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

equestftpin

UNKNOWN

ADAPTED_NOW

K-State Olathe focuses on industry-ready education, professional development, applied research, and regional workforce needs, with programs and partnerships in areas such as food science, animal health, advanced manufacturing, supply chain, community health, and food as medicine. Through academic programs, professional workshops, research facilities, and event space, the campus connects students, professionals, businesses, and community partners to education and innovation that create real-world impact.

Kansas State University

Instructor Pool, Biostatistics

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. Bring • Communication skill • Self-management • Team habits • A spine — integrity is not optional .

AO Garcia Agency

Remote Benefits Solutions Consultant

CompuMark Online Search is Clarivate's trademark and industrial design search platform that uses AI and image-recognition technology to help customers and intellectual property offices search, compare, and analyze trademarks and designs. Contribute to ongoing work to maintain system security certifications including FedRAMP and Soc2 type 2. Support the sales and marketing teams with product demos, client queries, and RFI/RFP drafting.

YEAR

Clarivate Plc

Product Owner (TrademarkVision - Intellectual Property)

Our nationwide network of board-certified psychiatrists, psychiatric nurse practitioners, behavioral health clinicians, licensed social workers, and other healthcare providers deliver high quality care to our partner facilities via on-site and telehealth placements. Our benefits for full-time providers include: Credentialing, licensure, billing, and collections assistance, The ability to change facilities, hours, and roles within IPC''s partner organizations, Administrative support for office management, allowing you to focus on your patients.

Integrated Psychiatric Consultants PA

Tele/Remote Consult-Liaison Psychiatrist

Applying knowledge of contract types-such as firm-fixed price, firm-fixed price with economic price adjustments, and cost-reimbursement-and acquisition methods including simplified acquisitions, sealed bidding, negotiations, cost sharing, multiple awards, commercial items, and special provisions. Assists the Acquisition Team Supervisors in coordinating contracting activities, performs contract reviews and provides guidance regarding complex contracts administered by other contract specialists, identifies special training needs, and conducts mentoring and contract training.

U.S. Department of Veterans Affairs

Contract Specialist

Technical Skills: Knowledge of TRICARE policies and procedures, Case Management, Utilization Management, Managed Care concepts, Behavioral Health practices and principles, Medicaid and Medicare eligibility requirements and benefits, community resources, alternative funding programs, medical management systems, and protected health information; proficiency with the use of medical necessity criteria to evaluate care requests; working knowledge of medical coding. Problem Solving / Analysis: Thorough knowledge of health care delivery, UM, CM, managed care concepts, management reporting tools, and medical management systems; ability to perform critical, in-depth analysis of medical records for appropriateness and level-of-care determinations.

Manager, Case Management Special Programs

In support of TRICARE beneficiaries enrolled in the Autism Care Demonstration (ACD), the Autism Services Navigator (ASN) collaborates and oversees the assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services for TRICARE beneficiaries diagnosed with autism spectrum disorder (ASD). • Current unrestricted licensure in an appropriate state or territory of the United States, as a Licensed Independent Clinical Social Worker (LICSW), Licensed Clinical Social Worker (LCSW), Registered Nurse, or other licensed mental health professionals who possess a Certification in Case Management (CCM).

Autism Services Navigator

Technical Skills: Thorough knowledge of TRICARE policies and procedures, data collection and reporting, TriWest Care Radius medical management systems, and Referral Management Specialists function. • Two or more years of supervisory experience Managed care and operational experience in medical management systems, including referral management/prior authorization, or utilization management.

Supervisor, Referral Management

This work includes data entry and task processing in medical management and customer relationship management (CRM) systems, and making and receiving telephone calls, including participation in outreach campaigns. The Healthcare Operations Specialist provides non-clinical support to TriWest healthcare operations teams, supporting the access to care our military community deserves.

Healthcare Operations Specialist- HI

Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources. The position collaborates to ensure relevant analysis and complete, timely reporting is provided to meet TriWest business needs and Government's Healthcare requirements.

Business Analyst Sr

Technical Skills: Knowledge of TRICARE program and benefits; managed care program concepts and health care delivery processes; management reporting tools and medical management systems; legal, regulatory requirements, and HIPAA privacy regulations. Under the direction of the Director of Referral Management, the Manager will lead and guide non-clinical staff in processes that maintain accuracy, efficiency, and timeliness for all network and military referral requests.

