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Supvr, Pre-Authorization Job (Tampa, FL, US)

Description:GENERAL SUMMARYResponsible for the daily supervision of pre-authorization to include the telephone/fax authorization and retrospective claim review processes. Serves in an active managerial...

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Appeals Coord Job (Louisville, KY, US)

Description:GENERAL SUMMARYResponsible for coordinating behavioral health appeals and retrospective review activities and ensuring compliance with state and federal regulations and accrediting...

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Complex Case Mgr with Pediatric Foster Care Experience valuable! Job...

Description:GENERAL SUMMARYFunctions as the central coordinator of care for members identified as having chronic disease processes or for members/injured employees in select physician practices....

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Complex Case Mgr, Disease Mgmt, UR or Discharge Planning experience helpful!...

Description:GENERAL SUMMARYFunctions as the central coordinator of care for members identified as having chronic disease processes or for members in select physician practices. Responsible for...

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Medical Director Job (Louisville, KY, US)

Description:GENERAL SUMMARYOversees the medical management programs for assigned business sector. Provides medical leadership to ensure excellent quality of care and service is provided to our...

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Health Care Analyst Job (Louisville, KY, US)

Description:GENERAL SUMMARYCollects data and provides analyses for a broad array of issues. Carries out detailed tasks assigned by project teams. May work independently or as a part of a project team....

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Mgr, Finance Job (Louisville, KY, US)

Description:GENERAL SUMMARYManages specified finance functions to ensure compliance with financial objectives, accounting policies and procedures, and management/user information requirements.ESSENTIAL...

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Behavioral Health Case Manager Job (Louisville, KY, US)

Description:GENERAL SUMMARYProvides case management services for the behavioral health unit through evaluation and review of inpatient and outpatient behavioral health treatments for medical necessity,...

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Behavioral Health Case Manager Job (Louisville, KY, US)

Description:GENERAL SUMMARYProvides case management services for the behavioral health unit through evaluation and review of inpatient and outpatient behavioral health treatments for medical necessity,...

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Behavioral Health Case Manager Job (Louisville, KY, US)

Description:GENERAL SUMMARYProvides case management services for the behavioral health unit through evaluation and review of inpatient and outpatient behavioral health treatments for medical necessity,...

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Concurrent Review Coordinator, with Retroactive Claims Review experience...

Description:GENERAL SUMMARYReviews all inpatient admissions to assure appropriate level of care. Coordinates with physicians, staff, and facilities regarding patient care. In conjunction with and under...

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Medical Review Nurse Job (Louisville, KY, US)

Description:GENERAL SUMMARYResponsible for reviewing and analyzing information to make medical determinations as necessary. Applies clinical knowledge to assess the medical necessity, level of...

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Quality Improvement Coord Job (Urbandale, IA, US)

Description:Quality Improvement Coordinator It’s a great time to put the strength of Coventry Health Care behind your career! Coventry Health Care is a $14 billion growth oriented national managed...

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Quality Improvement Coord Job (Richmond, VA, US)

Description:Coventry Health Care, Inc., a local leader in the managed care industry, has an opening for a Quality Improvement Coordinator who will be responsible for the research and identification of...

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Pre-Authorization Coord Job (Tampa, FL, US)

Description:GENERAL SUMMARYResponsible for implementing and coordinating all utilization management functions relating to preauthorization of outpatient testing/surgery, and inpatient admissions.An...

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Medical Review Nurse Job (Newark, DE, US)

Description:Coventry Health Care is seeking a Review Nurse in our Newark,DE Service Center. As a strategic member of the Customer Service Operations (CSO) team, the successful candidate will be...

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Concurrent Review Coord Job (Bristol, VA, US)

Description:Coventry Health Care of Virginia, Inc., a local leader in the managed care industry, has an opening for a Nurse Reviewer in the Bristol area. The individual will review all inpatient...

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SIU Review Nurse Job (Wichita, KS, US)

Description:Coventry Health Care is seeking a SIU Review Nurse in our Wichita, KS Service Center. The successful candidate will be responsible for the planning, design, production, and maintenance of...

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Complex Case Mgr Job (Kansas City, MO, US)

Description:Coventry Health Care is currently seeking an Advanced Illness Complex Case Manager for our Kansas City, MO location. The Condition Management Program case management model focuses on...

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Concurrent Review Coord Job (Omaha, NE, US)

Description:Coventry Health Care is an organization of people dedicated to serving the health care needs of our community. We foster team involvement, encourage continuing education, and reward...

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