- Children's Mercy KC (Kansas City, MO)
- …Engagement Oversees and directs the work of Nurse Case Managers, Social Workers, and Utilization Review specialist team members and support staff Analyzes, ... support tools and related software applications and implementations. Engages in utilization review committee. Qualifications Master's Degree MSN or Masters… more
- Ross (Dallas, TX)
- …Front-End Operations, MPT, etc.) and analytics. Identify shortage risks through regular review of indicator reports; partner with stores to develop action plans to ... to the company and address new types of theft and fraud. Maximize utilization of all available merchandise protection tools and resources (including EAS, domes,… more
- Ross Stores (Mckinney, TX)
- …Front-End Operations, MPT, etc.) and analytics. *Identify shortage risks through regular review of indicator reports; partner with stores to develop action plans to ... to the company and address new types of theft and fraud. *Maximize utilization of all available merchandise protection tools and resources (including EAS, domes,… more
- PlayStation Global (Los Angeles, CA)
- …IT Manager will lead a team consisting of skills ranging from support specialist through senior level Systems Administrators, providing all levels of support and ... cross-departmental expertise vital to effectively respond to issues Perform periodic review and evaluation of all employees, handling performance issues, training… more
- Mt. Hood Community College (Gresham, OR)
- …both remotely and in-person to meet program needs. This position may be eligible for remote work on a hybrid basis. Any remote work requires prior approval and ... must comply with MHCC Remote Work policies and administrative regulations. Remote ...in your application that you want the College to review towards potential placement. Hired employees will not have… more
- Abbott (Bessemer, AL)
- …mothers, female executives, and scientists. The Opportunity This position is a remote position Qualified candidates must currently live in the Hoover, AL area ... support and technical troubleshooting & elevate Level 2+ issues to service specialist to minimize overall cost to serve. Coordinate order; delivery; and billing.… more
- Spectrum Billing Solutions (Skokie, IL)
- …revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review Specialist to our growing team. The Utilization ... admission and clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization for… more
- Catholic Health Initiatives (Omaha, NE)
- …2 hours of a Commonspirit Health Facility Are you a skilled and experienced Utilization Review Specialist looking for a rewarding opportunity to impact ... patients. **This position offers the flexibility to work remotely with proven Utilization Review experience.** Medical Coding experience is a plus! As our … more
- Niagara Bottling LLC (Diamond Bar, CA)
- …compensation and benefits packages for our Team Members. Sr. Manufacturing Technology Specialist - Warehouse Excellence ( Remote ) The Sr. Manufacturing Technology ... with the Manufacturing Technology Manager + Provides a final technical review of all eLearning courseware + Communicate effectively with training stakeholders… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Denials Management Specialist reviews inpatient CMS and third party denials for medical necessity and tracks ... outpatient denials for experimental, coding or other issues that may require record review . Provides billing with information needed to obtain payment of claims. … more
- University of Miami (Hialeah, FL)
- …Documentation Specialist 1 provides clinically based concurrent and retrospective review of inpatient medical records to evaluate the documentation and ... or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Clinical...utilization of acute care services. + Facilitates appropriate physician… more
- Integra Partners (Troy, MI)
- …do whatever it takes to get things done. PREFERRED SKILLS: + Certification in Utilization Review or Case Management + Experience with health insurance operations ... our Operations Training & Development team as an Operations UM Training Specialist , specializing in Utilization Management (UM) processes. The ideal candidate… more
- Pfizer (Lansing, MI)
- …patients. **What You Will Achieve** The Rare Cardiac, Amyloidosis Multi-disciplinary Specialist (AMS), will target health care providers (HCPs), spanning multiple ... will report into the Area Business Manager (ABM). Amyloidosis Multi-disciplinary Specialist (AMS) will demonstrate strong business acumen and an expert understanding… more
- Washington County Hospital and Clinics (Washington, IA)
- …leadership to monitor effectiveness of training efforts. Monitoring may include routine review of reports and utilization data used in the development ... Informatics Specialist Job Details Job Location Washington Co Hospital - Washington, IA Remote Type Hybrid Position Type Full Time Job Shift Day Job Category… more
- Elevance Health (Richmond, VA)
- …regarding case and determines appropriate area to refer or assign case ( utilization management, case management, QI, Med Review ). + Provides information ... **Medical Management Specialist I** **Location:** This role enables associates to...and documents all actions. + Responsibilities exclude conducting any utilization management review activities which require interpretation… more
- Robert Half Accountemps (Laguna Hills, CA)
- Description A Healthcare Laboratory company is in the need of a remote Medical Billing Collections Specialist . The Medical Billing Collections Specialist ... (HMO, PPO, IPA, TPA Indemnity) and Patient Billing. The Medical Billing Collections Specialist must possess detailed knowledge of all medical benefit levels and a… more
- AdventHealth (Daytona Beach, FL)
- …will be remote . **The role you'll contribute:** The Oncology Data Specialist Certified is responsible for improving quality and outcomes for the Cancer Institute ... public reporting. The ODS-C serves as the Cancer Registry content expert to review patient diagnosis, treatment, and outcomes across the care continuum. The ODS-C is… more
- Huntington National Bank (Pittsburgh, PA)
- Description Summary: The Insurance Program Senior Compliance HR Specialist position is responsible for delivering the Employee Benefits Compliance suite of services ... for clients. + Plan Document preparation services (in-house), including carrier certificate review to determine discrepancies in plan provisions as well as plan… more
- AdventHealth (Orlando, FL)
- …we are even better. **Schedule:** Full Time **Location:** Orlando, FL ( Remote ) **Shift** : Days, 7:30am-4:00pm/8:00am-4:30pm **The community you'll be caring for: ... and 125,000 outpatients each year **The role you'll contribute:** Oncology Data Specialist (ODS) is responsible for improving quality and outcomes for the Cancer… more
- State of Arkansas (Rogers, AR)
- PARK SPECIALIST II Date: Jul 18, 2025 Req ID: 50189 Location: Rogers, AR, US, 72756 Category: DEPT OF PARKS AND TOURISM Anticipated Starting Salary: $14.00 per hour ... Trail Maintenance Coordinator advertised as Park Specialist II [Part Time] Position #: 22091990 Salary: $14.00 per hour Grade: GS03 Requisition: 50189 Location:… more
