Care Manager – Denials & Compliance (Flexible Schedule)

Harris Health seeks a Care Manager Clinical Denials (CM-CD) to oversee audits and denials related to inpatient medical necessity and level of care. The role reviews records, applies clinical and payer rules, and coordinates appeals with physician advisors.

As a liaison between Case Management and physicians/providers, you will ensure regulatory compliance, perform audits, and support prevention of readmissions through diligent denial management.