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Consulting and discussing contract form provisions, regulations, and case law with OIC staff to ensure consistent and uniform review standards of health care benefit management forms. We are looking for a candidate who is interested in learning about the contract relationships between insurance companies and intermediaries who perform health care benefit management services such as pharmacy benefit management, prior authorization review, and disease management.
$6,705 a monthFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Perform financial planning; review budget preparation and justification of labor and non-labor expenditures. Perform financial planning; review budget preparation and justification of labor and non-labor expenditures.
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Provide deputy/assistant project management and environmental planning knowledge for tribal fee-to-trust projects and provide support on environmental impact analysis, coordination of biological and cultural assessment, NEPA and/or CEQA research and document production, and coordination for other environmental projects.
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Complete initial review and interpretation of diagnostic studies to include but not limited to: laboratory, pulmonary function and ECG studies. In coordination with the PCs, we specialize in disability-focused medical examinations, independent medical exams and review services, occupational health services, diagnostic testing, and case management solutions.
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The Research Nurse will review EPIC schedules, screen, consent, administer a questionnaire and collect nose and throat swabs from participants, and a blood draw on a subset of participants. May perform medical record review requiring professional clinical background/education/ experience for correct interpretation and data collection.
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Review potential investments for possible inclusion in the Tangible Assets portfolio; conduct robust due diligence efforts including general investment overview, document review, financial structure analysis, meetings with management, and the preparation/presentation of findings and conclusions to the appropriate investment committee following approval by the SIO. Position may include additional duties that utilize the required skills.
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In collaboration with EDW and Business Intelligence Teams, the Data Quality Analyst will design, review, and refine data quality reports and alerts and take actions to remedy issues detected. Ability to review and interpret data quality reports and identify actions needed to address issues.
$105,435 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Minimum two (2) years of RN experience in utilization review, ambulatory case management, care coordination or disease management. Document interventions and interactions with patients or caregivers according to KFHPW and Care Management policy and procedure.
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The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination.
$83.2 an hourFull-timeExpandApply NowActive JobUpdated 11 days ago - UpvoteDownvoteShare Job
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This position requires specialized training and experience to perform independent, professional respiratory care, ventilator management, diagnostic and therapeutic procedures, and clinical evaluation of care, including the establishment of therapy and treatment objectives, and the review of care based on the age and needs of the patient.
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Previous insurance industry experience preferred - Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills Application Deadline Applications for this position will be accepted through Friday, September 27th, 2024, subject to earlier closure due to applicant volume.
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Coordinate with Master Scheduler to develop “project launch cycle” and monitor progress and develop corrective actions where neededCoordinate with Purchasing Department to ensure on time/on budget material procurementParticipate in prototype development and review processMonitor production of product through both physical review of work in process and through review of labor and costing report data.
$110,000 a yearFull-timeRemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. 1+ years’ experience Utilization Review experience.
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We specialize in providing professional management, administrative, healthcare, court reporters and transcriptionist experts, and document/ record and telehealth operational support solutions to U.S. Government, State and commercial clients.
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Perform quality assurance review, data migration audit, reconciliation and exception reporting. Work collaboratively with subject matter experts and project team to define, organize, document, and communicate requirements.
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review document attorney jobs in Washington
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