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Three to Five (5) years experience in Case Management/Utilization Review (as either CADC, LAADC, LCSW, LMHC, LMFT, or Utilization Review Coordinator). The Utilization Review Specialist will also perform pre-certification reviews, concurrent reviews and will perform appeal reviews as needed.
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Acquires and maintains a functional working knowledge of applicable systems like QNXT, Visual Cactus, and proprietary provider databases, and routinely relays information about additions, deletions, or changes to the LAC Provider Network Management (PNM) Provider Data Management department.
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Specific to CTC/PWC and MCC: training and perform quality assurance duties by reviewing medical documentation utilizing audit tools as outlined by County of San Diego Quality Management. Attend all meetings facilitated by County of San Diego Quality Management team.
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The Data Management Specialist will be responsible for managing and optimizing our organizations data infrastructure, ensuring data quality, and implementing data solutions using PySpark, DataBricks, Snowflake, and/or Redshift.
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Coordinate closely with cross-functional teams including Quality Control, Bioinformatics, Translational, Analytical Development, Supply Chain, Process Development, and Manufacturing to ensure seamless sample management.
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As UVM Operations Supervisor, you will assume a pivotal role in the daily management of your team of five, overseeing Utility Vegetation Management operations. - 3 years of utility vegetation management experience.
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10+ years of relevant, senior subject matter expertise experience related to water resource management and transboundary water governance, including experience with USAID or other international donors.
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O Contributes to the risk management culture by providing reasonable assurance of risk through secondary monitoring and reviews of Asset & Liability Management, Interest Rate Risk, Credit Risk Management, Allowance for Loan & Lease Losses, Vendor & Project Management programs.
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The incumbent is considered the subject matter expert and will use that expertise to deliver Property Management tools and processes that effectively manage property through its life cycle. This position will be a key point of contact for Property Management; therefore, excellent communication, relationship management, and customer service skills will be required.
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Bowhead seeks a Records Management Specialist to support Naval Surface Warfare Center Carderock Division. The contract supports business services in support of Code 80 and other organizations associated with or sponsoring the NSWCCD. The business services include Program Management and Planning, Finance, Logistics, Security, Space Planning, Safety, Administrative Services, Technical Editing, Records Management, and Computer Engineering and IT support.
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Contribute to the maintenance of and responsible utilization of career management system ( CMS ) information for students, employers, and academic departments. Plan and coordinate the administration and delivery of the career services program to enhance the career exploration, job search preparation, career readiness competency development, and career management activities of Millersville University students and alumni.
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All Utilization Management activities are performed in accordance with the mission vision and values of UVA Medical Center. Under general direction: The Utilization Management RN serves as a leader resource in the Utilization Management process.
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Proficiency in Yardi, Nexus and/or other ERP software systems is a plusProficiency in advanced data analytics tools such as PowerBi or Tableau is a plusUnderstanding of basic concepts in data base management such as Azure, SQL, et cetera is a plusBeing able to quickly master new software packages is a must.
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Under general direction of the Deputy Chief Development Officer, the Project Management Office (PMO) Manager is responsible for project management functions and processes. In accordance with the District's Transit Management Plan (TAM) and strategic objectives, this position oversees the development and prioritization of Capital Improvement Program (CIP) projects input for funding and executive leadership approval.
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The Wealth Management Associate is an integral member of the advisory team and is responsible for delivering a consistent, positive client experience to help ensure all commitments are completed and delivered in a timely manner.
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Title: utilization management Company: La Care Health Plan
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