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CW Admin Clerk

Talentburst, Inc. - Cedar Rapids, IA

Position Summary: Responsible for the processing of various administrative and processing activities generated via various queues, including electronic and paper work queues, system reports, databases and incoming correspondences. Meet compliance expectations for all Standard Operating Procedures as well as Policies and Procedures (FOPP). Essential Duties and Responsib...

CW Admin Clerk

Talentburst, Inc. - Cedar Rapids, IA

Position Summary: Responsible for the processing of various administrative and processing activities generated via various queues, including electronic and paper work queues, system reports, databases and incoming correspondences. Meet compliance expectations for all Standard Operating Procedures as well as Policies and Procedures (FOPP). Essential Duties and Responsib...

Legal Assistant I LL&PJ

Talentburst, Inc. - Sunnyvale, CA

Job Title: Legal Assistant I LL&PJ Duration: 12 months The Legal Department is looking for a legal assistant to join its Law Enforcement Response team. This team of passionate, dedicated legal professionals specializes in responding to the legal process (e.g., subpoenas) received for user data. The position demands an adaptable, passionate, self-driven, high-caliber legal ass...

Provider Network Specialist I

LA Healthcare Connections - Shreveport, LA

Position Purpose: Perform duties to act as a liaison between providers, the health plan and Corporate. Perform training, orientation and coaching for performance improvement within the network and assist with claim resolution. Serve as primary contact for providers and act as a liaison between the providers and the health plan Conduct monthly face-to-face meetings w...

Provider Network Specialist I

LA Healthcare Connections - Baton Rouge, LA

Position Purpose: Perform duties to act as a liaison between providers, the health plan and Corporate. Perform training, orientation and coaching for performance improvement within the network and assist with claim resolution. Serve as primary contact for providers and act as a liaison between the providers and the health plan Conduct monthly face-to-face meetings w...

Provider Network Specialist I

LA Healthcare Connections - Lafayette, LA

Position Purpose: Perform duties to act as a liaison between providers, the health plan and Corporate. Perform training, orientation and coaching for performance improvement within the network and assist with claim resolution. Serve as primary contact for providers and act as a liaison between the providers and the health plan Conduct monthly face-to-face meetings w...

Apple Health Foster Care - Provider Network Specialist I - Seattle

Coordinated Care - Seattleold, WA

Position Purpose: Perform duties to act as a liaison between providers, the health plan and Corporate. Perform training, orientation and coaching for performance improvement within the network and assist with claim resolution. Serve as primary contact for providers and act as a liaison between the providers and the health plan Conduct monthly face-to-face meetings w...

Supervisor, Call Center Operations (Clinical) - RN

NurseWise - Tempe, AZ

Position Purpose: Supervise clinical and non clinical staff to ensure productivity and quality metrics are met and/or exceeded. Oversee daily operations of call centers toward achievement of successful call outcomes and organizational goals/initiatives. Oversee all related activities including department workflow and communicate and reinforce standards for the call center team

Quality Improvement Specialist II

Superior Health Plan - Austin, TX

Position Purpose: Assist with the daily operations and support within the Quality Improvement department including data management, data reporting needs, and project management. Manage the HEDIS project to include assignment of nurses, adherence to plan timeline, and vendor oversight for timeliness and quality Assist in data collection, data entry and generation of ...

Behavioral Referral Specialist I

Cenpatico National - Austin, TX

Position Purpose: Receive, review and process Outpatient Treatment Requests (OTR) from providers as it relates to eligibility, benefits and authorization of services. Resolve issues and educate providers on policies and procedures. Review OTR for accuracy and completeness of data and interact with providers Perform research for OTR discrepancies as identified by pro...

Data Analyst I

Buckeye Community Health Plan - Cincinnati, OH

Position Purpose: Responsible for analytic data needs of the business unit. Manage multiple, variable tasks and data review processes, as well as mass data entry, maintenance, and update projects Complete data audits and evaluations within core systems Identify and resolve complex issues, including mass change updates, reconciliation projects, and the ...

Medical Management Auditor

Trillium Community Health Plan - Eugene, OR

Position Purpose: Responsible for the auditing of corporate, health plan, and specialty company staff related to clinical systems entry and/or processes Develop and maintain the audit process and tools related to: authorizations, appeals, quality events, and case management in CCMS; interrater reliability related to InterQual; and data entry into the credentialing subsystem ...

Supervisor, Call Center Operations (Clinical) - RN

NurseWise - FL

Position Purpose: Supervise clinical and non clinical staff to ensure productivity and quality metrics are met and/or exceeded. Oversee daily operations of call centers toward achievement of successful call outcomes and organizational goals/initiatives. Oversee all related activities including department workflow and communicate and reinforce standards for the call center team

Data Analyst I

Buckeye Community Health - Cincinnati, OH

Position Purpose: Responsible for analytic data needs of the business unit. Manage multiple, variable tasks and data review processes, as well as mass data entry, maintenance, and update projects Complete data audits and evaluations within core systems Identify and resolve complex issues, including mass change updates, reconciliation projects, and t...

Administrative Project Coordinator I

The University of Texas at Dallas - Richardson, TX

Select, collect, develop, and organize appropriate supporting documentation for all AACSB and SACS accreditation reporting requirements. Provide support for the Jindal School deans and administrations in developing, implementing, and reviewing assessment of academic degree programs and other accreditation requirements. Minimum Education and Experience Bachelor's de...