Manage medical appeals and state hearing reviews by investigating clinical information and preparing case narratives. Represent the organization at state hearings and ensure all resolutions meet regulatory requirements and timelines.
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Grievance Resolution Specialist (Provider Resolution)
CalOptima Health
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Full Time
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1 Week Ago
CalOptima Health
Coordinate the resolution process for grievances and appeals from members and providers regarding eligibility, benefits, and claims. Collaborate with internal departments and external stakeholders to ensure timely case disposition and regulatory compliance.
CONTRACT MANAGEMENT SPECIALST
Arizona Department of Administration
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Full Time
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1 Week Ago
Arizona Department of Administration
Manages post-award administration of contracts, grants, and interagency agreements, including scope of work creation and execution. Conducts statewide compliance reviews and provides technical assistance to contractors to ensure adherence to regulations.
Procurement Specialist
Arizona Department of Administration
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Full Time
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1 Week Ago
Arizona Department of Administration
Execute end-to-end solicitations, contract renewals, and purchasing workflows while ensuring compliance with state statutes. Serve as the system administrator for the Arizona Procurement Portal to optimize functionality and process purchase orders.
Coordinate complex, cross-functional projects from concept through execution, acting as a bridge between Product and Operations for feature rollouts and operational transformations. Drive efficiency by implementing new vendors, designing operational experiments, and leveraging AI automation across workflows.
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Lead a team of all-source investigators to disrupt scam networks by fusing on-chain and off-chain data into actionable intelligence. Manage the operational cadence of legal processes and ensure the high quality of target packages and attribution write-ups.
Lead OSINT-driven investigations to identify sextortion actors and dismantle their infrastructure. Trace illicit funds across payment apps and cryptocurrency to produce actionable targeting packages for law enforcement.
The role involves partnering with healthcare providers to educate them on immunotherapy compounds and managing oncology accounts in the Chicago North territory. Responsibilities include developing account plans, analyzing buying trends, and collaborating with cross-functional teams to ensure a consistent customer experience.
The role involves partnering with healthcare providers to educate them on immunotherapy compounds and managing oncology accounts in the Oregon territory. The representative is responsible for creating value rationales for products and collaborating with a cross-functional customer team to ensure a consistent patient experience.
The Solutions Consultant configures and optimizes mobile and web products for healthcare clients throughout the implementation lifecycle. This includes managing client relationships, structuring indoor hospital data, and traveling to sites to capture wayfinding points of interest.
Lead the agile delivery of finance-domain data products and manage the product backlog for BI, data science, and AI solutions. Act as the primary liaison between Finance & Accounting stakeholders and the analytics development team to drive self-service BI adoption.
Manager Stakeholder Relations (12 month contract) – Diabetes Care (British Columbia, Remote)
Abbott
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Full Time
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1 Week Ago
Abbott
Lead and execute the stakeholder engagement strategy for Western Canada to shape policy and strengthen partnerships for Abbott Diabetes Care. Act as the primary liaison between the organization and government bodies, HTA organizations, and patient association groups.
Supervisor, Epic Enrollment and Benefits (Tapestry) Applications - 26-68
PriMed Management Consulting Services, Inc.
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Full Time
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1 Week Ago
PriMed Management Consulting Services, Inc.
Lead a team of analysts to oversee the accurate support of enrollment and benefits data using the Epic Tapestry application. Act as the primary point of contact for users while ensuring compliance with industry standards and implementing system enhancements.
Resolve customer inquiries and issues across phone, email, and chat channels while mastering ShowingTime products. Document cases accurately and collaborate with internal teams to promote additional services and ensure flawless service delivery.
Design and deliver robust UiPath automation solutions in alignment with enterprise standards and strategic blueprints. Collaborate with technical teams and stakeholders to translate customer requirements into effective software and platform configurations.
Serve as the first point of contact for applicants and medical professionals to provide program information and conduct waiver eligibility screenings. Responsibilities include responding to inquiries via phone and web portals, documenting interactions, and educating consumers on health services.
Bilingual Customer Service Representative
1 Alpha Consulting
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Full Time
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1 Week Ago
1 Alpha Consulting
Provide information and support to Medical Assistance customers regarding benefits and program services via phone, IVR, and web portals. Document all interactions and educate consumers on available physical and behavioral health services.
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Territory Sales Representative
Buechel Stone Corporation
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Full Time
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1 Week Ago
Buechel Stone Corporation
The role focuses on increasing sales in an assigned multi-state territory by identifying potential customers and building lasting relationships. Key duties include executing sales strategies, delivering product training, and managing leads via a CRM system.
WFH - Account Sales Advisor
Virtualite Business Process Outsourcing Services
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Full Time
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1 Week Ago
Virtualite Business Process Outsourcing Services
The role involves connecting with prospective clients through outbound and inbound leads to conduct consultative discovery conversations. The advisor will recommend customized solutions and manage the sales pipeline to close new accounts.
WFH Customer Onboarding Consultant
Virtualite Business Process Outsourcing Services
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Full Time
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1 Week Ago
Virtualite Business Process Outsourcing Services
Guide new customers through the onboarding process by leading virtual meetings and confirming client needs. Maintain accurate documentation and identify opportunities for account expansion within CRM tools.
Customer Success Manager - Atlantic Southeast or Southcentral USA
PaceMate™
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Full Time
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1 Week Ago
PaceMate™
The Customer Success Manager is responsible for onboarding, training, and maintaining relationships with customers to ensure software success and revenue capture. They collaborate with sales managers to drive market adoption and provide customer feedback to the product development team.
Lead the end-to-end delivery of advanced software integration and automation solutions for the energy sector. Act as the primary bridge between internal engineering teams and external industrial partners to optimize pipeline operations.
Support Specialist (Real Estate Property Platforms) MUST work 8:00am-5:00pm MT
Radian
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Full Time
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1 Week Ago
Radian
Provide technical support and training to users of the Pyramid Platform and Red Bell systems via email and phone. Identify system enhancements, collaborate with the development team, and test new features before production release.
Responsible for completing care coordination tasks including e-filing, insurance verifications, and prior authorizations for DME and diagnostic testing. The role involves managing high volumes of medical documents and ensuring accuracy within client EHR systems.
Lead multinational clients' global benefits management programs by designing strategies and overseeing global execution teams. Responsible for driving revenue growth, managing senior client relationships, and delivering brokerage and consulting services for insured benefit programs.
Own the positioning, messaging, and commercialization strategy for Casechek's surgical supply chain solutions. Develop ROI narratives and sales enablement tools to help the commercial team win across various hospital buyer personas.
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Lead the growth of Managed Service Providers (MSPs) within a specific geographic region by identifying and recruiting new partners and expanding existing service offerings. Act as the subject matter expert for MSP programs, coordinating with regional sales teams to close complex deals and drive adoption of pricing models.
Own the reference architecture for agent identity and lead the most strategic, technically complex deployments. Synthesize field patterns to shape the product roadmap and serve as the primary technical authority for C-level executives.
Lead and mentor the Colombia engineering team while setting technical standards for AI system design and delivery. Develop and ship complex production AI systems, including multi-step agent systems and RAG pipelines for B2B clients.
Own the end-to-end demand generation strategy and execute multi-channel campaigns to drive qualified pipeline and revenue. Manage ABM programs and marketing operations to optimize the conversion funnel in partnership with Sales and Product teams.
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