...Castle County and northern Maryland.
Visit us online:
Rockford Center is searching for a talented and patient centric Utilization Review Specialist!
Key Responsibilities include:
+ Completes pre-certs and concurrent reviews as assigned, on appropriate day and by the...
Suggested
Relief
Immediate start
...card, send you a check, or ask you for payment as part of consideration for employment.
Medical Oncology Medical Director – Utilization Review
+ Job Family: MED Licensed Physician/Doctor/Dentist
+ Type: Full time
+ Date Posted:Apr 17, 2024
+ Anticipated End...
Suggested
Holiday work
Full time
Work experience placement
Local area
Remote job
Work from home
Relocation bonus
...Company in Dover, Delaware, United States
Refrigeration/Utility Specialist at a glance...
This position is responsible for ensuring... ...temperature and humidity within the plant.
Perform regular reviews of system performance, identifying problems and concerns and...
Suggested
Local area
Visa sponsorship
Work visa
...for payment as part of consideration for employment.
Nurse Reviewer I
+ Job Family: MED Licensed Nurse
+ Type: Full time... ...appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines....
Suggested
Holiday work
Full time
Temporary work
Work experience placement
Local area
Remote job
Shift work
Monday to Friday
...+ Apply judgment within defined parameters
+ Receive general guidance and additional detailed instruction on new projects
+ Review work for sound reasoning and accuracy
+ Occasional travel to the office for training/meetings as needed
Responsibilities
+ Execute...
Suggested
Temporary work
Work experience placement
Local area
Flexible hours
...Evolent for the mission. Stay for the culture.
What You’ll Be Doing:
As a Cardiology, Physician Clinical Reviewer you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical...
Suggested
...a sensitive issue, the Army National Guard’s Human Resources Specialist is the primary go-to person. As an HR Specialist, you will help... ...of the HR Specialist may include: organizing, maintaining, and reviewing personnel records; data entry and retrieval; processing...
Suggested
...at Citigroup in Wilmington, Delaware, United States
The Process Review Manager will report into the Business Control Head team for Branded Cards. The role will lead efforts to create standard methodology and processes for control execution across Branded Cards. Excellent...
Suggested
Holiday work
Full time
...Newark, Delaware, United States
KYC REVIEW ANALYST - OPS
WHAT IS THE OPPORTUNITY... ...What you will do
+ The KYC Review (Specialist – Senior) will perform Enhance Due... ...commercial loan borrowers and prospect reviews utilizing a variety of internal bank systems and...
Suggested
Hourly pay
...us put health first
The Supervisor, Utilization Management Pharmacy is a clinical pharmacist... ...who perform medical necessity reviews for prescriptions requiring pre-authorization... ...with management and top professionals/specialists in selection of methods, techniques,...
Suggested
Holiday work
Full time
Temporary work
Apprenticeship
Remote job
Home office
...Newark, Delaware, United States
Case Review Analyst
Req number:
R1927
Employment... ...answers to questions from Product Specialists regarding cases at hand
Any further duties... ...conduct repetitive tasks on a computer, utilizing a mouse, keyboard, and monitor.
Reasonable...
Suggested
Full time
Apprenticeship
Local area
Saturday
...the front desk. That’s where you come in. As a patient service specialist, you’ll manage both the patient side and business side of our... ...individuals via email and phone, manage patient payments and utilize multiple computer programs. Don’t underestimate the impact you...
Suggested
Permanent employment
Full time
Flexible hours
Shift work
Day shift
Afternoon shift
Monday to Friday
...ask you for payment as part of consideration for employment.
Utilization Management Representative I
+ Job Family: CUS Care... ...coordinating cases for precertification and prior authorization review.
How you will make an impact:
+ Managing incoming calls or...
Suggested
Holiday work
Full time
Contract work
Temporary work
Work experience placement
Local area
Remote job
Work from home
Shift work
Monday to Friday
...at Century Engineering, Inc. in Dover, Delaware, United States
Utility Locator
ID
2024-6634
Job Locations
US-DE-Dover
Category
CoMET/CM/Field/Lab
Position Type
Regular Full-Time
Step into Your New Role
Century Engineering, a Kleinfelder...
Suggested
Full time
Remote job
...Distribution Design Experience. For this role, we are providing make-ready/joint-use and general distribution design services to power utility companies. We're in need of knowledgeable, already-skilled staff to join our program teams.
