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Medical Management - Utilization Management RN 145-2015 at CommunityCare
Tulsa, Oklahoma, United States - Full Time
Skills Needed
Utilization Review, Clinical Review, Medical Necessity, Documentation, Care Coordination, Collaboration, Data Entry, Communication, Organizational Skills, Time Management, Community Resources, Managed Care, Population Health, Case Management, Acute Care Experience, Continuing Education
Specialization
Candidates must have a current RN license in Oklahoma and preferably three years of acute care experience. Strong communication skills and knowledge of managed care are essential.
Experience Required
Minimum 2 year(s)
Park Worker II Seasonal - 9168 Recreation at Milwaukee County
Milwaukee, Wisconsin, United States - Full Time
Skills Needed
Customer Service, Cash Handling, Communication Skills, Teamwork, Positive Attitude, Work Ethic, General Park Operations, Administrative Skills, Basic Computer Knowledge
Specialization
Applicants must be at least sixteen years old and have previous customer service experience preferred. Basic knowledge of computer applications such as Microsoft Word, Outlook, and Excel is also preferred.
CPP Operator (2nd Shift) - Ridgeway at isola
Ridgeway, South Carolina, United States - Full Time
Skills Needed
Machine Operating, Quality Inspection, Multitasking, Problem Solving, Communication, Sap
Specialization
Candidates should have strong verbal and written communication skills and preferably previous machine operating experience. Familiarity with work instructions, work orders, and SAP is also preferred.
Layup Operator (2nd Shift) - Chandler at isola
Ridgeway, South Carolina, United States - Full Time
Skills Needed
Machine Operating, Work Instructions, Work Orders, Erp Systems, Forklift Experience, Communication Skills, Material Verification, Automated Equipment Operation, Sap Inventory Tracking, Problem Reporting, Multitasking, Teamwork, Task Orientation, Bending, Reaching, Lifting
Specialization
Candidates must have prior machine operating experience and strong communication skills. Previous experience with work instructions and ERP systems is preferred.
Instructor Broadway at CorePower Yoga
Denver, Colorado, United States - Full Time
Skills Needed
Yoga Instruction, Communication Skills, Interpersonal Skills, Cpr Certification, Class Planning, Student Engagement, Safety Awareness, Community Building, Cleaning Standards, Customer Service, Time Management, Physical Fitness, Inclusivity, Professionalism, Team Collaboration, Adaptability
Specialization
Candidates must have a 200-hour yoga teacher training certificate and current CPR/AED certification. Strong communication skills and the ability to lead physical activity in heated environments are essential.
Mechanical Maintenance Operator - Melting & Casting at SSAB
Muscatine, Iowa, United States - Full Time
Skills Needed
Mechanical Maintenance, Welding, Hydraulic Systems, Pneumatic Systems, Plumbing, Pipefitting, Maintenance Engineering, Industrial Electricity, Plc Understanding, Teamwork, Problem Solving, Communication Skills, Microsoft Office
Specialization
Candidates must have a high school diploma or equivalent and a strong mechanical background with at least 2 years of heavy industrial experience. Preferred qualifications include an associate degree or certificate in a mechanical or electrical field and basic PLC/electrical understanding.
Experience Required
Minimum 2 year(s)
Customer Service - Customer Service Team Lead 105-1027 at CommunityCare
Tulsa, Oklahoma, United States - Full Time
Skills Needed
Customer Service, Problem Resolution, Communication Skills, Training, Motivation, Organizational Skills, Time Management, Relationship Building, Negotiation Skills, Microsoft Applications, Attention To Detail, Bilingual, Hmo Plans, Ppo Plans, Enrollment, Benefits, Claims
Specialization
Candidates should have a thorough knowledge of HMO and PPO plans, along with at least 3 years of customer service experience. A bachelor's degree and supervisory experience are preferred.
