- CVS Health (Santa Fe, NM)
- …criteria specific to Behavioral Health to evaluate inpatient and outpatient services requiring precertification. + Conduct clinical reviews via phone and electronic ... gather necessary information. + Use established guidelines to authorize services or escalate to Medical Directors as needed. +...and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to… more
- Highmark Health (Camp Hill, PA)
- …the sale and implementation of optimal clinical interventions that deliver clinical and financial results. The incumbent is also expected to stay current on market ... of analytics and performance metrics to track quantitative clinical and financial results, and communicating value and progress for clients which contributes… more
- RGP (Dallas, TX)
- …* Bachelor's Degree of Accounting, Finance or related field * Role aligned to Financial Services Practice * Extensive experience in auditing within the ... financial services industry, particularly in credit risk management. * Strong understanding of traditional lending products and counterparty credit risk. * Proven… more
- Health Care Service Corporation (Chicago, IL)
- …territory. Responsible for education of providers and for ongoing provider service . Provide subject matter expertise to improve efficiencies and results. NOTE: ... years provider contracting experience. Contracting experience involves negotiating reimbursements, financial arrangements and rates. *Extensive knowledge of provider and… more
- Insight Global (Charlotte, NC)
- …ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by ... EPM Cloud - FCCS implementation and support * Strong understanding of financial close, consolidation, and reporting processes * Hands-on expertise in FCCS metadata,… more
- Saliense Consulting (Arlington, VA)
- …work to solve our client's toughest challenges within the Defense, Civilian, Financial , and Healthcare industries. Our diverse employees support vital missions for ... applications to break current tight integration processes between systems into web services /servlets. + Integrates data exchange between systems using system API and… more
- Deloitte (Tampa, FL)
- …are critical to businesses. Your contributions can help clients improve financial performance, accelerate new digital ventures, and fuel growth through innovation. ... reports, and other materials to support AI solutions and services + Guide federal clients with high autonomy in...open source packages. The Team Deloitte's Government and Public Services (GPS) practice - our people, ideas, technology and… more
- Henry Ford Health System (Troy, MI)
- …and rates on behalf of HFHS Hospitals, Medical Group, Behavioral Health Services and other business units. 1. Independently evaluate and analyze contract proposals ... utilization review, credentialing site visits, notification of site closures or new services . 9. Assist in the development and revision of department policies and… more
- AAA Northern California, Nevada & Utah (Walnut Creek, CA)
- …+ Collaborative Environment - AAA will value your contribution to providing exceptional service to our members + Free AAA Classic Membership + AAA Product Discounts ... At AAA, our Team Members strive to deliver amazing service and help our Members outsmart life's roadblocks. We...gives you the opportunity to achieve all of your financial goals! RESPONSIBILITIES / JOB DUTIES + Work within… more
- Trustmark (Frankfort, KY)
- …then transitions account to an account manager for ongoing maintenance and service . Develops new accounts and/or generates new business from existing accounts. ... mission of helping people increase wellbeing through better health and greater financial security. At Trustmark, you'll work collaboratively to transform lives and… more