CONTRACTOR

FEED

UNKNOWN

Complete Clinical Reviews and provide a determination of Medicare-Medicaid Coverage Determination/Redetermination, Medical Review, Global Exception et cetera, by following established clinical process. 4. Assists Member Services and other internal customers in responding to and resolving pharmacy-related inquiries from members (NCQA Requirement).

Apidel Technologies

Pharmacist - Clinical Pharmacist

partner Conrep

The ideal candidate will drive the overall architectural strategy and lead the technical execution of our data platform, with a strong focus on the integration, optimization, and best practices implementation of Microsoft Fabric. Tiger Analytics is a global leader in AI and advanced analytics consulting, empowering Fortune 1000 companies to solve their toughest business challenges.

Tiger Analytics

Microsoft Fabric Solutions Architect

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Working knowledge and experience may be required with the usage of hand held scanners, iPods, flash drives and laptops (as applicable) in order to collect, save, rename, and transfer confidential information.\'. This position interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS and CMS performance measures.

HEDIS Reviewer III

OTHER

When you join us as a Radiology Reporting Coordinator you will be joining a dedicated team of professionals who deliver quality, value, and access in the 21 st century and align all stakeholders- patients, providers, payors, and regulators to achieve the best clinical outcomes. Demonstrate strong customer service, multitasking, critical thinking, persuasion and analytical abilities, with superior communication and interpersonal skill.

HOUR

RadNet

Radiology Reporting Coordinator

[AW]-iCims

The ServiceNow Developer for Nuvolo, working remotely, will play a crucial role in the customization and enhancement of the ServiceNow platform utilized within our Nuvolo environment. Greenberg & Larraby, Inc. will never send offer letters of employment unless a thorough interview process has taken place and all other internal processing has taken place.

Greenberg-Larraby, Inc. (GLI)

ServiceNow Developer, Nuvolo, Remote

Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member\'s needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member\'s benefit plan and available internal and external programs/services. The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.

Nurse Case Manager II - West Virginia

Provides support for Healthcare Effectiveness Data and Information Set (HEDIS) quality initiatives and regulatory/contractual requirements including outreach to members who are noncompliant in the designated outreach services. Provides support for Healthcare Effectiveness Data and Information Set (HEDIS) quality initiatives and regulatory/contractual requirements including outreach to members who are noncompliant in the designated outreach services.

Coordinator III

Case Management Coordinators will determine appropriate services and supports due to members health needs; including but not limited to: Prior Authorizations, Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and supports. Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.

Healthcare Consultant I - MID MIAMI AREA

This position interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS and CMS performance measures. Locate and review ALL assigned medical charts, perform abstraction, copy all supporting documentation per specifications and data enter into the applicable software system ALL assigned abstracts.

HEDIS Reviewer II

Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member\'s needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member\'s benefit plan and available internal and external programs/services. Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member\'s needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member\'s benefit plan and available internal and external programs/services.

Nurse Case Manager II - RN Case Manager

PART_TIME

To help develop and execute a well-defined account strategy in order to gain distribution, improve shelf placement, and increase sales with specific national accounts. The employee frequently is required to stand, sit, use hands to finger, handle, or feel and reach with hands and arms.

Amy's Kitchen, LLC

National Account Manager, Walmart

Hands on experience in understanding and mapping existing forecasting processes, identifying gaps and working with business teams on process improvements and reengineering. Experience in working with forecasting tools and solutions such as SAP IBP, Oracle, Blue Yonder, o9, or similar platforms.

TMS LLC

Remote Opportunity | Supply Chain Forecasting Lead | Long-Term Contract | 10+ Years of Experience

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Build and maintain deep relationships, and act as a thought partner with key decision-makers and influencers across a range of business functions (e.g., C-suite, VP and Director-level administration, Quality, Primary Care, Endocrinology, Population Health, Health Equity, IT/EMR/EHR, Pharmacy, and other relevant stakeholders) to strengthen the perception of ADC as a trusted resource in helping to improve patient outcomes and addressing diabetes management challenges within health systems. Lead the development of key account plans based on gathering customer insights, identifying unmet needs in diabetes management, and having a deep understanding of Abbott's partnership solutions to ensure seamless execution of the resulting account strategies.

