Commercial Claims Programs Consultant - Remote CSAA Insurance GroupCommercial Claims Programs Consultant - RemoteHome Teleworkers, SDRemote$129,825–$144,250 / yearAlabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, California - Home Teleworkers, Colorado - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker {+ 21 more}. Operating as a senior individual contributor, the position manages key TPA and client relationships, supports strategic program initiatives, and helps ensure operational alignment, transparency, and strong partner experiences across multiple stakeholders and programs.
NewRegulatory Nurse Consultant South Dakota Legacy Health CareRegulatory Nurse Consultant South DakotaSioux Falls, SDQualifications / SkillsRegistered Nurse currently licensed in the State of South DakotaMinimum of ten (10) years of experience in a long‑term care setting; five (5) years of experience as a Director of Nursing or Regional Nurse Consultant preferredExperience applying State and Federal long‑term care regulationsKnowledge of the long‑term care survey processDeep understanding of healthcare legislation, adverse event regulations, and critical thinking. Strong communication, organizational, and writing skillsAbility to educate and mentor clinical and administrative staffProficient in regulatory documentation review and compliance monitoring75% extensive travel throughout the state of South DakotaKey ResponsibilitiesServes as a liaison between company facilities and State and Federal government agencies regarding regulatory compliance, surveys, investigations, and corrective action activities.
Lead Reviewing Physician Consultant (Bid) MaximusLead Reviewing Physician Consultant (Bid)Rapid City, SDFull timeAfter completing all research, the physician must write a case rationale in the correct format that introduces the question at hand, summarizes the correct guideline, analyses the pertinent case details related to the guideline, and then make a final determination as to the medical necessity of the requested service. Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment.
Complex Claims Consultant - Private & NFP D&O CNA Financial CorpComplex Claims Consultant - Private & NFP D&OSD$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex Financial Lines claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
Managing Consultant, Environmental Permitting ERM International Group LtdManaging Consultant, Environmental PermittingSD$79,395–$101,693 / yearWho We Are: As the largest global pure play sustainability consultancy, we partner with the world's leading organizations, creating innovative solutions to sustainability challenges and unlocking commercial opportunities that meet the needs of today while preserving opportunity for future generations. Our diverse team of world-class experts supports clients across the breadth of their organizations to operationalize sustainability, underpinned by our deep technical expertise in addressing their environmental, health, safety, risk and social issues.
Sr. Client Service Consultant, EB Holmes MurphySr. Client Service Consultant, EBSioux Falls, South DakotaDraft complex Request for Proposals (RFPs) for review by appropriate sales/service team member, make requested edits to RFPs, distribute RFPs to insurance carrier market, ensure timely response by insurance carriers, negotiate with vendors as needed, summarize and analyze insurance carrier proposals. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members.
Client Service Consultant, PC Holmes MurphyClient Service Consultant, PCSioux Falls, South DakotaWe do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members. Consistent merit increase and promotion opportunities — Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important — not only with your financial wellbeing, but also your career wellbeing.
Institutional & Specialty Sales Consultant, Stroke/Thrombosis, Sioux Falls, SD Bayer AGInstitutional & Specialty Sales Consultant, Stroke/Thrombosis, Sioux Falls, SDSioux Falls, SD$124,320–$186,480 / yearDemonstrate expertise and knowledge of disease state, the marketplace, competitors, industry, and cross-functional activities/plans, as well as possessing the analytical rigor to anticipate and identify business opportunities and challenges. You, as a Pharmaceutical Sales Representative will have a rare opportunity to shape access, accelerate clinical adoption, and play a pivotal role in a high-profile neurology launch-delivering innovation to patients when it matters most.
Therapy Clinical Consultant Sanford HealthTherapy Clinical ConsultantSioux Falls, SD$43–$71 / hourThe Clinical Specialist helps develop and maintain EMR"s utilized for service line documentation of care delivery; completes policy review and provides updates as warranted; reviews billing and coding as well as intermittently assist in denial management. We have primarily an in-house therapy model that covers multiple services lines with a leadership team that includes clinical and operational expertise.
Service Excellence Consultant Avera HealthService Excellence ConsultantAberdeen, SDBachelors and/or 5+ years customer service experience in healthcare or service-oriented industry • Technical Certificate Executive coaching • Registered Nurse (RN) - Board of Nursing An active license in the state of practice Upon Hire. • Analyze patient and resident/family experience results to identify opportunities for improvement and design and deliver education and individual and team coaching specific to the needs of various individuals and entities across Avera.
Alternate Vision Reviewing Physician Consultant (BID) MaximusAlternate Vision Reviewing Physician Consultant (BID)Rapid City, SDFull timeMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. - Maintain working knowledge of Office of Personnel Management (OPM) medical and suitability policies and ensure all consultations reflect current clinical best practices, regulatory requirements, and program objectives.
Staff Cost Consultant Acuity International LLCStaff Cost ConsultantSDem> Performs any other duties as directed by the Project Manager / Supervisor / Manager Qualifications and Skills: Candidate must be a US Citizen Bachelor's degree in Engineering, Construction Management, or related field of study and a minimum of 5-10 years of relevant experience in related industry. The Staff Cost Consultant leads quality control reviews and maintains relationships with project personnel, particularly with individual discipline group leaders and engineers and provides technical direction to assigned personnel, when delegated.
OpenShift Infrastructure - Senior Consultant Red Hat IncOpenShift Infrastructure - Senior ConsultantPierre, SDRemote$130,420–$215,300 / yearWithin 12 months, begin to demonstrate technical leadership in container platforms by accomplishing the following: Successfully implementing complex, large-scale container platform solutions in challenging customer environments. Here's how your skill set will evolve and what you'll learn during your first year in the role: At 2 months, be prepared to join a project team by acquiring the following: Understanding of how to build production-ready container and virtualization platforms, integrated with existing enterprise systems.