Clinical Policy Ops Specialist: Turn Policies into Action
Humana
Humana Inc. is seeking a Clinical Policy Operations Professional 2 in Austin, TX to support clinical pharmacists by translating approved strategies into operational policies, drug lists, and benefit rules. You will ensure accuracy and compliance in UM criteria, policy system configurations, and external accreditation submissions, while delivering quality analyses and reports. Working with clinicians, pharmacists, and business partners, you will help align formulary and workflow configurations #J-18808-Ljbffr Humana
$16 per hour
...fashion or the outdoors? SCHEELS can turn your passion into a rewarding career through our extensive... ...while following Scheels' policies and procedures. Maintain excellent written... ...Mentality Demonstrate genuine interest and action in helping others before yourself, regardless...PolicyHourly payPart timeWork at officeLocal areaMonday to FridayShift workNight shiftWeekend work- ...TX 78723, USA Austin Regional Clinic has been voted a top Central Texas... ...according to established policy and procedure with all supporting... ...’ needs. Ability to align own actions with those of other team... ...to organize thoughts and ideas into understandable terminology. Ability...PolicyMonday to FridayFlexible hours
- ..., USA Austin Regional Clinic has been voted a top Central... ...care by requesting specialist records and other... ...specialties and services, policies and procedures, protocols... ...Ability to align own actions with those of other team... ...organize thoughts and ideas into understandable...PolicyWork at officeFlexible hours
- ...employment programs. About the role The People Ops team is responsible for driving business... ...employee offboarding. The People Ops Specialist is highly skilled in communication and... ...providing orientation, reviewing company policies, gathering new hire logistics, explaining...PolicyWork at officeLocal area
- Baylor Scott & White Health in Round Rock, TX is seeking a Clinic Charge Registered Nurse to streamline patient care in the Pain Management... ..., strong communication, and adherence to laws and hospital policies. You will work on a secure, therapeutic environment and...Policy
- Action Behavior Centers is seeking a Clinic Admissions Associate located in Austin, TX. In this role, you will be the first point of contact for families starting their journey into ABA therapy, guiding them with empathy and care through the admissions process. Responsibilities...
$34.86k
...Health Information Management Specialist Purpose: The Health... ...Manager and works closely with clinical staff, IT professionals, and... ...equal opportunity/affirmative action employer, complies with all applicable... ...University is committed to a policy of equal opportunity for all...PolicyWork at office- ...technically skilled Strategic Sourcing Specialist II to drive sourcing and... ...new technologies and expand into emerging markets. This high-... ...autonomously with a bias for action and continuous improvement. Advanced... ...and qualifications. It is our policy to administer all personnel...PolicyFor contractors
- Specialist, Supply Network Planner page is loaded## Specialist... ...supply constraints into the Demand Plan as part... ...and the ability to turn data into information, conclusions & targeted action* Ability to quickly extract... ...paid time off policy that empowers you to take...PolicyH1bWork at officeShift work
$34.86k
...Health Information Management Specialist ---- Hiring Department:... ...Manager and works closely with clinical staff, IT professionals, and... ...equal opportunity/affirmative action employer,complies with all... ...University is committed to a policy of equal opportunity for all...PolicyFor contractorsWork at officeImmediate start- ...client is seeking a full time EHS Specialist supporting the location of... ...AND RESPONSIBILITIES Policy Development and Compliance... ...knowledge, and best practices into all documentation, risk assessments... .... Recommend corrective actions, equipment upgrades, or process...PolicyFull timeWork at officeLocal areaRemote workOverseasWeekend work
$140k - $192.5k
...Execution, Integrity, and Inclusion. We weave AI into the fabric of everything we do and use it... ...value. Translate Strategy to Security Policy: Convert customer business and security... ...translate valuable field feedback into actionable feature requests, serving as a critical...PolicyRemote workVisa sponsorshipWork visa$90k
...Overview Database Specialist role at The University of Texas at Austin... ...the organization. Compliance, Policy, Documentation: Support compliance... ...equal opportunity/affirmative action employer. It does not... ...Experts add insights directly into each article, started with the...Policy$75.3k
...advancement, scientific discovery and cutting-edge manufacturing, turning abstract ideas into realities that transform the world for good. Your... ...has an unlimited U.S. Personalized Paid Time Off (PPTO) policy for full-time salaried/exempt employees, seven paid holidays...PolicyFull timeWork experience placementFor subcontractorLocal area$90k