Experience Required
Minimum 2 year(s)
Medical Management - Intake Coordinator 145-1030 at CommunityCare
Tulsa, Oklahoma, United States - Full Time
Skills Needed
Oral Communication, Written Communication, Logical Reasoning, Judgment, Time Management, Prioritization, Medical Terminology, Microsoft Applications
Specialization
Candidates must possess strong communication skills and have a basic knowledge of medical terminology. A high school diploma or equivalent is required, along with two years of related work experience preferred.
Experience Required
Minimum 2 year(s)
Low Code Process Engineer - Financial Crime Platform at TymeX
Manila, Metro Manila, Philippines - Full Time
Skills Needed
Process Engineering, Business Process Modeling, Kyc, Cdd, Edd, Financial Crime, Aml, Low Code, Ai, Bpmn, Cmmn, Dmn, Analytical Skills, Problem Solving, Communication Skills, Collaboration
Specialization
Candidates must have 3+ years of experience in process engineering or analysis, with strong knowledge of business process modeling. Familiarity with KYC/CDD/EDD processes and low-code/AI-based modeling is essential.
Experience Required
Minimum 2 year(s)
UX Low Code Business Engineer - Financial Crime Platform at TymeX
Manila, Metro Manila, Philippines - Full Time
Skills Needed
Ux Design, Low Code Development, Business Analysis, Financial Crime, Kyc, Cdd, Edd, Case Management, Wireframing, Prototyping, Usability Testing, Stakeholder Management, Agile, Data Driven Interfaces, Documentation, Problem Solving
Specialization
Candidates must have 3+ years of experience in a technology or financial environment with a strong focus on UX design and low code development. A solid understanding of business workflows in financial services and excellent communication skills are essential.
Experience Required
Minimum 2 year(s)
Stage Développeuse / Développeur Back end at Capgemini Portugal
Nantes, Pays de la Loire, France - Full Time
Skills Needed
Back End Development, Agile Methodology, Teamwork, Curiosity, Proactivity
Specialization
You should be in your first year of a master's program in engineering or computer science and looking for a 3 to 4-month internship, or in your final year seeking an end-of-studies internship. A curiosity and proactive attitude, along with teamwork appreciation, are essential.
Miscellaneous Equipment Operator-Not Gas at Pacific Gas And Electric Company
San Jose, California, United States - Full Time
Skills Needed
Equipment Operation, Driving, Maintenance, Construction, Heavy Lifting, Safety Compliance, Team Support, Mechanical Knowledge, Crane Operation, Truck Operation, Ppe Usage, Travel Flexibility, Communication, Problem Solving, Technical Skills, Construction Standards
Specialization
Candidates must possess a high school diploma or GED and a valid Class A California Driver's License Permit. They should be able to lift heavy loads, work extended hours, and travel throughout the PG&E service territory.
Rocket Sled Mechanical Engineer at Canvas Inc.
Holloman AFB, New Mexico, United States - Full Time
Skills Needed
Mechanical Engineering, Rocket Propulsion, Cfd Accuracy, Data Collection, Design Engineering, Test Engineering, Communication Skills, Teamwork, Project Management, Vibration Analysis, Aerodynamic Design, Heat Transfer Modeling, Customer Interaction, Safety Standards, Independent Work, Fast Paced Environment
Specialization
A bachelor's degree in mechanical engineering or a relevant discipline is required, with no prior experience necessary. Knowledge of mechanical engineering concepts and excellent communication skills are essential.
Senior ICBM Guidance, Navigation & Control (GN&C) Test & Evaluation Enginee at Canvas Inc.
, , United States - Full Time
Skills Needed
Guidance Navigation & Control, Test & Evaluation, Technical Engineering Expertise, Performance Assessment, Technical Assessments, Cross Functional Team Collaboration, Mentoring, Test Planning, Verification & Validation, Inertial Navigation Systems, Error Propagation, Statistical Methods, Data Analysis, Hardware In The Loop Testing, Icbm Missile Systems, Test Planning & Processes
