FULL_TIME

FEED

OTHER

Technical Skills: Thorough knowledge of policies and procedures, knowledge of managed care principles and methods; medical terminology; proficiency in the application of clinical criteria: InterQual, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, current Procedural Terminology, and Healthcare Common Procedural Coding System, and American Dental codes; working knowledge with medical management systems; proficient with Microsoft Office; knowledge of UM Process; reporting techniques. • Prepares work schedules and monitors staff caseloads to ensure adequate staffing levels at all times and accurate data entry and application of the medical management system.

TriWest Healthcare Alliance

Supervisor, Utilization Management

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Accurately and professionally answer health care inquiries and provide resolutions to TRICARE beneficiaries & providers over the phone, chat, email or other written correspondence. • Effectively and professionally answer customer inquiries by taking ownership of issues, utilizing sound judgement and the tools at your disposal to resolve customer issues on the initial contact.

TRICARE Customer Service Rep

Complies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).

Program Integrity Investigator

The Transition of Care Coordinator provides clinical oversight and coordination for beneficiaries moving between levels of care, supports discharge planning, conducts post-discharge follow up, completes assessments and reassessments as needed, identifies barriers to care, and reviews and processes authorization and referral requests according to policy. Technical Skills: Thorough knowledge of internal policies and procedures, utilization management principles, managed care concepts, medical terminology, and medical management system, clinical decision support tools, International Classification of Diseases, and Current Procedural Terminology.

Transition of Care Coordinator RN/LCSW

Medicaid, Medicare, TRICARE, VAPC3), and the insurance industry; skill in diplomacy and negotiation; skill in financial analysis to analyze contractual reimbursement; skill in project management; skill in presentation; proficient with Excel. Develops hospital, physician and ancillary service agreements, ensures adherence with government operational manuals, monitors network shortfalls, and resolves access issues throughout the assigned region.

Direct Contracting Manager

Technical Skills: Strong knowledge of data warehouse design; data modeling; proficiency with SQL; strong experience with data extraction, transformation, and loading (ETL); working knowledge of report and dashboard development; strong knowledge of SQL Server / Snowflake databases; working knowledge of Oracle databases. • Bachelor's Degree in Business Administration, Computer Science, Mathematics, Engineering, or related field with programming and database systems coursework or equivalent database development experience.

Data Engineer Sr.

Functions on TriWest standing and ad hoc committees as a representative of the Legal department including, but not limited to, committees responsible for TriWest's peer review, quality, and credentialing programs. • Experience advising managed care administrators, health plans, or healthcare providers, • Familiarity with HIPAA, False Claims Act, Stark, Anti-Kickback and other healthcare-related laws & regulations.

Assoc Gen Counsel - Healthcare

Functions as an advocate for the beneficiary by ensuring access to necessary care and maintaining Beneficiary's safety, locating specialized services outside the network by identifying providers, exploring nature of services offered, and facilitating process. Independent Thinking / Self-Initiative: Resourceful critical thinker who is able to prioritize tasks essential to achieving desires outcomes, demonstration a proactive commitment to task completion and the ability to identify and secure necessary resources.

Case Manager

Develop compelling proposal content that clearly articulates TriWest's unique capabilities, market expertise, provider relationships, analytical capabilities, and demonstrated ability to build and maintain networks that meet complex customer requirements. The Director of Network Strategy is responsible for developing and executing TriWest's enterprise strategy for network adequacy and network optimization across its VA Community Care Network (CCN) and TRICARE programs.

Dir, Provider Network Strategy

Ensures accuracy and completion of authorization data from customer information, medical records, referral/authorization forms, Military Treatment Facility electronic transmission and other documents into medical management system. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.

Referral Specialist

Accurately assesses caller requests, answers caller inquires and processes requests while focusing on first call resolution and/or appropriate call escalation protocols. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.

Customer Service Rep

UNKNOWN

Executive Presentations & Technical Advocacy: Review, refine, and occasionally deliver high-impact technical presentation materials regarding complex system designs to customers, pre-sale, and post-sale engineering leadership. The Manager of Regional MCN Deployments NSA Team - Network Practice Office (NPO) provides leadership, strategic direction, and technical oversight to a team of regional Network Solutions Architects (NSAs).

YEAR

Motorola Solutions Inc

Manager of Regional MCN Deployments NSA Team - Network Practice Office (NPO)

With our expansive platform of management solutions and decades of temperature-controlled supply chain expertise, Cryoport Systems helps Enable the Outcome by supporting certainty and precision in the supply chain, whether advancing groundbreaking therapies, supporting families on their reproductive journeys, or enhancing animal health programs. The Logistics Coordinator will report to one or more Logistics Managers and is responsible for alerting the logistics management team of any shipments with delays or other potential causes for concern, assisting with special projects, miscellaneous tasks as needed, and answering the logistics helpline to address or redirect calls.

HOUR

CryoPort Inc

Logistics Coordinator (Contingent)

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Bachelor's degree in Electrical Engineering, Computer Engineering, Computer Science, Network Engineering, or a related C5ISR field with 2-5 years of demonstrated experience in systems engineering, technical business development, or defense technology roles; OR High School Diploma/GED with 5+ years of relevant technical or defense experience. Assist Business Development in engaging with technical stakeholders across Department of the Air Force Program Executive Offices (DAF PEO C3BM, PEO C3I&N), Air Force Research Laboratory (AFRL), Air Force Life Cycle Management Center (AFLCMC), and Tactical Operations Center-Light (TOC-L) leads.

