offers a portfolio of products that are greatly improving the life of others. Bring along your passion and do your life's best work.The Field Account Manager is the ''field-based Service Owner'' responsible for the customer's (Benefit Manager) total s...
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Description: Come grow your data analytics career with a top performing healthcare industry leader! The Healthcare Economics Analyst is part of the Medical Informatics department within UnitedHealthcare Employer & Individual. This position will be dedicated to performing quantitative analyses of utilization and health cost data. This role will be dedicated to the Performance Based Contracting init...
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Description: There's a lot more to come in the changes sweeping through our industry. So when the rules keep changing, it helps to be with the team that's writing them. Here, your performance, your ideas and your innUnitedHealthcare Medicare & Retirement will combine with a rich assortment of contributors to ensure you will always be challenged at UnitedHealth Group to do your life's best work.(sm...
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Description: Position Description: OptumRx is a pharmacy benefit management company. Within Operations, the Benefits Department's primarily role is to support the adjudication of pharmacy claims by implementing benefits, formularies, client/pharmacy pricing and pharmacy network. It is responsible for the configuration of benefits and set-up of formularies, client and pharmacy pricing, and pharmacy...
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Description: Position Description: When you are in the business of health care, you're in the business of people. At UnitedHealth Group we want every customer experience to be distinctly personal. The challenge is complex. When people call us for help, their focus is on getting the best care possible. We help them understand their benefits and their options. This part of their lives matters a lot ...
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Description: What makes your management career greater with UnitedHealth Group? Advancement, access to data, variety of product lines, and rewards for delivering on our mission. This manager position will perform critical research and investigation of key business problems. He/she will perform quantitative analyses of utilization and health cost data, estimates and forecasts. This individual will ...
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Description: Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)The Network Pricing Consultant supports and validates Provider Network (physicians, hospitals, ...
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Description: Position Description: Primary service contact for Public Sector Employer Groups (5000+ employees) and their respective brokers/consultants. Facilitates resolution of administration/service issues and develops strong working relationships that encourage renewal and future business with United Healthcare.Primary Responsibilities: Educate broker/consultant and client on administrative pr...
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Description: In providing consumer-oriented health benefit plans to millions of people, our goal is to create higher quality care, lower costs and greater access to health care. As a finance professional, you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. Responsibilities include:-Ove...
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Description: Position Description: If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Financial discipline and accountability count more today than ever. Which is why your performance and innovation will find a reception here like nowhere else as you help people live healthier lives while doing your life's best work. Positions...
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Description: Position Description: Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reli...
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Description: Position Description: Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reli...
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Description: Position Description: Positions in this function are predominantly involved in designing, coding, testing, debugging, documenting and supporting Internet/Intranet applications consistent with established specifications and business requirements. Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get...
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Description: What makes your Underwriting career greater with UnitedHealth Group? Advancement, an elite group of peers, variety of product lines, and rewards for delivering on our mission ensures you will always be challenged to do your best. The Associate Director, Underwriting will lead the underwriting initiatives to ensure that cases are appropriately assessed from a risk perspective and are a...
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Description: For those who believe in the power of data to help write the next chapter in the history of health care, here's your opportunity. Advancement, an elite group of peers, variety of product lines, and rewards for delivering on our mission ensures you will always be challenged at UnitedHealth Group to do your life's best work. The Senior Underwriting Consultant will analyze health benefit...
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Description: Position Description: Working in Operations at UnitedHealth Group is one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. Through our family of businesses and a lot of inspired individu...
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Description: Position Description: Positions in this function coordinate the processes and activities that focus on restoring service after an incident occurs. Monitors environment health and the facilitation of high severity incidents to improve the state of service availability and continuity. This function also includes those who operate and monitor computer and peripheral equipment. Coordinate...
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