Note: This position can work...
Suggested
Remote job
Holiday work
Full time
Night shift
...will generate tangible value for all stakeholders.
Within the Utilization Management (UM) Strategy team, our goal is to enable members... ...requirement definition, prior authorization and claims review, UM vendor management, analytics / reporting)
+ Knowledge of...
Weekly pay
Full time
Work from home
Home office
Flexible hours
...through in our work, as we are united by our mission of creating opportunities for people where they live, learn, and work.
The Loan Review Analyst ( LRA ) performs various functions which are primarily related to the oversight of underwriting and collection decisions,...
Temporary work
Work experience placement
Local area
...communicative, efficient, and effective behavioral health clinical review practices to help client’s members with mental health service... ...time.
Collaboration Opportunities: As a Behavioral Health Utilization Manager, you will be working with a diverse team of social...
...Experience required.
Experience in InterQual Milliman
Understanding State Policies
Skills:
Prior Authorization, Clinical review, Licensed Practical Nurse, LPN , Interqual
About Actalent
Actalent is a global leader in engineering and sciences services...
...other fields of AI
+ Solid understanding of NVIDIA GPUs and GPU applications
+ Enterprise Sales experience
+ Energy or Utilities vertical experience is essential!
buildingchangingtheworldsolvenegotiatingintheworldbuildingstakeholdersmana
Responsibilities...
Holiday work
Temporary work
Flexible hours
...the front desk. That’s where you come in. As a patient service specialist, you’ll manage both the patient side and business side of our... ...individuals via email and phone, manage patient payments and utilize multiple computer programs. Don’t underestimate the impact you...
Permanent employment
Full time
Flexible hours
Shift work
Day shift
Afternoon shift
Monday to Friday
...or property owner at the work site.
Your Responsibilities as a Locator:
+ Correctly, safely, and efficiently locate underground utilities, including telecommunications, electric power, cable TV, gas, water, and sewer systems.
+ Thoroughly search for underground utilities...
Hourly pay
Holiday work
Full time
For contractors
Second job
Outdoor
Weekend work
...part of our caring community and help us put health first
The Utilization Management Nurse 2 utilizes clinical nursing skills to support... ...courses of action.
The Utilization Management Nurse 2 reviews the medical documentation, completes telephonic reviews with the...
Weekly pay
Holiday work
Full time
Temporary work
Apprenticeship
Home office
Monday to Friday
...information, such as your job duties and employee benefits offered at the unit, during the interview process.
What You’ll Do: As a Utility Worker at Sodexo, you are a team unifier and solutions driver. Your dedication to team needs and client solutions will make an...
Hourly pay
Holiday work
Full time
Flexible hours
...What Is the Opportunity?
This position is responsible for reviewing outside counsel’s invoices for compliance with Travelers’ Retention... ...and negotiate resolution of billing issues or disputes.
+ Utilizes claim file and document review to obtain claim strategy...
Holiday work
...all operating parameters are being maintained.
5. Required to utilize manual or automated pallet jack for material/product movement.... ...actions to correct or stop any unsafe conditions or practices.
+ Review Material Safety Data Sheet instructions before working with any...
For contractors
Summer work
Local area
Immediate start
Shift work
Day shift
Job Description
The Facilities Specialist is responsible for a wide range of tasks. These tasks include technical reviews of projects that are being considered for acceptance at the facilities, technical review of sampling results, facility approvals. This position is...
Permanent employment
Immediate start
...at Humana in Dover, Delaware, United States
Become a part of our caring community and help us put health first
The Claims Review Representative 2 makes appropriate claim decision based on strong knowledge of claims procedures, contract provisions, and state and...
Weekly pay
Holiday work
Full time
Contract work
Temporary work
Apprenticeship
Remote job
Work from home
Home office
...health first
Humana Healthy Horizons in Ohio is seeking a Utilization Management Administration Coordinator 2 who contributes to administration... ...telephone experience desired
+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care...
Holiday work
Full time
Temporary work
Apprenticeship
Work from home
Home office
...at Guardian Life in Dover, Delaware, United States
Guardian has an opportunity reporting to the Reviewing Dentist Manager for a Reviewing Dentist where you will be responsible for maintaining a regular clinical review schedule of a minimum of 20 hours per week (hours...
Holiday work
Full time
Remote job
Flexible hours
Monday to Friday