Business Development Engineer (BDE), US Air Force

Bachelor's degree in Electrical Engineering, Computer Engineering, Computer Science, Network Engineering, or a related C5ISR field with 2-5 years of demonstrated experience in systems engineering, technical business development, or defense technology roles; OR High School Diploma/GED with 5+ years of relevant technical or defense experience. Assist in analyzing USMC operational priorities (e.g., Force Design, Expeditionary Advanced Base Operations [EABO], Marine Air-Ground Task Force [MAGTF] network design goals) and mapping operational requirements to tactical radio solutions.

Business Development Engineer (BDE), US Marine Corps

FASST & LSNRS Ownership & NPI: Directing the technical requirements, driving physical hardware New Product Introduction (NPI) cycles, and validating the end-to-end user experience for the FASST Handheld and LSNRS product portfolios, ensuring operational interfaces and dedicated hardware platforms are optimized for combat and emergency responders in high-stress situations. Product Lifecycle & NPI Management: Overseeing the technical lifecycle and physical hardware New Product Introduction (NPI) of the FASST and LSNRS products from initial concept, prototype validation, physical manufacturing coordination, and regulatory clearance through development, operational test and evaluation, deployment, and long-term sustainment.

Technical Product Manager - (Electronic Warfare (EW) & Sensing Solutions)

The Cell Therapy Account Management (CTAM) will be responsible for driving Amtagvi demand by building a robust referral network between community practices and academic centers; enable early patient identification and streamline referral pathways; and collaborate with internal teams to enhance scientific and operational excellence in cell therapy account management. As the first and only company to take TIL therapy from concept to a broadly accessible commercial treatment, Iovance operates as an end-to-end cell therapy company, anchored by fully owned, centralized U.S.-based manufacturing that is scaled to serve thousands of cancer patients worldwide each year.

Iovance Biotherapeutics Inc

Cell Therapy Account Management - North Central

This key leadership role establishes, builds, and leads a dedicated revenue pillar responsible for driving business growth across the US Department of War, National Guard, Federal Civilian & Law Enforcement agencies (DOJ, DHS, DOI, etc.), as well as State & Local Public Safety organizations. This position leads a team of specialized Sales Directors, executing a bottom-up tactical sales strategy while aligning closely with top-of-funnel Market Development Executives (MDEs), Business Development Directors, and Spectrum Overlay specialists.

Senior Sales Director, Law Enforcement & Homeland Defense

Bachelor's degree in Business, Engineering, Communications, or a related technical discipline and a minimum of 10 years of successful sales leadership experience in unmanned systems, tactical or public safety communications, C4ISR, electronic warfare, or defense/public safety technology; or Associate's degree with a minimum of 12 years; or High School Diploma/GED with a minimum of 14 years. In this key leadership role, you will lead a high-performing team of Sales Directors responsible for driving B2B "design-win" revenue across major defense primes, uncrewed system manufacturers (UAS, UGV, USV, loitering munitions), systems integrators, and C-UAS platform builders.

Senior Sales Director, Original Equipment Manufacturer (OEM) & Defense Primes

Must reside in Alabama, Colorado, Florida, Georgia, Iowa, Kansas, Louisiana, Michigan, Minnesota, Missouri, North Carolina, North Dakota, New Mexico, Oklahoma, Pennsylvania (some counties excluded), South Carolina, South Dakota, Texas, or Wisconsin. KLDiscovery, a leading global provider of electronic discovery, information governance and data recovery services, is seeking actively licensed U.S. attorneys for ongoing remote Document Review projects.

Work From Home Jobs in Fargo, ND

Supervisor, Utilization Management TriWest Healthcare Alliance

TRICARE Customer Service Rep TriWest Healthcare Alliance

Program Integrity Investigator TriWest Healthcare Alliance

Transition of Care Coordinator RN/LCSW TriWest Healthcare Alliance

Direct Contracting Manager TriWest Healthcare Alliance

Data Engineer Sr. TriWest Healthcare Alliance

Assoc Gen Counsel - Healthcare TriWest Healthcare Alliance

Case Manager TriWest Healthcare Alliance

Dir, Provider Network Strategy TriWest Healthcare Alliance

Referral Specialist TriWest Healthcare Alliance

Customer Service Rep TriWest Healthcare Alliance

Manager of Regional MCN Deployments NSA Team - Network Practice Office (NPO) Motorola Solutions Inc

Logistics Coordinator (Contingent) CryoPort Inc

Business Development Engineer (BDE), US Air Force Motorola Solutions Inc

Business Development Engineer (BDE), US Marine Corps Motorola Solutions Inc

Technical Product Manager - (Electronic Warfare (EW) & Sensing Solutions) Motorola Solutions Inc

Cell Therapy Account Management - North Central Iovance Biotherapeutics Inc

Senior Sales Director, Law Enforcement & Homeland Defense Motorola Solutions Inc

Senior Sales Director, Original Equipment Manufacturer (OEM) & Defense Primes Motorola Solutions Inc

Document Reviewer Kldiscovery Ontrack LLC

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