6 Results for

Clinical Specialist Jobs in Cheyenne, WY

Jobs

Cheyenne, WY30+ days ago

Remote

Full-time

Technical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.

Cheyenne, WY30+ days ago

Remote

Full-time

Assist with training department-specific needs, such as, maintaining required training documentation, maintaining both clinical and non-clinical training and orientation curriculum, participating in clinical operations leadership meetings, process improvement meetings, and other duties as appropriate and requested. In addition, this position requires designing, developing and presenting synchronous training courses relating to clinical and operational topics, and includes content, visual aides, exercises for the student and examinations.

Cheyenne, WY30+ days ago

Remote

Full-time

o Bachelor's in Nursing or Certified Professional in Healthcare Quality (CPHQ) o 1 or more years team lead or supervisory experience o 1 year experience in Quality Management o 1 year experience with data analysis and reporting o Experience with InterQual or similar criteria sets o General knowledge of Medicare, Veterans Administration, or other government health care programs. Technical Skills: General knowledge of Medicare, Veterans Administration, or other government health care programs; knowledge in the application of clinical criteria: InterQual, Milliman, PAS-LOS, ICD-9-CM, DSM, CPT-4, and HCPCs; Proficient with Microsoft Word and Excel.

New!

Cheyenne, WY2 days ago

Remote

$35–$45 Per Hour

As an Inpatient Auditing Specialist you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, andlife sciences companies.

Cheyenne, WY30+ days ago

Full-time

The incumbent will also work closely with MTF staff to support TRICARE beneficiaries and provide non-clinical support for patient referrals and authorizations; outreach to network providers as necessary; and to facilitate the support of applicable TriWest departments for resolving network gaps, provider and contract concerns, customer service requests, and discharge coordination for patients from network and non-network facilities. • Performs on-site and virtual outreach activities for military installation community and beneficiary groups such as Family Readiness Groups, Retiree Associations, and Installation New-comers Orientation, and provides educational briefings on such matters as transferring TRICARE enrollment, PCM selection, and other interest areas for new people to the community.

New!

Cheyenne, WY2 days ago

Remote

$45,000–$60,900 Per Year

As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more.

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Clinical Specialist Jobs in Cheyenne, WY

Program Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare Alliance

Clinical Education Training Specialist TriWest Healthcare Alliance

Clinical Quality Reviewer TriWest Healthcare Alliance

Inpatient Audit Specialist FT- Sign on Bonus Datavant

Field Support Specialist TriWest Healthcare Alliance

Bilingual Outbound Tele Sales Agent CenterWell

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