Responsible for reviewing clinical information to assess medical necessity and ensure consistent administration of plan benefits. Conducts precertification and concurrent reviews while referring complex cases to senior nurses or Medical Directors.
Online Jobs (228,706)
Customer Service Associate Specialist
Ensemble Health Partners
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Full Time
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7 hours ago
Ensemble Health Partners
Handle incoming patient calls to resolve billing questions, post payments, and set up payment plans. Partner with other departments to resolve customer service issues and meet departmental collection goals.
Supportive Care Specialist
Florida Cancer Specialists
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Full Time
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7 hours ago
Florida Cancer Specialists
Acts as a link between patients and care providers to facilitate clinical and supportive care services. Performs administrative tasks including scheduling visits and responding to inquiries for behavioral health, genetics, and nutritional services.
Data Analyst Senior
General Dynamics Information Technology
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Full Time
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7 hours ago
General Dynamics Information Technology
Support data collection and analysis to monitor the implementation of a government program regarding care provider networks. Responsibilities include developing data collection tools, performing high-level interpretation, and presenting findings to agency leadership.
Associate Director Field Reimbursement Manager - West
Kite Pharma
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Full Time
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7 hours ago
Kite Pharma
Serve as a subject matter expert for access and reimbursement at Authorized Treatment Centers (ATCs) in the US-West region. Coordinate with internal stakeholders to resolve reimbursement barriers, provide education on billing and coding, and capture field insights to inform market access strategies.
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Accountable for the safe and successful execution of technical services and maintenance strategies across a diverse client portfolio. Leads technical personnel and manages financial targets, contractual obligations, and client relationships to ensure high satisfaction.
Associate Director Field Reimbursement Manager - East
Kite Pharma
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Full Time
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7 hours ago
Kite Pharma
Serve as a subject matter expert for access and reimbursement at Authorized Treatment Centers (ATCs) in the US-East region. Coordinate with internal stakeholders to resolve reimbursement barriers, provide education on billing and coding, and capture field insights to inform market access strategies.
Infrastructure Services Lead Project Manager
General Dynamics Information Technology
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Full Time
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7 hours ago
General Dynamics Information Technology
Oversee IT support services projects for the NHLBI, ensuring compliance with federal government policies and regulations. Lead project teams through the full lifecycle while managing schedules, scope, costs, and risks.
The IT Security Engineer is responsible for protecting the organization's digital environment by implementing security solutions and monitoring threats. They will respond to security incidents and continuously improve cybersecurity capabilities.
The Corporate Events Coordinator provides foundational support for firm events by managing registration, reporting, and attendee communications. The role also involves coordinating logistics, travel, and vendor outreach for both on-site and virtual event delivery.
Provide technical support and operational solutions for avionics, sensors, and fire protection products for airline customers, primarily United Airlines. Act as the primary technical face of Collins Aerospace, coordinating with repair and engineering teams to resolve complex system issues on-site.
Lead the enterprise-wide strategy, roadmap, and adoption of the Tricentis test automation platform across various business units. Establish governance standards, optimize vendor licensing, and implement AI-driven quality engineering capabilities to improve scalability and reliability.
Manage the Procure-to-Pay process for indirect materials to ensure efficient purchasing and operational support. Collaborate with stakeholders and suppliers to drive cost-effective solutions and maintain policy compliance.
Principle PreSales Systems Engineer - Bay Area, CA
Hewlett Packard Enterprise
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Full Time
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7 hours ago
Hewlett Packard Enterprise
Serve as a technical advisor to design and deliver innovative networking solutions for strategic enterprise customers. Partner with Account Managers to identify opportunities and conduct technical presentations, demonstrations, and Proofs of Concept.
The Sales Account Representative is responsible for expanding the product base and increasing profit margins for both new and existing accounts. They serve as the primary contact for store owners and distributors, managing business plans and coordinating sales efforts to drive revenue growth.
The role focuses on designing and executing patient experience strategies by analyzing feedback and performance data to drive measurable improvements. You will collaborate across teams to translate complex data into actionable insights and lead experience improvement projects.
The Senior Accreditation Professional ensures the pharmacy meets regulatory standards from organizations like URAC, NABP, and ACHC. They focus on quality assurance, audit readiness, and resolving unmet metrics to minimize risk.
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The Tax Accountant is responsible for preparing and filing various state and local tax returns, including premium and municipal taxes. The role involves analyzing tax implications of business activities and performing account reconciliations to ensure compliance with financial standards.
Lead the design and delivery of scalable AI solutions for pharmaceutical and life sciences organizations to accelerate drug development. Act as a trusted advisor to stakeholders, translating complex scientific challenges into technical architectures using LLMs and knowledge graphs.
Site Enablement Lead (Trilingual: Portuguese, Spanish and English)
IQVIA
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Full Time
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7 hours ago
IQVIA
The Site Enablement Lead supports clinical study execution by identifying and training qualified research staff to accelerate study deliverables. They also optimize patient referral flows using the Referral Hub platform and manage site-level service agreements and staffing.
Pre-Reg Pre-Cert Supervisor
The University of Kansas Health System
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Full Time
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7 hours ago
The University of Kansas Health System
Oversees pre-registration and pre-certification staff to ensure accuracy of demographic and insurance information while monitoring productivity and quality. Provides leadership, manages employee workflows, and collaborates with various health system departments to maintain operational standards.
The EHS Manager leads and manages safety, health, and environmental programs across multiple laboratory locations to ensure regulatory compliance. Key duties include conducting risk assessments, managing waste streams, leading incident investigations, and acting as a liaison with regulatory authorities.
The specialist manages customer issues and Service Level Agreements (SLAs) while coordinating with Account Executives and Solutions Architects. They are responsible for formulating project take-offs, competitive product crosses, and identifying local codes and standards.
Lead the deployment of the Medtronic Performance System (MPS) by developing standards, training ecosystems, and communication strategies. Drive business process improvements to reduce costs and enhance quality while mentoring teams in continuous improvement capabilities.
Dairy RNG Regional Manager
South Jersey Industries
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Full Time
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7 hours ago
South Jersey Industries
The Regional Manager oversees the safe operation, maintenance, and performance of dairy RNG facilities within an assigned region. Key duties include managing plant technicians, establishing operating budgets, and ensuring compliance with state and federal regulations.
The role provides second-level service support for the Mining and Oil & Gas sectors, focusing on resolving customer complaints and managing warranty decisions. Key duties include performing field inspections to identify failure causes and delivering technical presentations to stakeholders.
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Perform multi-specialty quality reviews and audits for various service lines to ensure coding accuracy. Provide guidance, education, and feedback to global coding partners while serving as a primary point of contact for daily communications.
The role manages the financial aspects of research grants, including budget development and proposal coordination. It ensures strict adherence to institutional and sponsor compliance while facilitating grant applications and financial reporting.
The Denials Liaison executes denials prevention strategies and drives improvement efforts to reduce insurance rejections and write-offs. This involves analyzing performance variations, leading prevention workgroups, and collaborating with various revenue cycle departments to implement process improvements.
Manager-Virtual Health: Primary Care Support
American Addiction Centers
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Full Time
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7 hours ago
American Addiction Centers
Oversees daily practice operations including patient flow, scheduling, and financial management in collaboration with a physician co-leader. Ensures regulatory compliance and utilizes EMR data to improve clinical outcomes and patient satisfaction.
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