Essential Duties and Responsibilities: - Provides advanced clinical inquiry responses (verbal and written) to health-related inquiries from consumers, educators or medical/health professionals. - Provides medical subject matter expertise. - Performs advanced database searches. - Composes documents,
Essential Duties and Responsibilities: - Manage assigned teams and staff. - Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures. - Frequent interaction
Essential Duties and Responsibilities: - Provides advanced clinical inquiry responses (verbal and written) to health-related inquiries from consumers, educators or medical/health professionals. - Provides medical subject matter expertise. - Performs advanced database searches. - Composes documents,
Essential Duties and Responsibilities: - Facilitate and prepare all planning activities and artifacts for complex initiatives including project scope statements, work breakdown structure, and detailed project schedule. - Monitor schedule progress, and implement corrective measures as
Essential Duties and Responsibilities: - Provide feedback regarding the design, development and distribution of training programs and materials as needed. - Conduct, plan, and coordinate training to a variety of audiences. - Coordinate logistics for instruction
Essential Duties and Responsibilities: - Provides customer service for basic and routine inquiries and problems via multiple possible channels (i.e. telephone, emails, web chats, or written letters). - Calls are predominantly routine, but may require deviation
Essential Duties and Responsibilities: - Provides customer service for basic and routine inquiries and problems via multiple possible channels (i.e. telephone, emails, web chats, or written letters). - Calls are predominantly routine, but may require deviation
Essential Duties and Responsibilities: - Provides customer service for basic and routine inquiries and problems via multiple possible channels (i.e. telephone, emails, web chats, or written letters). - Calls are predominantly routine, but may require deviation
Essential Duties and Responsibilities: - Perform all job functions in compliance with HIPAA policies and adhere to local and externally relevant health and safety laws and policies. - Gather and provide necessary information to providers; may
Essential Duties and Responsibilities: - Responsible for reviewing favorable and partially favorable determinations in accordance with applicable regulations. - Render determinations for cases assigned. - Resolve all other technical issues within reconsideration assigned. - Review cases
Essential Duties and Responsibilities: - Manage assigned teams and staff. - Develop, monitor, and use quality control procedures and audit criteria to ensure consistent application of contractual requirements and established policies and procedures. - Frequent interaction
Essential Duties and Responsibilities: - Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments. - Provide written clinical rationales for CA Workers Compensation
Essential Duties and Responsibilities: - Supervise a team of employees through cultivation of a high performance team - Ensure adequate staff coverage for assigned program area - Serve as subject matter expert for identified area of
Essential Duties and Responsibilities: - Works on assignments that are semi-routine in nature but recognizes the need for occasional deviation from accepted practice. - Perform repetitive clerical steps such as document verification, manage inbound and outbound
- Train, mentor and coach less tenured change management analysts. - Partner with product management team to see changes through implementation. - Partner with project management team to see changes through implementation. - Communicate directly with
Essential Duties and Responsibilities: - Type/generate letters and other documents, as necessary. - Assist in the preparation of reports. - Create files in case management system. - Update status of case in case management system. -
Essential Duties and Responsibilities: - Provides customer service for basic and routine inquiries and problems via multiple possible channels (i.e. telephone, emails, web chats, or written letters). - Calls are predominantly routine, but may require deviation
Essential Duties and Responsibilities: - Conduct opportunity-focused customer and competitor research to support PTW assumptions and competitive positioning. - Collect, organize, and validate award history, procurement data, incumbent information, and relevant market intelligence. - Support competitive
Essential Duties and Responsibilities: - Lead competitive intelligence and PTW activities for assigned pre-bid and active bid opportunities, including competitive environment, customer, top-down, bottom-up, and parametric analyses - Develop integrated PTW hypotheses using customer intelligence, competitor
Essential Duties and Responsibilities: - Support Solution Leads and Senior Solution Leads by producing analyses, models, forecasts, and documentation needed to develop complete, compliant, and executable solutions. - Maintain volumetric models, workload forecasts, staffing calculations, operational