Hopkinton, Massachusetts, United States · On-site
$65k–$75k/yr
Join the VitalCore Team in Massachusetts! We're people who are fueled by passion, not by profit. VitalCore Health Strategies, (VCHS), an industry leader in Correctional Healthcare, has an opening for a Full-Time Utilizat…
Skills: Medical Coding, Claims Review, Utilization Management, CPT Coding, ICD Coding
Gulfport, Mississippi, United States · On-site
Join the VitalCore Team in Mississippi! We’re people who are fueled by passion, not by profit. VitalCore Health Strategies (VCHS), an industry leader in Correctional Health Care has an opening for a Full-Time Licen…
Skills: Nursing Care, Medication Administration, Wound Care, Patient Monitoring, Vital Signs Monitoring
Chesapeake, Virginia, United States · On-site
$30/hr–$32/hr
Join the VitalCore Team in Virginia! We're people fueled by passion, not by profit. VitalCore Health Strategies (VCHS), an industry leader in Correctional Health Care, has an opening for a Licensed Practical Nurse at Che…
Skills: Nursing Care, Medication Administration, Wound Care, Patient Monitoring, Vital Signs Monitoring
Chesapeake, Virginia, United States · On-site
$43/hr–$45/hr
Join the VitalCore Team in Virginia! We’re people fueled by passion, not by profit. VitalCore Health Strategies, (VCHS), an industry leader in correctional healthcare, has an opening for a Registered Nurse at Chesa…
Skills: Patient Care, Medication Administration, Vital Signs Monitoring, Patient Advocacy, Clinical Competency
Gardner, Massachusetts, United States · On-site
$50/hr–$53/hr
VitalCore Health Strategies (VCHS), an industry leader in Correctional Health, has openings for a Part-Time (Weekends Only) Registered Nurse at North Central Correctional Institute in Gardner, MA! Looking for a rewarding…
Skills: Patient Care, Medication Administration, Vital Signs Monitoring, Patient Advocacy, Care Planning
Topeka, Kansas, United States · On-site
Join the VitalCore Team in Kansas! We're people fueled by passion, not by profit! VitalCore Health Strategies (VCHS), an industry leader in Correctional Healthcare, has an opening for a Regional Manager at our Kansas DOC…
Skills: Operational Leadership, Healthcare Administration, Quality Assurance, Compliance Monitoring, Staff Supervision
Piney Grove Manor, Delaware, United States · On-site
VitalCore Health Strategies, (VCHS), an industry leader in correctional healthcare, has an opening for a Quality Assurance Registered Nurse (RN) in Georgetown, DE at Sussex Correctional Institution for Full-Time Day Shif…
Skills: Quality Assurance, Case Management, Patient Advocacy, Crisis Management, Clinical Monitoring
Hillsboro, Missouri, United States · On-site
$22/hr–$25/hr
Start A New Career with VitalCore Health Strategies! View our opportunities at: https://vitalcorehs.com/careers VitalCore Health Strategies, (VCHS), an industry leader in Correctional Healthcare seeking a PRN Dental Assi…
Skills: Patient Care, Instrument Sterilization, Radiography, Dental Charting, Infection Control
Topeka, Kansas, United States · On-site
Join the VitalCore Team in Kansas! We’re people who are fueled by passion, not by profit. VitalCore Health Strategies (VCHS), an industry leader in Correctional Healthcare, has an opening for a Full-Time Statewide …
Skills: Clinical Oversight, Regulatory Compliance, Strategic Planning, Quality Assurance, Staff Supervision
Bridgewater, Massachusetts, United States · On-site
$38/hr–$43/hr
Join the VitalCore Team in Massachusetts! We’re people fueled by passion, not by profit! VitalCore Health Strategies (VCHS), an industry leader in Correctional Health Care has openings for Licensed Practical Nurses…
Skills: Patient Monitoring, Wound Care, Medication Administration, Vital Signs Monitoring, Medical Documentation
Greene County, Mississippi, United States · On-site
$20/hr–$21/hr
Join the VitalCore Team in Mississippi! We’re people who are fueled by passion, not by profit. VitalCore Health Strategies (VCHS), an industry leader in Correctional Health Care has an opening for a Part Time Certi…
Skills: Patient Care, Clinical Support, CPR, Medical Assisting, Correctional Healthcare
Village of Somers, Wisconsin, United States · On-site
$36/hr–$38/hr
VitalCore Health Strategies (VCHS), an industry leader in Correctional Health Care has an opening for a PRN Licensed Master's Level Behavioral Health Professional (LCSW, LCPC, LMSW, LPC, or equivalent) at Kenosha County …
Skills: Crisis Stabilization, Clinical Assessments, Group Therapy, One On One Therapy, Crisis Therapy
Nashville, Tennessee, United States · On-site
$33/hr–$35/hr
Join the VitalCore Team in Tennessee!! We’re people who are fueled by passion, not by profit. VitalCore Health Strategies (VCHS), an industry leader in Correctional Health Care has openings for a Licensed Practical…
Skills: Nursing Care, Wound Care, Medication Administration, Vital Signs Monitoring, Patient Documentation
Wilmington, Delaware, United States · On-site
$53k–$59k/yr
Join the VitalCore Team in Delaware! We’re people fueled by passion, not by profit! VitalCore Health Strategies (VCHS), an industry leader in Correctional Health Care, has an opening for a Substance Use Disorder Co…
