4 rn clinical operations jobs found

**$5,000 Sign On Bonus for External Candidates** Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)  The Sr. Clinical Coding Nurse Consultant will drive consistent, efficient processes and share best practices in a collaborative effort with Providers and Market Team, designed to facilitate achievement of goals set for HCC Ratio, HCC Covered Ratio, and HCC Percent Covered. The Sr. Clinical Coding Nurse Consultant will drive Risk Adjustment improvement initiatives, develop recommendations for Risk Adjustment remediation plans and create tools and databases to capture relevant data for assigned markets to achieve corporate and market specific Risk Adjustment goals and initiatives. This position will work collaboratively with each regional / market team and their leadership in a matrix relationship.  This position will...

**$5,000 Sign On Bonus for External Candidates** Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)  The Sr. Clinical Coding Nurse Consultant will drive consistent, efficient processes and share best practices in a collaborative effort with Providers and Market Team, designed to facilitate achievement of goals set for HCC Ratio, HCC Covered Ratio, and HCC Percent Covered. The Sr. Clinical Coding Nurse Consultant will drive Risk Adjustment improvement initiatives, develop recommendations for Risk Adjustment remediation plans and create tools and databases to capture relevant data for assigned markets to achieve corporate and market specific Risk Adjustment goals and initiatives. This position will work collaboratively with each regional / market team and their leadership in a matrix relationship.  This position will...

**$5,000 Sign On Bonus for External Candidates** Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)  The Sr. Clinical Coding Nurse Consultant will drive consistent, efficient processes and share best practices in a collaborative effort with Providers and Market Team, designed to facilitate achievement of goals set for HCC Ratio, HCC Covered Ratio, and HCC Percent Covered. The Sr. Clinical Coding Nurse Consultant will drive Risk Adjustment improvement initiatives, develop recommendations for Risk Adjustment remediation plans and create tools and databases to capture relevant data for assigned markets to achieve corporate and market specific Risk Adjustment goals and initiatives. This position will work collaboratively with each regional / market team and their leadership in a matrix relationship.  This position will...

Gallagher Bassett is the premier provider of global claims services, dedicated to exceptional customer service and demonstrably superior outcomes. GB helps people, teams and businesses overcome adversity and loss through the guiding expertise of over 5,000 claims professionals, all committed to going beyond expectations in the continuous pursuit of a better way. Position Summary: Provides utilization management review of worker's compensation claims . Accesses medical documentation and information provided by medical providers to determine the appropriateness of treatment, setting and length of treatment required. Essential Duties & Responsibilities: Communicates with medical providers and ancillary service providers to negotiate or approve treatment. Engages physician review agents as appropriate. Communicates and documents recommendations of treatment to all parties including claims professionals, medical providers, ancillary service providers,...