Manager, Referral Management

Develops effective collaborative relationships with TriWest's inter and intra-departmental stakeholders and other SMEs, C-Suite executives, and other leaders in Operations, Health Care Services, Provider Network, and IT to ensure that TriWest meets contractual requirements and fulfills organizational objectives. The Provider Program Manager ensures that strategic, enterprise-wide programs are well defined, planned, tracked, and communicated in a consistent manner; is responsible for collaborating with C-Suite executives and other stakeholders; and is responsible for deliverables that meet defined requirements and for utilizing project management best practices.

Provider Program Manager

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. You are paired with a growing team, given tools and mentorship, and expected to enroll and support clients who asked for guidance.

100% Remote Client Relations Specialist

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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

The ACD Specialist lends administrative support to beneficiaries, clinical staff, and providers in support of the Autism Care Demonstration (ACD) The ACD is a benefit program for eligible TRICARE beneficiaries who have an Autism Spectrum Disorder (ASD) diagnosis, and provides a set of services not available under basic TRICARE benefits. Independent Thinking / Self-Initiative: Critical thinker with ability to focus on things which matter most to achieving outcomes; Commitment to task to produce outcomes without considerable direction and to find necessary resources.

Autism Care Demonstration Specialist

Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources. This role spans many specialties such as Nutrition, Exercise Physiology, Clinical/Nursing, Respiratory Therapy, Counseling and Pharmacy and will spend time addressing individual health and lifestyle concerns of our beneficiaries.

Health Coach

Performs clinical research necessary to establish evidence-based clinical content guidelines, uses technical and medical writing capabilities to create content to support targeted population campaigns, population wellness portals and activity, support accreditation and contractual requirements, beneficiary educational and other work as needed. • Supports Medical Management projects and non-clinical resources such as project managers as a subject matter expert in evidence-based clinical criteria for building assessments, care plans, interventions and other clinically-based tools and programs.

PH Communications Specialist

About the Role: Responsible for assisting in building the Capital Markets Whole Loan Trading platform and for developing, structuring and executing strategic transactions through new Capital Markets - Structured Finance initiatives in order to optimize the bank's balance sheet and to improve the company's financial performance. Assist in driving execution with top investment banks, insurance companies, hedge funds, credit funds and private institutional investors to fund off balance sheet assets.

Pathward Financial Inc

Capital Markets Analyst I - Loan Trading

This position will be fully remote and can be hired anywhere in the continental U.S. The Director, Security Engineering is responsible for the service delivery and engineering of the SIEM, EDR, SOAR, and other security platforms supporting Optiv's Managed Security Services (MSS) and Advanced Fusion Center (AFC) delivery models. Lead the security engineering practice across the SIEM, EDR, SOAR, and other security platforms, providing operational and strategic planning, fostering innovation, and organizing and negotiating the allocation of resources across the MSS and AFC portfolio.

Work From Home Jobs in Lawrence, KS

Supervisor, Utilization Management TriWest Healthcare Alliance

Instructor Pool, Biostatistics Kansas State University

Remote Benefits Solutions Consultant AO Garcia Agency

Product Owner (TrademarkVision - Intellectual Property) Clarivate Plc

Tele/Remote Consult-Liaison Psychiatrist Integrated Psychiatric Consultants PA

Contract Specialist U.S. Department of Veterans Affairs

Manager, Case Management Special Programs TriWest Healthcare Alliance

Autism Services Navigator TriWest Healthcare Alliance

Supervisor, Referral Management TriWest Healthcare Alliance

Healthcare Operations Specialist- HI TriWest Healthcare Alliance

Business Analyst Sr TriWest Healthcare Alliance

Manager, Referral Management TriWest Healthcare Alliance

Provider Program Manager TriWest Healthcare Alliance

100% Remote Client Relations Specialist AO Garcia Agency

Referral Specialist TriWest Healthcare Alliance

Autism Care Demonstration Specialist TriWest Healthcare Alliance

Health Coach TriWest Healthcare Alliance

PH Communications Specialist TriWest Healthcare Alliance

Capital Markets Analyst I - Loan Trading Pathward Financial Inc

Director, Security Engineering | Remote, USA Optiv Security Inc

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