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Accountable for a full range of provider relations including engagement with and development of prospective providers Design and implement strategies to increase the membership of providers in the network Create and execute a marketing plan to build and nurture provider network Identify needs in provider network, incorporating potential gaps related to composition, servic
Posted 3 days ago
The world isn't standing still, and neither is Allstate. We're moving quickly, looking across our businesses and brands and taking bold steps to better serve customers' evolving needs. That's why now is an exciting time to join our team. You'll have opportunities to take risks, challenge the status quo and shape the future for the greater good. You'll do all this in an en
Posted 12 days ago
Processes claims accurately and efficiently. Reviews all incoming claims to verify necessary information. Determines that correct member and provider records are chosen and utilized to process claims. Enters claims data and information into the computerized Claims Processing System. Maintains all required documentation of claims processed and claims on hand. Adjudicates c
Posted 8 days ago
Blue Shield of CA
- Rancho Cordova, CA / Oakland, CA / Long Beach, CA / 4 more...
Your Role The Case Management team performs and case management (CM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members care including clinical nurses and treating MDs. . The Case Management Nurse, Senior will report to the Manager, Care Management. In this role you will determine, develop and im
Posted 5 days ago
The world isn't standing still, and neither is Allstate. We're moving quickly, looking across our businesses and brands and taking bold steps to better serve customers' evolving needs. That's why now is an exciting time to join our team. You'll have opportunities to take risks, challenge the status quo and shape the future for the greater good. You'll do all this in an en
Posted 18 days ago
Blue Shield of CA
- Rancho Cordova, CA / Oakland, CA / Long Beach, CA / 3 more...
Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care including clinical nurses and treating physicians . The Behavioral Health Registered Nurse Case Manager will report to th
Posted 6 days ago
American Family Insurance
- San Francisco, CA / Long Beach, CA / Santa Ana, CA / 18 more...
At American Family Insurance Claims Services (AFICS, Inc.), we're embarking on a transformation of our claims capabilities that will put customers at the center of what we do best protecting and restoring their dreams when they need us most. We're leveraging our expertise, technology and new ways of working to actively reinvent one of America's largest industries creating
Posted 1 month ago
Responsible for providing customer service and supporting the insured and broker with commercial property claims. ESSENTIAL DUTIES AND RESPONSIBILITIES Communicates with vendors, producers, policy holders, clients and insurance companies to communicate claim status; Provides initial and on going advocacy on losses including reserve, coverage analysis, and communication; R
Posted 28 days ago
Investigation and analyze recovery/subrogation and/or liability and property damage claims filed by or against the Company. Adjust and settle claims. Gather evidence for hearings, trials, and other dispositions through visual inspections, photographs, interviewing and questioning witnesses. Examine and analyze records and reports. Prepare and maintain detailed documentati
Posted 21 days ago
Blue Shield of CA
- El Dorado Hills, CA / Oakland, CA / Long Beach, CA / 3 more...
Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care including clinical nurses and treating physicians . The Registered Nurse Case Manager will report to the FEP Department M
Posted 20 days ago
Blue Shield of CA
- El Dorado Hills, CA / Oakland, CA / Long Beach, CA / 3 more...
Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination o
Posted 1 month ago
Blue Shield of CA
- Rancho Cordova, CA / Oakland, CA / Long Beach, CA / 3 more...
Your Role The Case Management team performs and case management (CM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members care including clinical nurses and treating MDs.. The Case Management Nurse, Senior will report to the Manager, Care Management. In this role you will determine, develop and imp
Posted 1 month ago
Load, process, and summarize various data types and files using MATLAB or similar program. Further organize, clean, sort, and analyze data using SPSS, R, SAS, or related data analysis programs and interpret meaningful findings in tables, graphs, and written form. Conduct casualty assessment using currently available high rate blast data and published computational models.
Posted Today
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