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$65k - $88.6k
Become a part of our caring community and help us put health first The Supervisor, Claims Review makes appropriate claim decision based on strong knowledge of claims procedures, contract provisions, and state and federal legislation. The Supervisor, Claims Review works...SuggestedFull timeContract workTemporary workApprenticeshipWork at officeRemote work$71.1k - $97.8k
**Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome office$71.1k - $97.8k
...part of our caring community and help us put health first The Utilization Management Nurse 2 utilizes clinical nursing skills to support... ...(G&A) Nurse who will assist in preparation of cases prior to review by the Humana G&A Medicare Medical Directors. The Nurse reviews...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to FridayRotating shiftWeekend work- Overview Paige, a GCG company, is currently seeking a Utility Solutions Sales Director to partner with leaders on ourRenewable Energy and Utilities team and execute a go-to-market strategy within the utility market, driving long-term growth through market penetration, team...SuggestedFull timeWork at officeLocal areaRemote workWork from home
$40k - $52.3k
...UM Administration Coordinator contributes to administration of utilization management. The UM Administration Coordinator 2 performs... ...CenterWell and Onehome. Responsibilities Manages NLP's for chart reviews for the nursing team Builds and pends authorizations for review...SuggestedBi-weekly payTemporary workApprenticeshipWork at officeRemote workHome officeMonday to Friday- As the E&U Industry Executive Director, you will have: Accumulated deep domain experience E&U companies and related industry partners. Solid functional knowledge of E&U information systems, technologies & applications used to drive their business. Acute understanding...Suggested
$79.1k - $158.2k
**Job Description** **Senior Oracle Utilities Consultant** **Location: United States** **Travel: 50%** **Key Responsibilities** + Analyze business requirements and deliver functional and technical Oracle Utilities solutions. + Implement and configure Oracle Utilities applications...SuggestedFull timeTemporary workRemote workFlexible hours$69 - $75 per hour
...and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices... ...for completion of UM projects and participation in site visit reviews. Respect and maintain HIPAA confidentiality guidelines....SuggestedWork at officeImmediate startMonday to FridayShift work$120.1k - $251.6k
**Job Description** **Seeking a Utilities industry expert with Oracle ERP &/or Oracle SCM sales, presales &/or delivery experience.** **... ...influence Oracle's competitive position. + Participate in weekly reviews for key industry areas such as financials, sales pipeline,...SuggestedTemporary workFlexible hours$113.1k - $185.1k
**Job Description** Oracle is leading the digital revolution. We are empowering nearly half a million businesses across the globe to turn untapped potential into real business value. You will connect the biggest enterprises of today with the tools to challenge in the digital...SuggestedContract workTemporary workLocal areaFlexible hours$116.5k - $251.6k
**Job Description** **As the E&U Industry Executive Director, you will have:** + Accumulated deep domain experience E&U companies and related industry partners. + Solid functional knowledge of E&U information systems, technologies & applications used to drive their business...SuggestedTemporary workFlexible hours$126.6k - $207.3k
**Job Description** **NA OCI Sales Representative, Energy and Utilities** **Overview** We are in search of an OCI and AI Infrastructure as a Service (IaaS) Sales Representative to be part of our exciting team. Our team **highly values** trust, diversity, coaching, innovation...SuggestedContract workTemporary workWork experience placementLocal areaFlexible hours$26.01 - $74.78 per hour
...it all with heart, each and every day. **Position Summary** + Utilizes clinical skills to coordinate, document, and communicate all aspects... ...the utilization/benefit management program. + Conduct clinical reviews for adult inpatient behavioral health cases, applying...SuggestedHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours$43.89k - $102.08k
...skilled at identifying outliers through data extraction and analysis, dedicated to a specific self-funded plan sponsor. The lead reviewer is accountable for the validation of existing fraud waste and abuse business rules and leads designed to detect aberrant billing patterns...SuggestedHourly payFull timeTemporary workWork experience placementLocal areaWork from homeFlexible hours$26.01 - $74.78 per hour
...uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary Utilizes clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program. Applies...SuggestedHourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours$70k - $74k