Specialization
A Bachelor's degree in a related field and 15 years of relevant experience are required. Senior-level expertise in inertial GN&C systems and familiarity with ICBM missile systems is essential.
Experience Required
Minimum 10 year(s)
Electrical Engineer - Facilities at Canvas Inc.
Holloman AFB, New Mexico, United States - Full Time
Skills Needed
Electrical Engineering, Facility Infrastructure, Building Codes, Communication Skills, Milcon Requirements, Project Management, Construction Projects, Strategic Financial Planning, Contractor Surveillance, Independent Government Estimates, Transformers Management, Transmission Lines, Ground Stations, Electric Repairs, Dod Installation Knowledge, Adaptability
Specialization
A Bachelor of Science degree in an Engineering field, preferably electrical, is required along with 1-2 years of relevant experience. Candidates must be familiar with DoD facility infrastructure needs and possess excellent communication skills.
Experience Required
Minimum 2 year(s)
Institutional Grievance Officer-Marion Correctional Institution at North Carolina Dept of Environmental Quality
, North Carolina, United States - Full Time
Skills Needed
Administrative Remedy Procedures, Grievance Program, Data Analysis, Microsoft Word, Microsoft Excel, Microsoft Powerpoint, Database Management, Investigation Skills, Report Writing, Communication Skills, Problem Solving, Organizational Skills, Consultation Skills, Policy Knowledge, Staff Guidance, Offender Interaction
Specialization
A Bachelor’s degree and one year of related experience are required for this position. An equivalent combination of education and experience may also qualify.
Category Buyer, Indirects, India. at Huhtamaki
Thane, maharashtra, India - Full Time
Skills Needed
Negotiation Skills, Analytical Skills, Ms Office Suite, Cost Comparison, Vendor Management, Procurement, Facility Management, Collaboration, Integrity, Multitasking, Business Acumen, Cost Optimization, Supplier Relationships, Process Improvement, Quality Standards, Communication Skills
Specialization
Candidates should possess strong negotiation skills and a good understanding of indirect sourcing tools and processes. Experience in manufacturing, particularly in FMCG or consumer industries, is advantageous.
Experience Required
Minimum 2 year(s)
Physician Assistant/Nurse Practitioner (CVWHA) at Sante Health
Fresno, California, United States - Full Time
Skills Needed
Communication Skills, Compassionate, Efficient, Service Oriented, Multi Tasking, Attention To Detail, Patient Focused Care, Teamwork, Problem Solving, Clinical Experience, Patient Education, Time Management, Collaboration, Medical History Taking, Emergency Management, Health Promotion
Specialization
Candidates must complete an approved Physician Assistant/Nurse Practitioner program and hold national certification. Professional clinical experience in a clinic setting is preferred, along with strong communication and multitasking skills.
Experience Required
Minimum 2 year(s)
Van Driver at Hallcon
Sweetwater, Texas, United States - Full Time
Skills Needed
Safe Driving, Vehicle Inspection, Navigation, Communication, English Writing
Specialization
Minimum age of 21 and a current valid state-issued driver's license are required. Successful completion of a pre-employment drug screen and background check is also necessary.
Van Driver at Hallcon
Auburn, Washington, United States - Full Time
Skills Needed
Safe Driving, Vehicle Inspection, Navigation, Communication, Reliability
Specialization
Candidates must be at least 21 years old and possess a valid state-issued driver's license. Successful completion of a pre-employment drug screen and background check is required.
Medical Management - Utilization Management RN 145-2015 at CommunityCare
Tulsa, Oklahoma, United States -
Full Time

