• Jacksonville, FL, USA
May 22, 2022  
Hiring for a Registered Nurse to work remotely performing case management! Requirements: + Must have a valid Registered Nurse license in the State of Florida or Compact License + Must have at least 3+ years of nursing experience in Case Management and Disease Management. + Strong team-oriented mindset with a passion for patient care, + Strong computer skills Responsibilities - including but not limited to: + Telephonic case management for patients - which includes patient education and managing continuous care. + Accomplishes patient care by assessing treatment needs; developing, monitoring, and evaluating treatment plans and progress. + Responsible for complying with policies and procedures under nursing laws and regulations About Actalent: Actalent connects passion with purpose. Our scalable talent solutions and services capabilities drive value and results and provide the expertise to help our customers achieve more. Every day, our experts around the globe...
Actalent Remote * (Orlando, FL, USA)
May 22, 2022  
Description: Candidates will be responsible for triaging either Pediatric or Adults (at times both) phone lines. Children's parents are calling in with concerns about their symptoms, and the triage nurse is responsible for scheduling following up appointments or leveraging protocol to provide advice. Adult patients would call into the Adult line with similar concerns for their own symptoms. Qualifications + 1+ years' nursing experience and medical terminology required + Licensed RN in State of NC + Active BLS/CPR Hours: Monday-Friday 8:00a-5:00p, no weekends or Holidays Pay Rate: $28.00 - $35.00/hour Worksite location: First few weeks (3 to 4 weeks) are onsite training in Durham, NC and then role will be 100% remote. Skills: triage, Pediatrics, Patient Care About Actalent: Actalent connects passion with purpose. Our scalable talent solutions and services capabilities drive value and results and provide the expertise to help our customers achieve more. Every day,...
Actalent Remote * (Durham, NC, USA)
May 22, 2022  
Job Description Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or providing health management program interventions. Utilizes clinical proficiency and claims knowledge/analysis to assess, plan, implement, health coach, coordinate, monitor, and evaluate the medical necessity and/or care plan compliance, options, and services required to support members in managing their health, chronic illness, or acute illness. Utilizes available resources to promote quality, cost-effective outcomes. + 50% Performs medical or behavioral review/authorization process. + Ensures coverage for appropriate services within benefit and medical necessity guidelines. + Assesses service needs, develops and coordinates action plans in cooperation with members, monitors services, and implements plans. + Evaluates outcomes of plans, eligibility,...
Actalent Remote * (Charleston, SC, USA)
May 22, 2022  
Job Duties Performs medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits or services, and appeals. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. + 80% May provide any of the following in support of medical claims review and utilization review practices: Performs medical claim reviews and makes a reasonable charge payment determination. Monitors process's timeliness in accordance with contractor standards. Performs authorization process, ensuring coverage for appropriate medical services within benefit and medical necessity guidelines. Utilizes allocated resources to back up review determination. Reviews interdepartmental requests and medical information in a timely/effective manner in order to complete utilization process. May conduct/perform high dollar forecasting research and...
Actalent Remote * (Raleigh, NC, USA)
May 18, 2022  
Description: Mid/Junior Mechanical Process Piping or MEP / Cost Consultant / Quantity Surveyor / Estimator. Use excel for pricing and takeoffs done in typically Bluebeam or 3D modeling for heavy process piping scopes • Develop budget estimates by performing accurate quantity take-offs using plans and specifications, or conceptual information. • Review, interpret and accurately estimate the scope of assigned work as described in the project documents. • Apply unit costs and productivity rates, as provided by the supervisor. • Solicit and collect subcontractor and vendor bids or quotations. • Develop and nurture subcontractor/vendor and client relationships. • Prepare subcontractor analysis sheets for the assigned scope of work. • Evaluate changes and subcontractor change order estimates. Provide expertise in all phases of construction work. • Perform other duties that are reasonably associated with the above essential functions and additional duties assigned by the...
Actalent Remote * (Hillsboro, OR, USA)