Responsible for case development and resolution of non-clinical cases, such as: certain types of claim denials, member complaints, and member and provider appeals. The end-to-end process requires the Specialist to independently:. Work within a framework that measures productivity and quality for eac...
Provides pre-sale product clinical evaluations and/or educational sessions to potential customers in partnership with customers, develop and administer clinical training to the end-user personnel aligned with Sales Order Agreement (SOA) to deliver excellent clinical education to achieve high Net Pro...
Claims Clinical Specialist – Medical Review Team. The Claims Clinical Specialist role is an excellent opportunity for a Registered Nurse seeking a career change. ...
Perform within the normal limits of the State Nurse Practice Act, Code of Ethics for Nurses, policies and procedures and facility policy/procedures and standards. In many cases, our doctors, nurses, and behavioral health professionals represent the patient's first experience with quality, compassion...
Demonstrate competent clinical skills; utilize critical thinking to identify and meet patient needs; achieve positive patient outcomes through group process; display leadership traits that contribute to attainment of patient and departmental goals; assist with unit QI/research projects; identify act...
Demonstrates basic clinical skills and nursing judgment (Novice).Patient Care: Demonstrates consistent use of nursing process in daily practice • Knowledge and Skills: Identifies personal learning needs and seeks learning opportunities; independently performs basic skills and begins to perform advan...
Demonstrates basic clinical skills and nursing judgment (Novice).Patient Care: Demonstrates consistent use of nursing process in daily practice • Knowledge and Skills: Identifies personal learning needs and seeks learning opportunities; independently performs basic skills and begins to perform advan...
Are you ready to explore new places while building your resume? At AB Staffing, we specialize in placing healthcare providers in facilities throughout the United States.Our travel assignments range from three (3) months to one year, and can be added onto another assignment or area, giving you the op...
Are you ready to explore new places while building your resume? At AB Staffing, we specialize in placing healthcare providers in facilities throughout the United States.Our travel assignments range from three (3) months to one year, and can be added onto another assignment or area, giving you the op...
Are you ready to explore new places while building your resume? At AB Staffing, we specialize in placing healthcare providers in facilities throughout the United States.Our travel assignments range from three (3) months to one year, and can be added onto another assignment or area, giving you the op...
Acquire and maintain clinical knowledge and information on the disease states in which the program is involved. Demonstrated ability to make valid clinical judgments concerning a patient's drug therapy needs, given the guidelines of the program. Registered Pharmacist in WV or Eligible for Registrati...
Manage project schedules and scope, assist in creating the project budget, oversee deliverables for quality and assist in staffing projects. Lead small project management teams assisting in project managing components of a larger technological program. Identify and mitigate risk through status repor...
The incumbent delivers data profiling, conducts testing and systems validation to troubleshoot data anomalies, monitors data management metrics and data loads. This job understands healthcare data from end-to-end and analyzes raw data and analytic data for the enterprise. Verify analytic data for th...
Lead Project Managers and/or Program team in the development and maintenance of comprehensive plans for a defined program. Deliver presentations of project status to effectively communicate throughout the project life-cycle. Adhere to the Organization's project management methods, project life-cycle...
The Project Manager is responsible for the successful execution of the life cycle of a range of AI-Data projects, through the utilization of expertise and technical skills to manage project budgets, timelines, and quality requirements. The Project Manager is a results-driven and innovative project l...
Posting City: Doral, FL, Fort Myers, FL....
Advanced project management skills and demonstrated application of project and program management fundamentals to complex engineering problems. Experience managing conflicting objectives and compressed timelines within complex industrial project execution. ...
This position will require the skillset of an experienced project manager who has successfully delivered large scale, multi-phased system implementations with multiple work streams, numerous different types of stakeholders and the ability to comfortably deliver updates and relay information to vendo...
Performs modeling of data sources and flows, works with data management staff to define an operational framework that will define, develop and implement policies and security frameworks to ensure precise and secure delivery of knowledge and information. Perform modeling of data sources and flows, wo...
The Project Manager works closely with senior management to make sure that the scope and direction of each project is on schedule, as well as coordinates with other departments for support. The Project Manager will need to focus on both Business and MIS resources, processes, and deliverables. Follow...
This job implements effective complimentary utilization and case management strategies for an assigned member panel.Provides oversight over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of the assigned member panel and util...
Customer Service - developing and maintaining relationships with Dutch Bros construction partners during all phases of construction 3) Organization and Management of Projects: review and analyze project drawings and documents, manage costs and profitability, coordinate and manage multiple tasks to e...
Ensures data integrity and compliance by performing data cleansing, data audit and/or data validation. Ensure data integrity and compliance by performing data cleansing, data audit and/or data validation. Provides business process, system support and data quality governance through data coordination...
Demonstrated ability to manage and motivate various project management team members, including project coordinators and project managers, in order to fulfill customer demands effectively and to the highest quality. X is currently hiring for Account Executive (Project Manager) to join our Domestic Re...
Completion of a program for Registered Nurses with an appropriate degree in Nursing and licensed as a Registered Professional Nurse in the State of West Virginia or Multi-State compact license. Here at Logan Regional Medical Center we value our nurses and recognize their exceptional contributions t...