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Humana is seeking a Utilization Management (UM) Coordinator to join the Wisconsin Medicaid Market (iCare) team. The UM Coordinator provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. Join this dedicated team and lead change in how health car...

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important...

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
Work Shift:
8 Hours - Day Shifts (United States of America)
Scheduled Weekly Hours:
40
Sa...

Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team.
Job Title: Health Services - Utilization Management Specialist.
Location: Baltimore, MD.
Purpose:
* Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospecti...

Company :
Highmark Inc.
Job Description :
JOB SUMMARY
This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physi...

Quality and Utilization Management Specialist
What you will be doing:
The Quality and Utilization Management Specialist will be the owner of, and the primary individual responsible for interdepartmental coordination of monitoring and preparing submissions for initial and renewal of Utilization Review (UR) state licenses. This role will work closely with legal and other industry resources to con...

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important...

Requisition Details
GENERAL REQUISITION INFORMATION
EEO Statement:
UNMC is an Equal Employment Opportunity Employer, including an equal opportunity employer of protected veterans and individuals with disabilities.
Location
Omaha, NE
Requisition Number:
Staff_14328
Department
Clinical Research Center 50000598
Business Unit
Vice Chancellor for Research
Reg-Temp
Full-Time Regular
Work S...

Overview
Come join a company that strives for Extraordinary People and Exceptional Performance! Chenega Government Mission Solutions, LLC, a Chenega Professional Services' company, is looking for a Financial Management Specialist I to support USARCENT G-8 by strengthening audit readiness, internal controls, and financial data integrity across Army financial systems. This position directly suppo...

Overview
We have an exciting opportunity for a Receivables Management Specialist I to join our team!
The Receivables Management Specialist I performs a variety of credit and collections activities to improve collections on outstanding receivables and reduce bad debt. This role processes Contact Center requests such as applying or adjusting security deposits, directing and transferring customer...

Join the Team at Concierge Home Care - Where Care Changes Lives!
At Concierge Home Care, we believe in the power of home health care to change lives-for patients and team members alike. Our mission, "Caring for people who care for people," is the foundation of who we are and what we do. Guided by our values-Integrity, Caring, Quality, Service, Innovation, and Team-we are dedicated to delivering...

Posting End Date:
September 12, 2025
Employee Type:
Regular-Full time
Union/Non:
This is a non-union position
An exciting role as a Work Management Process Specialist I is available at Enbridge. This position is vital for improving efficiency and safety within our Liquid Pipelines (LP) Operations teams. You will be responsible for developing and implementing effective work management ...

Site: Mass General Brigham Incorporated
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbr...

Crossroads Treatment Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Since 2005, Crossroads has been at the forefront of treating patients with opioid use disorder. Crossroads is a family of professionals dedicated to providing the most accessible, highest quality, evidence-based medication assisted tre...

Scheduled Hours
40
Position Summary
Under regular direction, the Analyst I EPIC EHR Application provides build support for Epic & other Clinical applications as it relates to change requests, maintenance and project business demands. Responsible for configuring, documenting, testing, modifying, supporting and maintaining software applications. Builds collaborative relationships with hospital ...

Commercial Sales System Engineer is responsible for the design of Everon Fire Alarm, Intrusion Security, CCTV, and Card Access Systems in accordance with Sales and Operations protocols. Receives project specifications from Sales Representative and designs system blueprint. Chooses the appropriate mix of products and installation methods to provide the most cost effective solution. Prepares all ...

Work Schedule
Standard (Mon-Fri)
Environmental Conditions
Office
Job Description
About Us:
Here at Thermo Fisher Scientific, our industry-leading scale means unparalleled commercial reach, unique customer access and a global footprint. Our broad customer base, from research, clinical to commercial production means you can have a broad and significant impact. All while working in an environment ...

Here are the job details for your review:
Job Title: Billing Specialist I - Pharmacy Billing Coordinator
Duration:6+ Months Contract (contract to start - Possible FTE)
Location: Monroeville, PA USA 15146
Pay Rate:$19.50/hourly on W2
Shift Hours: Mon-Fri 8a-4:30p
Start Date - 12/08/2025
Fully Remote - Worker must live within 1 hour of the site (Monroeville, PA) LIST CITY AND STATE ON RESUME,...

Job Description
Come join our amazing team and work remote from home!
The Vendor Management Specialist I will be responsible for providing ongoing oversight of an existing network of third-party service providers, their company profile, and building a relationship with such vendors to monitor and ensure their continued compliance with our applicable company policies and regulatory guidelines. E...