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Collaborates with workers' compensation patients, employers, providers, and claims adjusters to coordinate medical and disability services for timely return to work. The Workers' Compensation Nurse Case Reviewer collaborates with medical care providers, employers, employees, and at times, attorneys to support the appropriate return to work, the provision of necessary medical services, and the evaluation of coverage under the Plan. The Nurse Case Manager reports to the Casualty Department Manager.
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Aon Crisis Management delivers a unique broking proposition, bringing consistent and total risk management, on a global basis, to the perils of political risk, terrorism, political violence and product recall & contamination.
$150,000 a yearFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Partner with Global Markets Financial Risk (GMFR), Global Risk Analytics (GRA) and Model Risk Management (MRM) for business requirements. Since the regulatory landscape continues to evolve, there is a need for Market Risk to work hand-in-hand with Front Office and this role offers the selected candidate a real potential to utilize their skills as well as learn how risk management spans across Front Office Trading desks all the way to Market Risk exposure management and eventually reported to the regulators.
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Collaborate with the Director of Payment Integrity to identify opportunities for financial recoveries and to ensure integrity of claims payments. Working knowledge of claims processing, correspondence and CRM platforms and adjudication strategies Demonstrated Experience with claims testing/auditing/QA.
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Lead to build and oversee a cohesive risk MIS and data governance model that integrates and maps all enterprise risk; Lead the formulation and implementation of assurance governing transmission, storage, and use of information and data system;Responsible for the Branch’s risk MIS infrastructure including a sufficiently robust data architecture and information technology.
$340,000Full-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Provide SME-level support on insider risk matters leveraging knowledge of insider threat, cyber security, and counterintelligence. Minimum of 8 years of work experience supporting insider threat/risk and/or counterintelligence program, investigations or risk analysis.
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Collaborate with other organizational departments responsible for functional aspects of the HIV Special Needs Plan, including, but not limited to Integrated Care Management, Behavioral Health, Managed Long-Term Care, Utilization Management, Quality Management, Credentialing, Regulatory Affairs, Compliance, Corporate Affairs, Provider Network Operations, Medicare Services, Information Systems, Finance, Claims, and Member Services and Eligibility.
$157,236 a yearFull-timeExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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Collaborates with professionals, health plan departments such as Claims and Medical Management, and the third party administrator staff and legal, as necessary, to investigate and facilitate resolution of individual grievances and appeals.
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The Care Manager works to provide stability for at-risk youth who are chronically ill, underserved, mentally disable, and high inpatient and emergency department utilizers. The Care Manager for Children's health home works closely to collaborate services to link at-risk youth to services and programs that support that support functioning in the least restrictive community setting.
$50,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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A banking services organization in New York City is currently seeking an experienced Finance professional to join their team as their newVP - Counterparty Risk. In this role, theVP - Counterparty Risk will be responsible forleading counterparty credit risk analytics with core focus on understanding PFE modeling and analyzing various modeling approaches.
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All youth living with and at risk for HIV infection, especially youth of color and lesbian, gay, bisexual, and questioning (LGBQ) youth ? Medical Director- Adolescent AIDS Program The AAP is looking for a dynamic Medical Director to enhance the programs track record of excellence and national leadership in comprehensive medical and psychosocial care for youth living with or at risk for HIV and LGBTQ youth and youth of color.
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Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines – Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health. Minimum three years progressive professional experience in health care, including a minimum of two years in a grievance and appeals or related area such as medical or utilization management required.
$93,000 a yearPart-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The facility will provide 30 units of supportive housing to homeless or at-risk of homelessness, single adults (age 18 and over) diagnosed with HIV/AIDS, serious mental illness (SMI) or who are diagnosed as mentally ill and chemically addicted (MICA), currently known as persons with co-occurring disorders.
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Chartered Financial Analyst (CFA), Financial Risk Manager (FRM), Certified Internal Auditor (CIA) or relevant securities licenses preferred. Specifically, knowledge of trading and hedging strategies, supervisory procedures, P&L attribution, risk management, operational processes and regulatory landscape strongly preferred.
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Seeking BC Primary Care physician who is willing to work with geriatric population in Queens, NY. Rapidly growing, innovative company of community-based healthcare centers.
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tpa compensation claims risk jobs Company: Deloitte in New York, NY
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