Skills: Crisis Stabilization, Risk Assessment, Discharge Planning, Cognitive Behavioral Therapy, Motivational Interviewing
Wilmington, Delaware, United States · On-site
$75k–$80k/hr
Join the VitalCore Team in Delaware! We’re people fueled by passion, not by profit! VitalCore Health Strategies (VCHS), an industry leader in Correctional Health Care, has an opening for a Mental Health Clinician a…
Skills: Mental Health Assessment, Counseling, Crisis Intervention, Treatment Planning, Individual Therapy
Muskegon Charter Township, Michigan, United States · On-site
$38/hr–$40/hr
Join the VitalCore Team in Michigan! We’re people fueled by passion, not by profit! VitalCore Health Strategies (VCHS), an industry leader in Correctional Healthcare, has an opening for a PRN Registered Nurse at Mu…
Skills: Patient Care, Medication Administration, Vital Signs Monitoring, Patient Advocacy, Clinical Competency
Pearl, Mississippi, United States · On-site
$38/hr–$47/hr
Join the Vitalcore Team in Mississippi! We're people who are fueled by passion, not by profit. VitalCore Health Strategies (VCHS), an industry leader in Correctional Healthcare, has an opening for a Charge Registered Nur…
Skills: Registered Nurse, CPR, BLS, Supervision, Patient Advocacy
Nashville, Tennessee, United States · On-site
$47/hr–$49/hr
Join the VitalCore Team in Tennessee!! We’re people fueled by passion, not by profit! VitalCore Health Strategies (VCHS), an industry leader in Correctional Healthcare, has an opening for a Registered Nurse at Davi…
Skills: Registered Nurse, Patient Advocacy, Medication Administration, Patient Monitoring, Healthcare Coordination
Middleton, Massachusetts, United States · On-site
$24/hr–$28/hr
*MUST BE CERTIFIED MEDICAL ASSISTANT* VitalCore Health Strategies (VCHS), an industry leader in Correctional Health Care has an opening for a Full-Time Certified Medical Assistant at Essex County Correctional Facility in…
Skills: Patient Care, Clinical Support, Medical Assisting, Correctional Health Care, Behavioral Health Care
Nashville, Tennessee, United States · On-site
$22/hr–$24/hr
Start A New Career with VitalCore Health Strategies! VitalCore Health Strategies (VCHS), an industry leader in Correctional Health Care has an opening for Full-Time 2p-10p Certified Medical Assistants at Davidson County …
Skills: Patient Care, Clinical Support, Medical Assisting, Correctional Health Care, Behavioral Health Care
Hopkinton, Massachusetts, United States • On-site
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The specialist reviews and evaluates off-site healthcare service claims for accuracy, completeness, and compliance with regulatory guidelines. They manage the flow of medical information between providers and payers while identifying billing errors and fraud.
Requires an Associate's degree or equivalent and an active certification in Medical Coding. Preference is given to candidates with a Bachelor's degree and over 5 years of experience in healthcare or managed care.
VitalCore Health Strategies, (VCHS), an industry leader in Correctional Healthcare, has an opening for a Full-Time Utilization Management Claims Specialist at our Regional Office in Hopkinton, MA!
Looking for a rewarding career in the field of healthcare?
At VitalCore we pride ourselves on retaining and acquiring hardworking ethical individuals who are committed to providing quality services. Join our team and experience first-hand how VitalCore Health Strategies promotes a positive work environment that is based on respect and appreciation of the hard work and dedication of our staff.
UTILIZATION MANAGEMENT CLAIMS SPECIALIST BENEFITS:
UTILIZATION MANAGEMENT CLAIMS SPECIALIST POSITION SUMMARY:
The Utilization Management Claims Specialist is responsible for reviewing and evaluating off-site healthcare service claims for accuracy, completeness, and compliance with organizational and contractual policies and regulatory guidelines.
UTILIZATION MANAGEMENT CLAIMS SPECIALIST ESSENTIAL FUNCTIONS:
UTILIZATION MANAGEMENT CLAIMS SPECIALIST MINIMUM REQUIREMENTS:
VitalCore Health Strategies is an equal opportunity employer and is committed to creating and maintaining an inclusive workplace in which all employees have an opportunity to participate and contribute to the success of the business and are valued for their skills, experience, and unique perspectives.
Redefining Healthcare.
VitalCore Health Strategies provides community standards of healthcare in a correctional environment. Our patient-first approach and experienced medical staff ensure high-quality care aimed at creating positive outcomes for our patients.
Offices: 719 SW Van Buren St, Suite 100, Topeka, Kansas 66603, US
Redefining Healthcare.
VitalCore Health Strategies provides community standards of healthcare in a correctional environment. Our patient-first approach and experienced medical staff ensure high-quality care aimed at creating positive outcomes for our patients.
Offices: 719 SW Van Buren St, Suite 100, Topeka, Kansas 66603, US
