- Sedgwick (San Juan, PR)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Case Management Associate **PRIMARY PURPOSE** : To access and assign ... **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Accesses and assigns cases for medical case management , utilization review and clinical consultation. + Provides… more
- Abbott (San Juan, PR)
- …Our 114,000 colleagues serve people in more than 160 countries. **Clinical** **Sales** ** Associate I** , this position will be based in Puerto Rico. **North Area** ... provide support to our Medical Devices / **Cardiac** **Rhythm Management business** . Our medical devices help more than...for treatment of vascular disease. As the **Clinical Specialist Associate I** , you will Provides educational, sales and… more
- Fujifilm (San Juan, PR)
- **Position Overview** The Associate Clinical Specialist independently provides customer support of Fujifilm's ES equipment in the Endoscopy department and/or ... equipment. + Monitor, report, and support repair transactions. + Provide Case observation, continuous staff training on Fujifilm technologies, and overall Fujifilm… more
- Ford Motor Company (San Juan, PR)
- …than ourselves. Are you ready to change the way the world moves? As an Associate IT Software Engineer, you will collaborate with a broad array of talented software ... Vehicle discount program for employees and family members and management leases * Tuition assistance * Established and active...you reside within 50 miles of Dearborn, MI-in which case we request on-site presence up to 4 days… more
- Humana (San Juan, PR)
- …prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning and/or home health or ... + Experience working with Case managers or Care managers on complex case management , including familiarity with social determinants of health. + The… more
- Humana (San Juan, PR)
- …Degree. + Minimum 3 years of experience working in a clinic, hospital case management , managed care/ healthcare setting - working with providers, taking ... all paperwork and documentation is notated within the clinical management system. + ASN with care coordination efforts of...active-duty service members must be enrolled with EFMP and associate will educate and register them in the ECHO… more
- Humana (San Juan, PR)
- …overtime and/or weekends) **Preferred Qualifications** + Health Plan experience + Previous Case Management Experience + Call center or triage experience + ... rehabilitation or discharge planning + Knowledge in Chronic Condition management (treatment, pharmacological treatment, signs & symptoms, etc.) Diabetes,… more
- Datavant (San Juan, PR)
- …quality, compliance assessments, external payer reviews, coding education, interim coding management , and coding workflow operations reviews. In this role, you will ... and prioritize multiple cases concurrently to ensure departmental workflow and prompt case resolution. + Demonstrate versatility and exceptional work across a wide… more
- Humana (San Juan, PR)
- …prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning and/or home health or ... + Experience working with Case managers or Care managers on complex case management , including familiarity with social determinants of health. + The… more
- Humana (San Juan, PR)
- …prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning and/or home health or ... + Experience working with Case managers or Care managers on complex case management , including familiarity with social determinants of health. + The… more
- Zurich NA (San Juan, PR)
- …The position offers autonomy and requires strong analytical, negotiation, and litigation management skills. This position can be office, hybrid, or fully remote ... + Develop and implement effective claim resolution strategies, including case evaluations, issue escalation, and timely disposition planning. + Establish… more
- Datavant (San Juan, PR)
- …productivity benchmarks + Foster professional communication with colleagues, management , and hospital staff, while addressing clinical and reimbursement ... Strong verbal and written communication skills **What Helps You Stand Out:** + Associate or Bachelor's degree from an AHIMA-certified HIM or Nursing Program, or… more
- Terumo Medical Corporation (Caguas, PR)
- …baseline and threshold changes are tracked and required follow-ups are completed. Case Management and Return-to-Work Processes - Actively participate in ... case management discussions, facilitate post-injury/illness follow-up, support safe return-to-work and job accommodations, and coordinate specialist evaluations… more
- Humana (San Juan, PR)
- …complex to complex issues where the analysis of situations or data requires a case by case consideration of the Medicare rules, Humana policies and medical ... skills, with prior experience participating in teams focusing on quality management , utilization management , or similar activities **Preferred Qualifications:**… more
- Humana (San Juan, PR)
- …and Excel **Preferred Qualifications** + Bachelor's degree - BSN + Experience with case management , discharge planning, and patient education for adult acute ... require interpretation and independent determination of the appropriate courses of action. Associate will be expected to participate in weekend rotation a minimum of… more
- Humana (San Juan, PR)
- …prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning and/or home health or ... Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other… more
- Humana (San Juan, PR)
- …profit organization) or has several years' experience with stakeholder management (strategy/operations at a top-tier consulting/professional services firm). They ... also will be effective at multitasking and possess keen program and change management skills to balance an evolving set of priorities and deadlines. Healthcare… more
- Humana (San Juan, PR)
- …and member experiences to drive growth and improved retention + Support business case development for key initiatives **Use your skills to make an impact** ... full-time relevant strategic work experience, ideally post-MBA + Strategy management consulting experience + Experience leading broad initiatives with… more
- Humana (San Juan, PR)
- …guidelines such as NCD/LCD, MCG(R) or InterQual The Medical Director conducts clinical case reviews of requests received by members of the Medicare population and ... reports to the Lead Medical Director. **Other duties:** + Identify medical management operational improvements, including those within the medical director area +… more
- Philips (San Juan, PR)
- …various hospital committees or teams as requested by the customer with prior approval of site management + May be required to be available 24 x 7 via phone or pager, ... rotate in an on-call status. **You're the right fit if:** + Associate 's degree or equivalent training/experience in electronics or Biomedical Engineering and/or CBET… more