Start Date

Immediate

Expiry Date

20 Feb, 26

Salary

0.0

Posted On

22 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Utilization Review, Clinical Review, Medical Necessity, Documentation, Care Coordination, Collaboration, Data Entry, Communication, Organizational Skills, Time Management, Community Resources, Managed Care, Population Health, Case Management, Acute Care Experience, Continuing Education

Industry

Insurance

Description
JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk members, and other members identified with at risk or high utilization needs. Functions as an active team member of the Utilization Management Team. KEY RESPONSIBILITIES: Performs utilization review of outpatient and ancillary services as well as inpatient and post-acute services when indicated. Determines medical necessity and appropriateness of services using clinical review criteria. Accurately documents all review determinations and contacts providers and members according to established timeframes. Appropriately identifies and refers cases that do not meet established clinical criteria to the Medical Director. Appropriately identifies and refers quality issues to Medical Management leadership. Appropriately identifies potential cases for Care Management programs. Collaborates with physicians and other providers to facilitate provision of services throughout the health care continuum. Performs accurate data entry. Communicates appropriate information to other staff members as necessary/required. Participates in continuing education initiatives. Collaborates with other departments as needed. Performs other duties as assigned. QUALIFICATIONS: Knowledge of managed care and associated group benefit plans. Possess strong oral and written communication skills. Ability to reason logically and to use good judgment when interpreting materials or situations. Knowledge of community- based resources. Must have excellent organizational skills and be able to perform multiple tasks. Proficient in Microsoft applications. Excellent time management and documentation skills. Successful completion of Health Care Sanctions background check. EDUCATION/EXPERIENCE: Graduation from accredited School of Nursing. Current, active, unrestrictive license to practice as a Registered Nurse in the State of Oklahoma. Three years of acute care experience preferred. Two years of experience working with population health preferred. Previous discharge planning or case management experience preferred. Managed care experience a plus. CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin
Responsibilities
The role involves performing clinical reviews of utilization requests and assessing care coordination opportunities for various member populations. The RN will collaborate with healthcare providers and document review determinations accurately.
Medical Management - Utilization Management RN 145-2015 at CommunityCare
Tulsa, Oklahoma, United States - Full Time
Skills Needed
Utilization Review, Clinical Review, Medical Necessity, Documentation, Care Coordination, Collaboration, Data Entry, Communication, Organizational Skills, Time Management, Community Resources, Managed Care, Population Health, Case Management, Acute Care Experience, Continuing Education
Specialization
Candidates must have a current RN license in Oklahoma and preferably three years of acute care experience. Strong communication skills and knowledge of managed care are essential.
Experience Required
Minimum 2 year(s)
Park Worker II Seasonal - 9168 Recreation at Milwaukee County
Milwaukee, Wisconsin, United States - Full Time
Skills Needed
Customer Service, Cash Handling, Communication Skills, Teamwork, Positive Attitude, Work Ethic, General Park Operations, Administrative Skills, Basic Computer Knowledge
Specialization
Applicants must be at least sixteen years old and have previous customer service experience preferred. Basic knowledge of computer applications such as Microsoft Word, Outlook, and Excel is also preferred.
CPP Operator (2nd Shift) - Ridgeway at isola
Ridgeway, South Carolina, United States - Full Time
Skills Needed
Machine Operating, Quality Inspection, Multitasking, Problem Solving, Communication, Sap
Specialization
Candidates should have strong verbal and written communication skills and preferably previous machine operating experience. Familiarity with work instructions, work orders, and SAP is also preferred.
Layup Operator (2nd Shift) - Chandler at isola
Ridgeway, South Carolina, United States - Full Time
Skills Needed
Machine Operating, Work Instructions, Work Orders, Erp Systems, Forklift Experience, Communication Skills, Material Verification, Automated Equipment Operation, Sap Inventory Tracking, Problem Reporting, Multitasking, Teamwork, Task Orientation, Bending, Reaching, Lifting
Specialization
Candidates must have prior machine operating experience and strong communication skills. Previous experience with work instructions and ERP systems is preferred.
