• ABA Utilization Review (UR)…

    Spectrum Billing Solutions (Skokie, IL)
    …mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR Specialist | Revenue ... in a cohesive and rewarding environment. This is a remote or office/home hybrid position. Your Responsibilities: + Review... Utilization Review Specialist | ABA Utilization Management Specialist | ABA… more
    Spectrum Billing Solutions (10/30/25)
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  • PRN Clinical Utilization Review…

    Community Health Systems (Franklin, TN)
    **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of ... hospital services to ensure compliance with utilization management policies. This role conducts admission and continued stay reviews, supports denials and… more
    Community Health Systems (12/03/25)
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  • Utilization Rev Appeals Spec

    University of Michigan (Ann Arbor, MI)
    …withRHIT certificationOR Associate degree RN + At least 2-5 years of experience in Utilization Management , Appeals Management or Case Management + ... self-directed and work independently **Desired Qualifications + Experience with a case management / utilization management software program and EPIC (MiChart)… more
    University of Michigan (12/13/25)
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  • Central Authorization Specialist / Full…

    Henry Ford Health System (Troy, MI)
    …records and related documentation. + Current working knowledge of hospital operations, utilization management , case management , and managed care ... The purpose of the Central Authorization Specialist position is to centrally facilitate the successful...is obtained from back end coding, billing and denial management resources and distributed to ordering physicians and authorization… more
    Henry Ford Health System (10/23/25)
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  • Financial Clearance Specialist full-time…

    Trinity Health (Boise, ID)
    …appropriate service authorizations and will contact the physician and Case Management / Utilization Review personnel, as necessary. + Informs patient/guarantor of ... is full-time working office hours (Monday-Friday). The Financial Clearance Specialist obtains and/or verifies demographic, clinical, financial and insurance… more
    Trinity Health (12/08/25)
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  • Principal Specialist , HR Operations…

    RTX Corporation (Farmington, CT)
    …experts/ management /internal customers to plan, coordinate, and execute effective utilization of RTX learning tools/technologies. + Provide Tier 2 administrative ... to join our **RTX Corporate** team: RTX is looking for a **Principal Specialist , HR Operations** to join the Learning Operations team within Global People Services… more
    RTX Corporation (12/11/25)
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  • Clinical Documentation Specialist

    Trinity Health (Columbus, OH)
    …Minimum of 5 years acute care medical or surgical experience required;** ** Utilization /Case Management , managed care, or Clinical Documentation and experience ... time **Shift:** Day Shift **Description:** **Position Purpose:** Clinical Documentation Specialist utilizes advanced clinical and coding expertise to direct efforts… more
    Trinity Health (12/09/25)
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  • Lead ROI Medical Records Specialist

    Sharecare (Oklahoma City, OK)
    …and HIPAA regulations. This role also provides support to team members and management by serving as a subject matter expert, trainer, and escalation point. The ... or system issues. + Assists with administrative tasks such as queue management and work assignments. + Produce reports and metrics as requested. **Qualifications:… more
    Sharecare (12/04/25)
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  • RN Specialist Complex Case…

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …and Blue Shield of Minnesota Position Title: RN Specialist Complex Case Management - Transplant Location: Remote Career Area: Health Services About Blue ... Transplant Management ! Utilizing key principles of case management , the RN Specialist will research and...* 2+ years of managed care experience; eg case management /health coach, utilization management and/or… more
    Blue Cross and Blue Shield of Minnesota (11/28/25)
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  • Kinaxis Planning Specialist / Architect…

    ManpowerGroup (San Francisco, CA)
    **Job Title:** Kinaxis Planning Solution Architect **Location:** Remote **Minimum Qualifications:** **Kinaxis Certifications (Preferred):** + **Contributor Level 1** ... Kinaxis implementations** , with emphasis on supply planning, demand planning, and inventory management . + At least **3 years in a techno-functional role** , with… more
    ManpowerGroup (10/02/25)
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  • Provider Contracting Specialist -…

    CareFirst (Baltimore, MD)
    …care. + Reviews the performance of provider partners based on utilization , trends, and quality metrics to develop rate/reimbursement solutions. Ensures that ... geographically competitive, offers broad access, and meets cost and trend management objectives. **Regulatory and Healthcare Landscape** + Monitors and remains… more
    CareFirst (11/22/25)
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  • Medical Management Specialist I