YEAR

Abbott Laboratories

Strategic Account Executive -- Northwest Region

In this role, you will partner closely with Business stakeholders, the Gen AI Center of Excellence (COE), Data Science, Machine Learning, and Platform teams to design, develop, and deploy an AI orchestration layer that powers insight generation across BGS.This is a hands-on technical leadership role at the center of our AI maturity journey evolving our insight capabilities from proactive, to agentic, to autonomous. Experience building RAG / document intelligence pipelines over unstructured content (e.g., playbooks, guidelines, knowledge bases).Strong programming skills in Python; experience building APIs and microservices.

AI Engineer Lead

We are particularly interested in engineers who want meaningful influence over a product and technical direction, and who are energized by the pace and responsibility that come with joining a small or rapidly scaling engineering team. While the exact stack and product vary, the common denominator is a need for well-rounded builders who can take ambiguous problems, make sound technical and product decisions, and ship production software end-to-end.

Continuum Resource Network

Founding/Early-Stage Software Engineer

The ServiceNow Integration Engineer focused on Healthcare Systems/CDW will be responsible for designing and implementing integration solutions that connect ServiceNow with various healthcare systems and applications. 5+ years of experience with ServiceNow integrations and data interfaces Strong experience with SQL, ETL processes, data mapping, and data validation .

Servicenow Integration Engineer - Healthcare Systems / CDW (Remote)

Ensures that good customer relations are maintained and customer claims and complaints are resolved fairly, effectively and in accordance with the consumer laws. Provides customer services relating to sales, sales promotions, installations and communications.

Representative, Customer Service - Skilled

Servicenow Developer, Nuvolo, Remote

The Enterprise Architect for ServiceNow and Nuvolo will play a key role in designing and implementing architectural solutions that leverage ServiceNow and Nuvolo platforms to streamline operations and enhance service delivery. Bachelor’s degree in information systems, Computer Science, Healthcare IT, Biomedical Engineering, or related field (Master’s degree preferred but not required) .

Enterprise Architect, ServiceNow, Nuvolo, Remote, Contingent

FULL_TIME

When you join us as a Cloud & Platform Engineering Manager, you will be joining a dedicated team of professionals who deliver quality, value, and access in the 21st century and align all stakeholders- patients, providers, payors, and regulators to achieve the best clinical outcomes. Support GCP application platforms and services such as GKE, GKE on-premises or Anthos, Compute Engine, Cloud Run, Cloud SQL, Cloud Storage, and managed data and integration services as needed by application teams.

Remote Jobs in Remote, OR

Pharmacist - Clinical Pharmacist Apidel Technologies

Microsoft Fabric Solutions Architect Tiger Analytics

HEDIS Reviewer III Apidel Technologies

Radiology Reporting Coordinator RadNet

ServiceNow Developer, Nuvolo, Remote Greenberg-Larraby, Inc. (GLI)

Nurse Case Manager II - West Virginia Apidel Technologies

Coordinator III Apidel Technologies

Healthcare Consultant I - MID MIAMI AREA Apidel Technologies

HEDIS Reviewer II Apidel Technologies

Nurse Case Manager II - RN Case Manager Apidel Technologies

National Account Manager, Walmart Amy's Kitchen, LLC

Remote Opportunity | Supply Chain Forecasting Lead | Long-Term Contract | 10+ Years of Experience TMS LLC

Strategic Account Executive -- Northwest Region Abbott Laboratories

AI Engineer Lead Apidel Technologies

Founding/Early-Stage Software Engineer Continuum Resource Network

Servicenow Integration Engineer - Healthcare Systems / CDW (Remote) Greenberg-Larraby, Inc. (GLI)

Representative, Customer Service - Skilled Apidel Technologies

Servicenow Developer, Nuvolo, Remote Greenberg-Larraby, Inc. (GLI)

Enterprise Architect, ServiceNow, Nuvolo, Remote, Contingent Greenberg-Larraby, Inc. (GLI)

Cloud & Platform Engineering Manager RadNet

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