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Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. After training, the permanent schedule is an Monday-Friday, starting as early as 7 am CST and ending as late as 7 pm CST.
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Managing case work end to end covering settlements, PIPs, absence management and all aspects of grievance and disciplinaries (investigations, hearings, mediations, appeals, terminations) in line with legal requirements and company policy.
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Our offerings, powered by the iTwin Platform for infrastructure digital twins, include MicroStation and Bentley Open applications for modeling and simulation, Seequents software for geoprofessionals, and Bentley Infrastructure Cloud encompassing ProjectWise for project delivery, SYNCHRO for construction management, and AssetWise for asset operations.
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Our industry-leading software solutions are used by professionals, and organizations of every size, for the design, construction, and operations of roads and bridges, rail and transit, water and wastewater, public works and utilities, buildings and campuses, mining, and industrial facilities.
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The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. Assists providers with credentialing and re-credentialing and contracting questions and issues.
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Serve as the HR Manager/ Lead for the region providing guidance and counsel to managers and colleagues on employee relations issues and workplace practices. Patient and persistent in driving sophisticated projects over the finish line against a landscape of regularly changing priorities.
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You will be responsible for all HR core services in UK & Ireland, plus partnering with the corporate centers of excellence to drive global functions such as talent management, compensation, talent acquisition, learning and development, and analytics.
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There is a need to have superior verbal and written communication skills and they will be successful in influencing leaders and aligning with partners on compliance priorities, explaining the key legal and business requirements in compliance remediation projects, in developing clear and concise training and enablement materials, and in reporting on the results of monitoring and auditing existing processes.
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The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions.
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In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals.
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Eligible employees may enroll in the Companys 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. + Required high speed internet access (25 mbps or higher) and consistent connection.
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The Company offers a full range of medical, dental, and vision benefits. CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities.
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Explains member's rights and responsibilities in accordance with contract. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
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Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors. We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.
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CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
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