    Elevance Health (Washington, DC)
    **Medical Management Specialist I** **Location:** Washington, DC. This role requires associates to be in-office 4 days per week, fostering collaboration and ... law. **Schedule:** Monday-Friday 8:00AM-5:00PM or 8:30AM-5:30PM EST The **Medical Management Specialist I** will be responsible for...and determines appropriate area to refer or assign case ( utilization management , case management , QI,… more
    Elevance Health (12/13/25)
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  • Sr Staff Project/Program Management

    Renesas (Morrisville, NC)
    Sr Staff Project/Program Management Specialist Job Description **Applicants for this position must be currently authorized to work in the United States on a ... We are seeking a highly experienced and strategic **Sr Staff Project/Program Management Specialist ** to lead multiple, concurrent development projects globally.… more
    Renesas (12/12/25)
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  • MMIS Medicaid Project Management Experience…

    COOLSOFT (Raleigh, NC)
    MMIS Medicaid Project Management Experience Specialist (Jobs in Raleigh, NC) Requirement id 156257 Job title Specialist Job location in Raleigh, NC Skills ... DOE Status requirement Job interview type Email Recruiter:coolsoft Job Description Specialist : MMIS, State Government Experience., Medicaid, Project Management more
    COOLSOFT (12/10/25)
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  • Contract Support Specialist - Contract Life…

    Texas Health Resources (Arlington, TX)
    **Contract Support Specialist - Contract Life Cycle Management ** **_Bring your passion to Texas Health so we are Better + Together_** **Work Location: Texas ... effective utilization and adherence to best practices. 10% Data Management : Maintain accurate and up-to-date contract records in the Icertis system. Ensure… more
    Texas Health Resources (12/13/25)
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  • Wastewater Management Technician…

    Battelle Memorial Institute (Tyndall AFB, FL)
    …**Job Summary** Battelle's National Security Business Unit is seeking a **Wastewater Management Technician Specialist ** to support Research, Development, Test & ... located on-site at Tyndall Air Force Base, near Panama City, FL. The Technician Specialist will be a self-starter with experience in processes and systems for water… more
    Battelle Memorial Institute (11/25/25)
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  • Clinical Rehab Specialist PRN

    HCA Healthcare (Dallas, TX)
    …Case Management and the Rehab Medical Director. The Clinical Rehabilitation Specialist works closely with hospital case management to ensure a responsive ... **Description** **Medical City Healthcare** Clinical Rehabilitation Specialist PRN Position serves all of the Division...rehab through their assigned case manager. + Once Case Management has completed the Patient Choice process and the… more
    HCA Healthcare (09/27/25)
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  • Self Directed Billing Specialist - Arc…

    Arc Allegany-Steuben (Hornell, NY)
    …money, why wait to be paid! Job Summary The Self Direction Billing Specialist is responsible for ensuring timely, accurate, and compliant billing for services ... requires proficiency with EVero software to manage billing processes, track utilization , reconcile records, and ensure all billing is submitted to accounting… more
    Arc Allegany-Steuben (11/13/25)
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  • Clinical Specialist , Field Operations,…

    Corza Medical (AZ)
    Clinical Specialist , Field Operations, Wound Closure, West Region **Location of Work** Remote , Arizona; Remote , California; Remote , Chicago; Remote , ... Colorado; Remote , Denver; Remote , Idaho; Remote , Minnesota; Remote , Nevada; Remote ,...everything they do. **Job Purpose Summary** As a Clinical Specialist , you are responsible for delivering in-service training, hands-on… more
    Corza Medical (11/12/25)
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  • Telecommunications Specialist (Spectrum…

    Air Combat Command (Nellis AFB, NV)
    …Master Control (JMC) systems. Uses complex and unique RF spectrum management , data base automation and engineering software. Obtains national level authorization ... you must meet the requirements described in the Office of Personnel Management (OPM) Qualification Standards for General Schedule Positions, Administrative and … more
    Air Combat Command (12/06/25)
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