- Highmark Health (Providence, RI)
- …pharmacist the incumbent may also review UM requests; provide consultation into the case and disease management identification process, and consult with the ... and member educational initiatives that promote the Organization's Formularies, utilization management programs, and case / disease management initiatives;… more
- PPL Corporation (Providence, RI)
- …complex business processes and technical problems with a focus on financial management and regulatory support. The Business Operations Analyst will prepare and ... deliver well-constructed business insights to management , lead teams, and enhance other's understanding of business...**Basic Qualifications *this position will be filled at the Associate , Intermediate, or Senior level based on the successful… more
- Veterans Affairs, Veterans Health Administration (Providence, RI)
- …level Nursing education program. Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a ... (may be extended up to two years on a case -by- case -basis.) NOTE: Grandfathering Provision - All persons...care to assigned clients while developing technical competencies. An Associate Degree (ADN) or Diploma in Nursing, with no… more
- Advocates (Franklin, MA)
- …team. + Provide and set a positive team atmosphere. + Provide ongoing case management training to staff in teaching skills, assessment writing, behavior ... management , annual reviews, data collection and other case management responsibilities. + Provide supervision, mentoring...+ Serve as a member of the Day Program Management Team. **Qualifications** + Associate 's Degree in… more
- Wolters Kluwer (Providence, RI)
- …communications) + Learns and tests modern technology platforms introduced including Human Capital Management and Case Management + Provides backup and other ... review, analysis, and reporting. You will report to the Associate Director, HR Service Delivery. **RESPONSIBILITITES** + Be the...teams. + Navigate software systems and programs including multiple case management systems, ie, Workday Help and… more
- CenterWell (Providence, RI)
- …+ Set or adopt policies for, and keep records of criteria for admission to service, case assignments, and case management . + Represent the pharmacy in a ... contracts + Monitor the following key functions: + Program evaluation + Risk Management + Utilization Review + Patient Care Evaluation + Policies and procedures +… more
- Zurich NA (Providence, RI)
- …Degree in Nursing and 3 or more years of experience in Bill Review and Case Management + Knowledge of ODG, MTUS, State Guidelines + Experience in developing ... COHN. + 3-5 years of leadership experience in Nurse Case Management and Bill Review within a...Remote Work (US) Remote Working: Yes Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-MD1 #LI- ASSOCIATE … more
- UMB Bank (Providence, RI)
- …tools for managing fraud dispute claims. + Continually evaluate the effectiveness of the case management process. + Validate both UMB and vendor performance and ... fraud claims risk. This role will also assist with the oversight and management of third-party card fraud claim vendors and ongoing card fraud claims monitoring,… more
- Merck (Providence, RI)
- …and escalates performance issues and training needs to CRA (Clinical Research Associate ) manager and/or functional vendor and internal management as needed. ... is primarily accountable for the end-to-end performance and project management for assigned protocols in a country in compliance...pose an undue burden to business operations, in which case you may not be offered employment, or your… more
- SitusAMC (Providence, RI)
- …knowledge of the software or hardware systems being supported and effective personnel management skills. **Essential Job Functions:** + Can be called upon to perform ... SitusAMC operations + Escalate issues seen by operations (as required) to upper management and participate in planning sessions to remediate these issues + Provide… more