Instructor Broadway at CorePower Yoga
Denver, Colorado, United States - Full Time
Skills Needed
Yoga Instruction, Communication Skills, Interpersonal Skills, Cpr Certification, Class Planning, Student Engagement, Safety Awareness, Community Building, Cleaning Standards, Customer Service, Time Management, Physical Fitness, Inclusivity, Professionalism, Team Collaboration, Adaptability
Specialization
Candidates must have a 200-hour yoga teacher training certificate and current CPR/AED certification. Strong communication skills and the ability to lead physical activity in heated environments are essential.
Mechanical Maintenance Operator - Melting & Casting at SSAB
Muscatine, Iowa, United States - Full Time
Skills Needed
Mechanical Maintenance, Welding, Hydraulic Systems, Pneumatic Systems, Plumbing, Pipefitting, Maintenance Engineering, Industrial Electricity, Plc Understanding, Teamwork, Problem Solving, Communication Skills, Microsoft Office
Specialization
Candidates must have a high school diploma or equivalent and a strong mechanical background with at least 2 years of heavy industrial experience. Preferred qualifications include an associate degree or certificate in a mechanical or electrical field and basic PLC/electrical understanding.
Experience Required
Minimum 2 year(s)
Customer Service - Customer Service Team Lead 105-1027 at CommunityCare
Tulsa, Oklahoma, United States - Full Time
Skills Needed
Customer Service, Problem Resolution, Communication Skills, Training, Motivation, Organizational Skills, Time Management, Relationship Building, Negotiation Skills, Microsoft Applications, Attention To Detail, Bilingual, Hmo Plans, Ppo Plans, Enrollment, Benefits, Claims
Specialization
Candidates should have a thorough knowledge of HMO and PPO plans, along with at least 3 years of customer service experience. A bachelor's degree and supervisory experience are preferred.
Experience Required
Minimum 2 year(s)
Medical Management - Intake Coordinator 145-1030 at CommunityCare
Tulsa, Oklahoma, United States - Full Time
Skills Needed
Oral Communication, Written Communication, Logical Reasoning, Judgment, Time Management, Prioritization, Medical Terminology, Microsoft Applications
Specialization
Candidates must possess strong communication skills and have a basic knowledge of medical terminology. A high school diploma or equivalent is required, along with two years of related work experience preferred.
Experience Required
Minimum 2 year(s)
Low Code Process Engineer - Financial Crime Platform at TymeX
Manila, Metro Manila, Philippines - Full Time
Skills Needed
Process Engineering, Business Process Modeling, Kyc, Cdd, Edd, Financial Crime, Aml, Low Code, Ai, Bpmn, Cmmn, Dmn, Analytical Skills, Problem Solving, Communication Skills, Collaboration
Specialization
Candidates must have 3+ years of experience in process engineering or analysis, with strong knowledge of business process modeling. Familiarity with KYC/CDD/EDD processes and low-code/AI-based modeling is essential.
Experience Required
Minimum 2 year(s)
UX Low Code Business Engineer - Financial Crime Platform at TymeX
Manila, Metro Manila, Philippines - Full Time
Skills Needed
Ux Design, Low Code Development, Business Analysis, Financial Crime, Kyc, Cdd, Edd, Case Management, Wireframing, Prototyping, Usability Testing, Stakeholder Management, Agile, Data Driven Interfaces, Documentation, Problem Solving
Specialization
Candidates must have 3+ years of experience in a technology or financial environment with a strong focus on UX design and low code development. A solid understanding of business workflows in financial services and excellent communication skills are essential.
Experience Required
Minimum 2 year(s)
Stage Développeuse / Développeur Back end at Capgemini Portugal
Nantes, Pays de la Loire, France - Full Time
Skills Needed
Back End Development, Agile Methodology, Teamwork, Curiosity, Proactivity
Specialization
You should be in your first year of a master's program in engineering or computer science and looking for a 3 to 4-month internship, or in your final year seeking an end-of-studies internship. A curiosity and proactive attitude, along with teamwork appreciation, are essential.
Miscellaneous Equipment Operator-Not Gas at Pacific Gas And Electric Company
San Jose, California, United States - Full Time
Skills Needed
Equipment Operation, Driving, Maintenance, Construction, Heavy Lifting, Safety Compliance, Team Support, Mechanical Knowledge, Crane Operation, Truck Operation, Ppe Usage, Travel Flexibility, Communication, Problem Solving, Technical Skills, Construction Standards
Specialization
Candidates must possess a high school diploma or GED and a valid Class A California Driver's License Permit. They should be able to lift heavy loads, work extended hours, and travel throughout the PG&E service territory.