...Job Posting Title:Database Specialist-Hiring Department:Discovery to Impact... ...academic research into real-world solutions, serving... ...the organization.Compliance, Policy, Documentation: Support compliance... ...equal opportunity/affirmative action employer, complies with all applicable...PolicyOngoing contractFor contractorsFlexible hours$27.02 per hour
...HCC) Coding, medical coding, clinical terminology and anatomy/physiology... ...and interpreting into ICD10 diagnoses and HCC disease... ...Guidelines for Coding and Highmark's Policy and Procedures to guide HCC... ...(CRC) Certified Coding Specialist (CCS) Registered Health Information...PolicyFor contractorsWork at officeLocal areaRemote workFlexible hours$192k
..., and translating computational insights into strategic recommendations and solutions that... ...an environment where feedback is clear, actionable, and focused on your development. The... ...additional details regarding our global EEO policy and diversity initiatives, please visit...PolicyApprenticeshipWork at officeLocal areaEasy work$132.9k - $182.7k
...discovery and cutting-edge manufacturing, turning abstract ideas into realities that transform the world... ...hire the "best" candidates. The Code Specialist is a senior-level Registered... ...S. Personalized Paid Time Off (PPTO) policy for full‑time salaried/exempt employees...PolicyFull timeWork at officeLocal areaRemote work$20 per hour
...Patient Access Specialist Sign On Bonus $250.00 Monthly discretionary... ...and accurately enters data into the electronic medical record... .... Writes clerical and clinical patient related messages from... ...clinic protocols as well as APC policies and procedures Maintains...PolicyHourly payWork at officeRelocation packageRotating shift$110k - $142.44k
The ITIL Specialist, Mid leads the design, implementation, and continual... ...from data, and recommend actionable improvements. Act as or support... ...and ensuring alignment with policies, compliance requirements, and... ...to translate process designs into tool functionality, validate...Policy- Safety Specialist 1 Locations: Temple, TX; Dallas, TX; Nashville, TN;... ...compliance with laws and Company policies. Conducts safety audits on... ...with injured employees and clinics to ensure that the worker attends... ...Opportunity/Affirmative Action Employer and it is our policy...PolicyFor contractorsFor subcontractorLocal area
- ...employees worldwide. Senior Fraud Specialist The Senior Fraud Specialist is... ...: Lead investigations into high-complexity, multi-vector... ...with minimal to no guidance Policy & Procedure Recommendation: Consistently... ...requiring independent action and a high degree of initiative...PolicyWorldwide
- Voucher Specialist What you will do in this position: Voucher Review... ...records of payment processing actions, correspondence, and... ...Tracking: Enter case information into SHCC's proprietary STARS system... ...processes adhere strictly to HUD policies and SHCC's quality assurance...PolicyWork at office
$16 - $17 per hour
...Department Specialist Ace Retail Group (ARG), is a division of Ace... ...professional in appearance and actions. Perform all other duties... ...incorporate our Core Values into daily decisions and interactions... ...for the employment policies and practices of the independent...Policy- ...most. Job Description The HME Specialist will serve as a critical... ...mailed responses from Payors into Brightree and Salesforce systems... ...Authorization responses to direct actions to team members. Monitor... ...and regularly reviews our policies to ensure compliance with evolving...PolicyWork at officeLocal areaImmediate start
- ...Function The CS Journey & Programs Specialist is responsible for designing... ...journey architecture into practical toolkits, visual and... ...customer health, determine next actions, and identify escalation... ...Verint has a zero-tolerance policy against any form of discrimination...PolicySeasonal workLocal areaShift work
- ...needs while ensuring alignment with internal policies, system capabilities, and company... ...Translate sales and marketing requests into viable quote structures, finding creative... ...proud to be an equal opportunity/affirmative action employer. At Epicor, we're truly a team...PolicyPermanent employmentContract workWork at officeRelocation
- ...As a Cardiovascular Disease Specialist, you will drive meaningful patient... ..., pharmacies, and hospital clinics to execute your... ...plan in alignment with company policies, standards, and ethics. Maintain... ...comply with all affirmative action requirements for protected veterans...PolicyFor contractorsWork experience placementLocal areaRelocationFlexible hoursNight shift
- ...-5P Job Title: Revenue Cycle Specialist Department: Finance Position... ...regulations and organizational policies. Working Relationships... ...Relationships: All comments, actions and behaviors have a direct effect... ...billing activities with Nursing, Clinical, and Administrative staff to...PolicyDaily paidFor contractorsWork at officeShift work
$192k
Consulting Specialist - Payors (Job ID: 104020) Do you want to work on... ...pharmacy, value‑based care, clinical operations). Given this, you... ...environment where feedback is clear, actionable, and focused on your... ...details regarding our global EEO policy and diversity initiatives,...PolicyHourly payApprenticeshipWork at officeWorldwide
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