FULL_TIME

FEED

OTHER

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.

TriWest Healthcare Alliance

Manager, Referral Management

equestftpin

It is Siemens Healthineers' policy to comply fully and completely with all United States export control laws and regulations, including those implemented by the Department of Commerce through the Export Administration Regulations (EAR), by the Department of State through the International Traffic in Arms Regulations (ITAR), and by the Treasury Department through the Office of Foreign Assets Control (OFAC) sanctions regulations.". These requirements vary by client and may include, but are not limited to: Proof of valid identification (photo, driver's license, SSN) Criminal background checks Drug screens Immunizations (COVID-19, Hep B, MMR, Varicella, Influenza, Tetanus) Annual TB testing Healthcare training.

Siemens Healthineers

Software Project Manager

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.

Supervisor, Utilization Management

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

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

UNKNOWN

Monitoring and enforcing compliance with critical security frameworks (such as NIST CSF, NIST RMF, ISO 27001/27002, SOC 2, ISO 42001) and industry-specific regulations (such as GLBA, CCPA, GDPR) pertinent to the financial services and real estate valuation sectors. Relevant industry certifications: Certified Information Systems Security Professional (CISSP), Certified Information Security Manager (CISM), Certified Information Systems Auditor (CISA), Certified in Risk and Information Systems Control (CRISC), Artificial Intelligence Governance Professional (AIGP), or equivalent.

YEAR

restb.ai

GRC Security Analyst

ea_via_bold

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

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

Vibee takes into consideration a candidate’s education, training, and experience, as well as the position’s work location, expected quality and quantity of work, required travel (if any), external market and internal value, including seniority and merit systems, and internal pay alignment when determining the salary level for potential new employees. Support the marketing team by gathering internal data for marketing purposes, including pulling geographical data to tailor local campaigns and updating our decks with sales statistics.

HOUR

Insomniac Holdings

Vibee - Seasonal Data & Analytics Marketing Coordinator

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

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

Orders/receives medical records for Potential Quality Issues (PQI and CQM Department activities according to desk procedures, conducts follow-up telephone calls to providers, and completes other processes to resolve missing documents. 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.

Clinical Quality Support Specialist

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

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.

Lead Referral Specialist

We are seeking a knowledgeable and customer-focused HVAC Specialist to provide expert phone and email-based troubleshooting and applications assistance for residential and commercial water-source heat pump, geothermal, air-conditioning, and heat pump systems. Key Responsibilities: Provide troubleshooting and applications support via phone and email to external customers and internal teams (Customer Service, Sales) on a variety of HVAC systems and components.

The Bosch Group is a leading global supplier of technology and services. It employs roughly 375,000 associates worldwide (as of December 31, 2015). The company generated sales of 70.6 billion euros in 2015. Its operations are divided into four business sectors: Mobility Solutions, Industrial Technology, Consumer Goods, and Energy and Building Technology. The Bosch Group comprises Robert Bosch GmbH and its roughly 440 subsidiaries and regional companies in some 60 countries. Including sales and service partners, Bosch’s global manufacturing and sales network covers some 150 countries. The basis for the company’s future growth is its innovative strength. Bosch employs 55,800 associates in research and development at roughly 118 locations across the globe. The Bosch Group’s strategic objective is to deliver innovations for a connected life. Bosch improves quality of life worldwide with products and services that are innovative and spark enthusiasm. In short, Bosch creates technology that is “Invented for life.”

Robert Bosch GmbH

HVAC Specialist (Water Source Heat Pumps/Geothermal)

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. What comes with the seat • No cold calling • Qualified-interest pipeline • Performance-based advancement • Full training • Current tech stack • Work from home Traits that work here Driven.

AO Garcia Agency

Remote Enrollment Advisor

Closed-Loop Feedback Integration: Systematically capturing operational feedback, field trial results, and operator testing notes to continuously evolve backlog user stories and transform field-tested waveforms into robust commercial software solutions. By bridging the gap between theoretical R&D and reliable military systems engineering, the Technical Product Manager will ensure Silvus outpaces emerging electronic warfare (EW) threats and delivers robust software-defined spectrum dominance.

Motorola Solutions Inc

Technical Product Manager (Spectrum Dominance)

ROLE DESCRIPTION: Joining James Madrid - State Farm Agent as a Account Representative - State Farm Agent Team Member means becoming an essential part of a growing and customer-focused insurance agency. This opportunity allows you to pair strong communication with a results-driven approach while building meaningful relationships with customers.

James Madrid - State Farm Agent

Account Representative - State Farm Agent Team Member

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 .

Work From Home Jobs in Nevada

Manager, Referral Management TriWest Healthcare Alliance

Software Project Manager Siemens Healthineers

Supervisor, Utilization Management TriWest Healthcare Alliance

Supervisor, Referral Management TriWest Healthcare Alliance

Autism Care Demonstration Specialist TriWest Healthcare Alliance

GRC Security Analyst restb.ai

Manager, Case Management Special Programs TriWest Healthcare Alliance

Business Analyst Sr TriWest Healthcare Alliance

Vibee - Seasonal Data & Analytics Marketing Coordinator Insomniac Holdings

Autism Services Navigator TriWest Healthcare Alliance

PH Communications Specialist TriWest Healthcare Alliance

Clinical Quality Support Specialist TriWest Healthcare Alliance

Healthcare Operations Specialist- HI TriWest Healthcare Alliance

Lead Referral Specialist TriWest Healthcare Alliance

HVAC Specialist (Water Source Heat Pumps/Geothermal) Robert Bosch GmbH

Remote Enrollment Advisor AO Garcia Agency

Technical Product Manager (Spectrum Dominance) Motorola Solutions Inc

Account Representative - State Farm Agent Team Member James Madrid - State Farm Agent

Remote Member Account Specialist AO Garcia Agency

Remote Benefits Enrollment Representative AO Garcia Agency

Similar Job Searches

Stand out to leading employers.