UNKNOWN

FEED

In this role you will be supporting the FCR team in addition to a small clinical coder team of 2 clinical coders who will be responsible for performing in-depth quality audits of hospital claims to support ICD-10-CM and ICD-10 PCS codes as well as EDC (Emergency Department Coding), MS-DRG and APR-DRG reviews based on clinical determination. Acts as a resource and helps to validate post claim DRG downgrade denials related to coding and clinical determination to support appeal strategy, tracking by disease, payer and denial activity and works with teams to create transparency and improvements to mitigate and prevent denials.

At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry.  We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

Blue Cross and Blue Shield Association

Clinical Coding Analyst RN, Consultant

In collaboration with the Chief Medical Officer (CMO), the Director for Clinical Services works closely with CST members and other Planned Parenthood of Southern New England (PPSNE) departments to ensure that our health centers provide person-centered, high-quality care that complies with Planned Parenthood Federation of America (PPFA), federal, state, and local requirements. In partnership with the CMO and the Medical Director, the Director of Clinical Services directs, coordinates, and evaluates clinical services provided to patients, in consultation with the Clinical Support Team, and other appropriate personnel.

YEAR

Planned Parenthood of Southern New England

Senior Director of Clinical Services (Licensed: APRN, PA, CNM)

IRecruitee

1) Provide Comprehensive Pharmaceutical Care for Care Areas and Operational Support of Inpatient Care Areas: Participate in daily patient care rounds with the following goals: Monitor drug therapy to evaluate the appropriateness of use; Promote the optimal use of formulary medications; Review patient profiles including dose, dosage form, regimen, route, therapeutic duplication, and drug interactions; Coordinate care across the continuum as needed. The Clinical Pharmacy Specialist supports and leads clinical pharmacy and medication management initiatives, serves as the pharmacy representative on committees as appropriate, participates in research, and contributes to the advancement of knowledge through the teaching and education of Pharmacy students, Pharmacy residents, and Pharmacy staff, as well as Nursing staff and Prescriber staff both internally and externally.

Baystate Health

Clinical Pharmacy Specialist

ADAPTED_NOW

Clinical Pharmacy Specialist - Critical Care

Job Responsibilities: 1) Provide Comprehensive Pharmaceutical Care for Care Areas and Operational Support of Inpatient Care Areas: Participate in daily patient care rounds with the following goals: Monitor drug therapy to evaluate the appropriateness of use; Promote the optimal use of formulary medications; Review patient profiles including dose, dosage form, regimen, route, therapeutic duplication, and drug interactions; Coordinate care across the continuum as needed. The Clinical Pharmacy Specialist supports and leads clinical pharmacy and medication management initiatives, serves as the pharmacy representative on committees as appropriate, participates in research, and contributes to the advancement of knowledge through the teaching and education of Pharmacy students, Pharmacy residents, and Pharmacy staff, as well as Nursing staff and Prescriber staff both internally and externally.

Baystate Health System

The Clinical Pharmacy Specialist supports and leads clinical pharmacy and medication management initiatives, serves as the pharmacy representative on committees as appropriate, participates in research, and contributes to the advancement of knowledge through the teaching and education of pharmacy students, pharmacy residents, and pharmacy staff, as well as nursing staff and medical staff both internally and externally. Infectious Diseases Clinical Pharmacy Specialist serves as a key member of the multidisciplinary infectious diseases and antimicrobial stewardship teams, optimizing antimicrobial therapy, improving patient outcomes, reducing antimicrobial resistance, and supporting institutional quality and safety initiatives.

Clinical Pharmacy Specialist (Infectious Diseases)

Candidate demonstrates a breadth of diverse leadership experiences and capabilities including: the ability to influence and collaborate with peers, develop and coach others, oversee and guide the work of other colleagues to achieve meaningful outcomes and create business impact. Build strong partnerships across Drug Product Development and Supply, Drug Substance Development, Regulatory, Quality, Clinical Supply, and Commercial organizations to accelerate delivery of development milestones.

A career at Pfizer offers opportunity, ownership and impact. All over the world, Pfizer colleagues work together to positively impact health for everyone, everywhere. Our colleagues have the opportunity to grow and develop a career that offers both individual and company success; be part of an ownership culture that values diversity and where all colleagues are energized and engaged; and the ability to impact the health and lives of millions of people. Pfizer, a global leader in the biopharmaceutical industry, is continuously seeking top talent who are inspired by our purpose to innovate to bring therapies to patients that significantly improve their lives.

Pfizer

Senior Manager, Drug Product Analytics

Position Title: Case Manager Location: On Site – Springfield, Massachusetts Department: Clinical Services Reports to: Clinical Director Salary: Competitive, based on experience and qualifications. Founded in 2016, Boca Recovery Center is a nationally recognized addiction treatment provider specializing in substance use disorders and co-occurring mental health conditions.

Boca Recovery Center

Case Manager

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It includes Manchester Memorial Hospital, a 249-bed community hospital, Rockville General, a campus of Manchester Memorial Hospital, a 102-bed facility, a large multispecialty provider group and visiting nurse services. The Nurse Manager is accountable for overseeing the daily operations of Cardiology and Interventional Radiology at MMH & RGH for patient care services, which include Stress Lab, Echocardiography, Cardiac Rehab, and Interventional Radiology staff.

Hartford HealthCare Corp

Nurse Manager (RN) - Radiology Interventional

Initiates and participates in quality improvements, applying knowledge gathered from tracking nursing and unit indicators, national benchmark data, and evidence-based research findings to foster improvements in the quality of care and enhanced performance methodology. Collaborates with other frontline leaders, Clinical Managers, Assistant Clinical Manager and other discipline team members to determine effective resource utilization and management of patient care issues.