Rocket Sled Mechanical Engineer at Canvas Inc.
Holloman AFB, New Mexico, United States - Full Time
Skills Needed
Mechanical Engineering, Rocket Propulsion, Cfd Accuracy, Data Collection, Design Engineering, Test Engineering, Communication Skills, Teamwork, Project Management, Vibration Analysis, Aerodynamic Design, Heat Transfer Modeling, Customer Interaction, Safety Standards, Independent Work, Fast Paced Environment
Specialization
A bachelor's degree in mechanical engineering or a relevant discipline is required, with no prior experience necessary. Knowledge of mechanical engineering concepts and excellent communication skills are essential.
Senior ICBM Guidance, Navigation & Control (GN&C) Test & Evaluation Enginee at Canvas Inc.
, , United States - Full Time
Skills Needed
Guidance Navigation & Control, Test & Evaluation, Technical Engineering Expertise, Performance Assessment, Technical Assessments, Cross Functional Team Collaboration, Mentoring, Test Planning, Verification & Validation, Inertial Navigation Systems, Error Propagation, Statistical Methods, Data Analysis, Hardware In The Loop Testing, Icbm Missile Systems, Test Planning & Processes
Specialization
A Bachelor's degree in a related field and 15 years of relevant experience are required. Senior-level expertise in inertial GN&C systems and familiarity with ICBM missile systems is essential.
Experience Required
Minimum 10 year(s)
Electrical Engineer - Facilities at Canvas Inc.
Holloman AFB, New Mexico, United States - Full Time
Skills Needed
Electrical Engineering, Facility Infrastructure, Building Codes, Communication Skills, Milcon Requirements, Project Management, Construction Projects, Strategic Financial Planning, Contractor Surveillance, Independent Government Estimates, Transformers Management, Transmission Lines, Ground Stations, Electric Repairs, Dod Installation Knowledge, Adaptability
Specialization
A Bachelor of Science degree in an Engineering field, preferably electrical, is required along with 1-2 years of relevant experience. Candidates must be familiar with DoD facility infrastructure needs and possess excellent communication skills.
Experience Required
Minimum 2 year(s)
Institutional Grievance Officer-Marion Correctional Institution at North Carolina Dept of Environmental Quality
, North Carolina, United States - Full Time
Skills Needed
Administrative Remedy Procedures, Grievance Program, Data Analysis, Microsoft Word, Microsoft Excel, Microsoft Powerpoint, Database Management, Investigation Skills, Report Writing, Communication Skills, Problem Solving, Organizational Skills, Consultation Skills, Policy Knowledge, Staff Guidance, Offender Interaction
Specialization
A Bachelor’s degree and one year of related experience are required for this position. An equivalent combination of education and experience may also qualify.
Category Buyer, Indirects, India. at Huhtamaki
Thane, maharashtra, India - Full Time
Skills Needed
Negotiation Skills, Analytical Skills, Ms Office Suite, Cost Comparison, Vendor Management, Procurement, Facility Management, Collaboration, Integrity, Multitasking, Business Acumen, Cost Optimization, Supplier Relationships, Process Improvement, Quality Standards, Communication Skills
Specialization
Candidates should possess strong negotiation skills and a good understanding of indirect sourcing tools and processes. Experience in manufacturing, particularly in FMCG or consumer industries, is advantageous.
Experience Required
Minimum 2 year(s)
Physician Assistant/Nurse Practitioner (CVWHA) at Sante Health
Fresno, California, United States - Full Time
Skills Needed
Communication Skills, Compassionate, Efficient, Service Oriented, Multi Tasking, Attention To Detail, Patient Focused Care, Teamwork, Problem Solving, Clinical Experience, Patient Education, Time Management, Collaboration, Medical History Taking, Emergency Management, Health Promotion
Specialization
Candidates must complete an approved Physician Assistant/Nurse Practitioner program and hold national certification. Professional clinical experience in a clinic setting is preferred, along with strong communication and multitasking skills.
Experience Required
Minimum 2 year(s)
Van Driver at Hallcon
Sweetwater, Texas, United States - Full Time
Skills Needed
Safe Driving, Vehicle Inspection, Navigation, Communication, English Writing
Specialization
Minimum age of 21 and a current valid state-issued driver's license are required. Successful completion of a pre-employment drug screen and background check is also necessary.
Van Driver at Hallcon
Auburn, Washington, United States - Full Time
Skills Needed
Safe Driving, Vehicle Inspection, Navigation, Communication, Reliability
Specialization
Candidates must be at least 21 years old and possess a valid state-issued driver's license. Successful completion of a pre-employment drug screen and background check is required.