...Health Plan/Payer. The comprehensive process includes analyzing, reviewing, and processing medical necessity denials for resolution. You... ...log claims/appeals information on relevant tracking systems · Utilize critical thinking skills to interpret guidelines of internal policies...Temporary workWork at officeRemote workMonday to Friday$43.92 - $69.16 per hour
...GitHub workflows such as branching strategies, pull requests, peer reviews, governance with CODEOWNERS. SQL Server Integration Proven... ..., fault‑tolerant ingestion approaches (threaded boto3 utilities, checkpoints, etc.). Minimum Qualifications Proficiency with...Hourly payWork experience placement$61.36 - $90.18 per hour
...pharmaceuticals. Analyzes pharmacy claims to identify areas of utilization aberrations and opportunities for cost-efficiencies. Provides... ...experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain...Hourly payMonday to FridayFlexible hoursShift workWeekend workAfternoon shift$29.96 per hour
...Sergeant assigns work in terms of generalinstructions.Work is reviewed forcompliance with instructions and established procedures, accuracy... ...degree of dexterity, distinguishes between shades ofcolor, and utilizes the sense of smell. SUPERVISORY AND MANAGEMENTRESPONSIBILITY...Work at officeLocal areaRelocation package$74.9k - $158.2k
...design, implement, and maintain scalable automation solutions, utilizing tools such as Ansible, Python, PowerShell, and Golang to enhance... ..., and standard operating procedures Conduct code reviews and mentor junior team members on automation best practices...Temporary workFlexible hours$92.3k
...architecture, network systems and applications infrastructure. Reviews system requirements and business processes, ensures quality outcomes... ...working with operational computer systems 5 years utilizing various industry laws and regulations Preferred 5...Temporary workFor contractorsLocal area$65k - $88.6k
...documents into NCQA's online submission tool, coordinating document reviews with multiple stakeholders, and scheduling key meetings and... ...areas subject to accreditation requirements (such as utilization management, case management, credentialing, network operations...Bi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to FridayFlexible hours$71.2k - $158.2k
...APEX, Oracle SQL, and Oracle Analytics Cloud (OAC) for report and utility development. Key responsibilities include: + **Work directly... ...refine technical requirements. + **Implement high-quality code** , review code written by peers, and take part in design reviews. +...Contract workTemporary workWork experience placementFlexible hours- ...from on-call rotation). Optimize system operations and resource utilization as well as perform system capacity analysis and planning.... ...specifications, and 4+ years of experience providing quality assurance review and the evaluation of new and existing software products. US...Contract workWork at officeRemote workWeekend work
$78.4k - $107.8k
...develop content that supports key marketing objectives. You will utilize data analysis to inform creative decisions and emerging... ...Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward...Bi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeFlexible hours$29.05 - $44.24 per hour
...computer, phone, and cable set-up and use. + Expected to lift and utilize full range of movement to transport, pull, and push equipment.... ...to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel...Hourly payWork at office$199.61k - $240.24k
...their innovations and vice versa. Conduct design and code reviews. Analyze and improve efficiency, scalability, and stability... ...shipping high quality work and achieving high reliability Utilizing data and analysis to explain technical problems and provide...Work experience placementLocal areaRemote work$135.61k - $184.04k
...relating to the network infrastructure within the NPS environment; Review current best practices and provide recommendations for... ...Certification or equivalent BCNE Certification or equivalent Experience utilizing (RF) site survey tools such as Ekahau, RF Scanners and...Full timeLocal areaRemote workMonday to FridayFlexible hours$170k
...JOB SUMMARY This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy...For contractorsPrivate practiceWork at officeLocal area$40 per hour
...experience.*$40.00 - $40.00**Position Highlights**\*\*Flex staff are utilized according to the staffing needs of their department with an... ...practitioner when an exam indicates immediate attention.* Reviews appropriate indications for exams ordered and reports inappropriate...Permanent employmentTemporary workWork experience placementImmediate startFlexible hoursShift workNight shiftWeekend work