Hospital for Special Care

Registered Nurse Clinical Coordinator

If performed in Maryland, the base pay range is $103,400 - $192,200, the total target cash range is $159,200 - $295,600.If performed in New Jersey, the base pay range is $124,663 - $199,137, the total target cash range is $191,961 - $306,639.If performed in Ohio, the base pay range is $93,600 - $173,800, the total target cash range is $144,100 - $267,400. Building on our publishing heritage, we combine quality information and vast data sets with analytics to support visionary science and research, health education and interactive learning, as well as exceptional healthcare and clinical practice.

RELX Group plc

National Sales Manager, Medical Education

The Senior Manager, Market Access & Reimbursement will help shape and execute U.S. reimbursement and market access strategies for icobrain, an innovative imaging solution designed to support clinical decision-making and improve patient care. Experience in medical devices, medical imaging, diagnostics, digital health, healthcare software, artificial intelligence-enabled healthcare solutions, or a related field.

GE HealthCare Technologies Inc

Manager, Market Access & Reimbursement

Headquartered in Stamford, Connecticut, the Spire network spans the Northeast with more than 165 physicians, 1,800 employees, 285 other clinical providers and 40 locations in New York, Connecticut, Rhode Island and Massachusetts. Who we are: Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices for the future.

ONS MSO LLC

MRI Manager

Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program.

Sun Life Financial

Senior Clinical Risk Consultant

The Clinical Pharmacist Practitioner supports and leads clinical pharmacy and medication management initiatives, serves as the pharmacy representative on committees as appropriate, participates in research, and contributes to the advancement of knowledge through teaching and education of Pharmacy students, Pharmacy residents and Pharmacy staff, as well as Nursing staff and Prescriber staff both internally and externally. Ambulatory Clinical Pharmacist - Board of Pharmacy SpecialistBoard of Pharmacy SpecialistBoard of Pharmacy Specialist, Basic Life Support - American Heart Association, Board Certified Pharmacotherapy Specialist - Board of Pharmacy SpecialistBoard of Pharmacy SpecialistBoard of Pharmacy Specialist.

Clinical Pharmacist Practitioner (Primary Care)

Enovis Corporation (NYSE: ENOV) is an innovation-driven medical technology growth company dedicated to developing clinically differentiated solutions that generate measurably better patient outcomes and transform workflows. As a key member of Recovery Sciences, you will play an integral part in helping Enovis drive the medical technology industry forward through transforming patient care and creating better patient outcomes.

Enovis Corp

Sales Territory Manager - NYC/Conneticut

Coordinates and implements patient/family care by collaborating with the multidisciplinary team, other payors and partnering with patients/families; establishing a multidisciplinary plan to address identified issues and goals; documenting and communicating in a timely manner; and educating patient/family in order to meet established goals and ensure seamless, coordinated transitions across levels of care. Connecticut Children's offers a comprehensive compensation and benefits package for eligible team members, including medical, dental and vision insurance, hospital paid life and disability coverage, paid time off and leave programs, education and training assistance, a retirement savings plan with hospital match, and an employment assistance program.

Connecticut Children's Medical Center

Clinical Social Worker LCSW- 40hr

Connecticut Children's offers a comprehensive compensation and benefits package for eligible team members, including medical, dental and vision insurance, hospital paid life and disability coverage, paid time off and leave programs, education and training assistance, a retirement savings plan with hospital match, and an employment assistance program. Additionally, with support of the Medical Director and Manager of the Dept., will be involved in the competency program for all Technologists in the department including reviewing, revising and writing policy and procedures as well as completing the clinical assessment on the team.

Lead Neuro Tech Clinical/Ed

Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual''s medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services. General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services.

Based in Atlanta, Georgia, Crawford &amp; Company is the world's largest independent provider of claims management solutions to the risk management and insurance industry as well as self-insured entities, with an expansive global network serving clients in more than 70 countries. 

The Crawford System of Claims Solutions(SM) offers comprehensive, integrated claims services, business process outsourcing and consulting services for major product lines, including property and casualty claims management, workers compensation claims and medical management, and legal settlement administration 

The Company's shares are traded on the NYSE under the symbols CRDA and CRDB.

Audit Manager Jobs in Stamford, CT

Clinical Coding Analyst RN, Consultant Blue Cross and Blue Shield Association

Senior Director of Clinical Services (Licensed: APRN, PA, CNM) Planned Parenthood of Southern New England

Clinical Pharmacy Specialist Baystate Health

Clinical Pharmacy Specialist - Critical Care Baystate Health

Clinical Pharmacy Specialist Baystate Health System

Clinical Pharmacy Specialist (Infectious Diseases) Baystate Health

Clinical Pharmacy Specialist (Infectious Diseases) Baystate Health System

Senior Manager, Drug Product Analytics Pfizer

Case Manager Boca Recovery Center

Nurse Manager (RN) - Radiology Interventional Hartford HealthCare Corp

Registered Nurse Clinical Coordinator Hospital for Special Care

National Sales Manager, Medical Education RELX Group plc

Manager, Market Access & Reimbursement GE HealthCare Technologies Inc

MRI Manager ONS MSO LLC

Senior Clinical Risk Consultant Sun Life Financial

Clinical Pharmacist Practitioner (Primary Care) Baystate Health

Sales Territory Manager - NYC/Conneticut Enovis Corp

Clinical Social Worker LCSW- 40hr Connecticut Children's Medical Center

Lead Neuro Tech Clinical/Ed Connecticut Children's Medical Center

Medical Case Manager Crawford & Co

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