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University of Maryland Medical System Logo
ADMINISTRATIVE COORDINATOR
University of Maryland Medical System

Towson, Maryland

NEW!
Baylor Scott & White Health Logo
Care Manager RN 1 QA
Baylor Scott & White Health

Dallas, Texas

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Indiana University Health Logo
Adult Academic Health Center Peri-Operative Medical Director
Indiana University Health

Indianapolis, Indiana

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BJC HealthCare Logo
Assistant Nurse Manager - GI Endoscopy
BJC HealthCare

Saint Louis, Missouri

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Geisinger Logo
Physician Hospitalist
Geisinger

State College, Pennsylvania

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Geisinger Logo
Physician Division Director, Pediatric Palliative Care
Geisinger

Danville, Pennsylvania

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Harris Health System Logo
Utilization Management LVN
Harris Health System

Houston, Texas

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Kindred Hospitals Logo
Chief Operating Officer / Chief Clinical Officer
Kindred Hospitals

Aurora, Colorado

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AdventHealth Logo
Exec Director Operations
AdventHealth

Tampa, Florida

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Penn State Health Logo
Utilization Management Specialist - Utilization Management
Penn State Health

Hershey, Pennsylvania

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Phoenix Children's Logo
Health Systems Program Manager
Phoenix Children's

Phoenix, Arizona

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Pediatric Intensivist - Medical Director
Pediatrix Medical Group

Sunrise, NY, USA

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AdventHealth Logo
Exec Director Operations
AdventHealth

Tampa, Florida

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Centura Health / CommonSpirit Health Logo
Director Critical Care Services
Centura Health / CommonSpirit Health

Layton, Utah

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Foundation Health Partners Logo
Ambulatory RN Director
Foundation Health Partners

Fairbanks, Alaska

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Vanderbilt Health Logo
Director for Continuing Professional Development
Vanderbilt Health

Nashville, Tennessee

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Section Chief, Pediatric Rheumatology
CareerPhysician LLC

Little Rock , Arkansas

NEW!
PIH Health Logo
Care Management Coordinator, Part Time Nights
PIH Health

Downey, California

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Vanderbilt Health Logo
Mechanical Assist Device Coordinator (Registered Nurse required)- Heart & Vascular Administration- FT Days- VUMC
Vanderbilt Health

Nashville, Tennessee

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Outstanding Division Director Opportunity - Pediatric Cardiology
CareerPhysician LLC

Iowa City, Iowa

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Sonic Healthcare USA Logo
Account Executive
Sonic Healthcare USA

Oklahoma City, Oklahoma

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Mercy Logo
Nurse Practitioner or Physician Assistant - Pain Management - Edmond, Oklahoma
Mercy

Edmond, Oklahoma

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Duke University Health System Logo
Supply Chain Manager
Duke University Health System

Durham, North Carolina

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Sonic Healthcare USA Logo
Specimen Management Manager
Sonic Healthcare USA

Memphis, Tennessee

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Centura Health / CommonSpirit Health Logo
Enterprise Regional Medical Director
Centura Health / CommonSpirit Health

Centennial, Colorado

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Care Manager Clinical Denials
JOB SUMMARY: The Care Manager Clinical Denials (CM-CD) is responsible for the management of clinical audits and denials related to inpatient medical necessity and/or level of care, and coding. The CM-CD reviews patient medical records and all other pertinent patient information, and applies clinical and regulatory knowledge, screening criteria and judgment, as well as knowledge of payor requirements and denial reason codes/rationale, to determine why cases are denied and whether an appeal is required. For all inappropriate denials, relevant information is submitted, according to each payor's appeal timeframes, through denial management tracking software with bi-directional interface with physician advisor appeal coordinat


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