- Beth Israel Lahey Health (Burlington, MA)
- …healthcare fields. Competence in standardized medical necessity criteria Three years of recent case management or utilization management experience ACM, ... Functions and Responsibilities:** Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that… more
- Beth Israel Lahey Health (Burlington, MA)
- …The Utilization Analyst works with physicians, the payers and inpatient case management team to validate the medical necessity of the hospital care. ... Using the concepts of utilization review, clinical documentation improvement and revenue integrity, these specialized case managers analyze medical documentation… more
- Premier Health (Dayton, OH)
- …5 years of job related experience Prior job title or occupational experience: Case management , Utilization review Prior specific functional responsibilities: ... CLINICAL DENIALS ADMIN Full-Time / DAY SHIFT The Denials Management Clinical Analyst (DMCA) is a registered...and expertise in process analysis, clinical outcome data analysis, utilization management , and utilization of… more
- The Cigna Group (Bloomfield, CT)
- Nurse Case Management Lead Analyst -Nurse Clinician - Accredo Job Description Summary The Nurse Clinician - RN is responsible for reviewing escalated clinical ... providers, members and patient client advocates within the Prior Authorization/ Utilization Management department. Identify and track trends...of relevant RN experience with a BSN degree + Case management experience preferred + 5+ years… more
- CVS Health (Columbia, KY)
- …advantage for Aetna. Health Services strategies, policies, and programs are comprised of utilization management , quality management , network management ... quality outcomes. * Creates direction and communicates a business case for change by focusing on and addressing key...the unit. * May be accountable for the day-to-day management of teams for appropriate implementation and adherence with… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …business teams ( Case Management , Clinical Claims Review, Quality Management & STARS, Utilization Management , etc.) and information technology ... Case Management , Clinical Claims Review, Quality Management & STARS, Utilization Management ,...management leadership and coordination as needed. Business Systems Analyst IV + Creation and maintenance of end-to-end automation… more
- CaroMont Health (Gastonia, NC)
- …license or multi-state (compact) license). Certification in Utilization Review / Management , Quality and/or Case Management preferred. Minimum of three ... via fax, Provider Link, or telephonically. Gathers and disseminates Utilization Management information to medical staff departments,...be cross trained to work for the Commercial Resource Analyst when the need arises. Act as liaison to… more
- Treasury, Departmental Offices (Washington, DC)
- …of the Department of the Treasury's Departmental Offices. As the Office's primary Management and Program Analyst , you will use Human Resources Information ... on critical human capital issues, policies, and programs. Responsibilities As a Management and Program Analyst , you will: Gather information, conduct research,… more
- Tri-State Generation and Transmission Association, Inc. (Westminster, CO)
- …accuracy of results. Additionally, this position will assist with data request responses and management of the rate case processes. This position will also work ... at one of four job grade levels: FERC Rate Analyst , job grade 6, FERC Rate Analyst ...case proceedings, including interaction with regulators, preparation and management of data requests and responses, aid in the… more
- National Archives and Records Administration (Spanish Lake, MO)
- …and will receive training to help you grow in this position. As a MANAGEMENT ANALYST , you will: Conduct management studies, audits, analyses, reporting, ... analysis, local and organizational policy, manpower and human capital utilization , space management , communications, physical layout, work-flow methodologies,… more
- PPL Corporation (Allentown, PA)
- …focus on improving operational effectiveness and excellence. The Business Operations Analyst will prepare and deliver well-constructed business insights to ... management , lead teams, and enhance other's understanding of business...passion to optimize the decision making process through rigorous utilization of data. **_THIS IS NOT A REMOTE POSITION._**… more
- MyFlorida (Fort Pierce, FL)
- …positions may be filled. Your Specific Responsibilities: This position provides medical case management to persons infected and affected by HIV/AIDS within ... HUMAN SERVICES ANALYST - 64006335 Date: Nov 21, 2024 The...Counties (area 15). This position provides proactive and inclusive case management activities through office or field… more
- CGI Technologies and Solutions, Inc. (Charlotte, NC)
- **Business System Analyst - Hardware Asset Management (HAM)** **Category:** Business Analysis (functional and technical) **Main location:** United States, ... Type:** Full Time **Position Description:** We are seeking a skilled Excel Data Analyst with experience in Hardware Asset Management to join our dynamic… more
- Nuclear Regulatory Commission (Rockville, MD)
- …subject to security ownership restriction reporting requirements. Responsibilities As a management and program analyst , performs analytical and evaluative work ... of the following functional areas: budget execution and formulation, resource utilization , performance management and internal controls, program evaluation,… more
- Arizona Public Service (Phoenix, AZ)
- …Financial Analyst / Consultant to act as an internal management consultant, leading high-impact projects that influence officer-level decision-making and company ... Strategic Financial Analyst / Consultant | Executive Decision Support Apply...details that drive business outcomes. + Advisory Experience: Exceptional management consulting skills with a history of advising executives… more
- US Air Force - Agency Wide (Scott AFB, IL)
- …specialized experience requirements described in the Office of Personnel Management (OPM) Qualification Standards for General Schedule Positions, Administrative and ... Management Positions. EXPERIENCE REQUIRED: Your resume must reflect the...precedents applicable to military and civilian manpower acquisition and utilization in order to perform studies concerning the efficiency… more
- Amazon (Arlington, VA)
- …to hire a WFM Analyst to be part of the MHLS Workforce Management team. The selected candidate will be responsible for managing operational KPIs and site level ... for the team. The expectation is to ensure effective management of the incoming and outbound phone, chat and...Ensure that Operational metrics like service levels, occupancy, PTL, utilization etc. are being met by all Orgs/skills at… more
- Live Nation (CA)
- …program, incrementality testing and attribution thought leadership. THE ROLE The Senior Analyst , Data & Dashboard will lead data enablement and dashboard projects ... for ensuring the accuracy, usability, and accessibility of data utilization deliverables. They will provide the best dashboards and...data accuracy and reliability and work with Data QA analyst for long-term solutions. They will be the liaison… more
- University of Washington (Seattle, WA)
- … Analyst team this role will provide analytics support for HMC's growing Care Management and Utilization Management as well as collaborate with ambulatory ... and public reporting of quality and patient safetymeasures + Collaborate with Utilization Management nurses and physicians on improvement efforts around… more
- Amazon (Arlington, VA)
- …to hire a WFM Analyst to be part of the MHLS Workforce Management team. The selected candidate will be responsible for managing operational KPIs and site level ... for the team. The expectation is to ensure effective management of the incoming and outbound phone, chat and...Ensure that Operational metrics like service levels, occupancy, PTL, utilization etc. are being met by all Orgs/skills at… more