- Elevance Health (Meridian, ID)
- **Title: Utilization Management Representative I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live ... within 50 miles of one of our PulsePoint locations. The ** Utilization Management Representative I** will be responsible for coordinating cases for… more
- Ryder System (Boise, ID)
- …CI Manager or Sr. CI Manager and is closely aligned with Operations Management . + Lean background is mandatory + Warehouse Engineer experience is required + ... Identify and support Automation projects. Regularly interacts with operations management and/or customer(s). + Develop and demonstrate competency in wide… more
- OrePac Building Products (Boise, ID)
- …hours accrued annually after year 1 Paid Sick Time: 24 hours annually Management Position: Yes Branch Location: Boise, ID POSITION SUMMARY: The Operations Manager is ... responsible for the daily management and administration of all activities related to the...+ Review the effectiveness of operating procedures, maintenance, space utilization , and protection of equipment. + Confer with department… more
- RES (Boise, ID)
- …routine maintenance schedules and communicates schedules for maintenance, repairs and utilization to Equipment Manager and field personnel. + Reviews third (3rd) ... to monitor repairs and ensure timely turnaround to keep utilization of assets high. + Oversees performance of and...& Abilities:** + Advanced knowledge in solar equipment + Management of multiple direct reports + Experience with diagnostic… more
- Highmark Health (Boise, ID)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...+ Ability to visualize, articulate and solve complex problems representative of a broad range of service and claim… more
- Guardian Life (Boise, ID)
- …attitude. You can collaborate with stakeholders to provide effective case management within the boundaries of contractual definitions. **You will:** + Assess ... providers to formulate viable return to gainful work plans. Cost effective utilization of vendors to provide rehabilitative services to support program goal.… more
- HealthEdge Software Inc (Boise, ID)
- …support people need, when and where they need it. We call it Digital Health Management . Our comprehensive suite of Digital Health Management solutions for care ... ; ideally with a variety of experience in primary care, chronic disease management and/or public health. **Must have active license + Prior experience in **clinical… more
- HUB International (Boise, ID)
- …independent judgment + Proficient in Microsoft Word, Excel, Outlook, and internet utilization + Applied Agency Management System (Epic) experience preferred but ... disputes + Reviews for accuracy change received or downloaded into the agency management system + Participates in the renewal preparation being sure that all… more
- CBRE (Boise, ID)
- …13-Aug-2024 Service line GWS Segment Role type Full-time Areas of Interest Project Management Location(s) Phoenix - Arizona - United States of America, Remote - US ... healthcare vernacular. **What you'll do** Leads all facets of project management (budget, schedule, procurement, quality & risk) for individual healthcare projects… more
- Carrington (Boise, ID)
- …operational report metrics. + Gain expert knowledge of the operational systems and utilization within the business process. + Act as the primary contact for ... technology, reporting and process related analysis. + Assist with scope management , change management and solution definition. + Create functional specifications… more
- HealthEdge Software Inc (Boise, ID)
- …Quality Assurance), CMS (Centers for Medicare & Medicaid Services), URAC ( Utilization Review Accreditation Commission) and other State regulatory bodies. The ideal ... where they need it. We call it Digital Health Management . Our comprehensive suite of Digital Health Management...permanent **Work Environment:** The physical demands described here are representative of those that must be met by an… more
- Sutherland Global Services (Boise, ID)
- …+ Billing Inquiries & Complaints + Authorizations + Status Inquiries + Utilization Management Inquiries **Eligibility and Benefits** + Status Inquiries + ... working in a high-volume call center environment as a customer service representative + Effective verbal and written communication skills + Strong typing and… more
- Sutherland Global Services (Boise, ID)
- …of Benefits Requests + Authorizations + Status Inquiries + Denial Rationale + Utilization Management Appeals + Prior Authorization Verification + Eligibility and ... a high-volume call center environment as a customer service representative + Effective verbal and written communication skills +...skills with a strong attention to detail + Time Management skills + Sufficient Internet speeds while connected to… more
- Trinity Health (Nampa, ID)
- …(pre-certifications, third-party authorizations, referrals) and contacts physicians and Care Management / Utilization Review personnel, as needed. + Obtains and ... routine payer or provider issues and escalates to Lead Patient Financial Services Representative . + Acts as a point of contact for assigned payers. + Maintains… more
- Guardian Life (Boise, ID)
- …negotiation skills. + The ability to accelerate impact and lead change. + Time management skills. **You will** + Manage PPO and DHMO recruitment efforts within your ... using market data to negotiate fee schedules and increasing utilization . + Speak to dentists/decision makers on the value...+ Complimentary 1:1 financial guidance with a licensed Fidelity representative **Time Off and Remote Work** + Flexible work… more