Key member of the utilization management team, and provides timely medical review of service requests that do not initially meet the applicable medical necessity guidelines. Routinely interacts with physicians, leadership and management staff, other Physician Clinical Reviewers (PCR), and health plan members and staff whenever a physician`s input is needed or required. Directs daily involvement in the following utilization management functions: Reviews all cases in which clinical determinations cannot be made by the Initial Clinical Reviewer. Discusses determinations with requesting physicians or ordering providers, when available, within the regulatory time frame of the request by phone or fax. Provides clinical rationale for standard and expedited appeals. Provides assistance and act as a resource to Initial Clinical Reviewers as needed to discuss cases and problems. Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process...

[Customer Support / Remote] - Anywhere in U.S. / Competitive Pay / Full medical, dental, and vision insurance - As a Customer Service Rep you'll: Handle customer support inquiries via text, email, phone, chat, and social media; Work directly with end users as needed to resolve issues, answer questions, and delight; Help build knowledge base articles and other self help content that keeps the people at bay and allows customers to solve their own issues up front; Constantly help track metrics, communicate trends across the company, and respond accordingly to capitalize on opportunities and remedy any issuesHiring Fast >>

[Customer Support / Remote] - Anywhere in U.S. / Up to $45K per year / Benefits (Medical-Vision-Dental-401k-PTO) / Ability to work 1 weekend day - As a Customer Service Specialist you'll: Thoughtfully reply to customer inquiries through phone, chat, and email; Provide general support to customers on topics ranging from the services that HomeLister offers, the sign up process, and updates on their listing; Direct specific questions related to real estate, operations or other areas to the appropriate teams and/or individuals; Relay suggestions to management based on customer feedbackHiring Fast >>

Key member of the utilization management team, and provides timely medical review of service requests that do not initially meet the applicable medical necessity guidelines. Routinely interacts with physicians, leadership and management staff, other Physician Clinical Reviewers (PCR), and health plan members and staff whenever a physician`s input is needed or required. Directs daily involvement in the following utilization management functions: Reviews all cases in which clinical determinations cannot be made by the Initial Clinical Reviewer. Discusses determinations with requesting physicians or ordering providers, when available, within the regulatory time frame of the request by phone or fax. Provides clinical rationale for standard and expedited appeals. Provides assistance and act as a resource to Initial Clinical Reviewers as needed to discuss cases and problems. Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process...

Key member of the utilization management team, and provides timely medical review of service requests that do not initially meet the applicable medical necessity guidelines. Routinely interacts with physicians, leadership and management staff, other Physician Clinical Reviewers (PCR), and health plan members and staff whenever a physician`s input is needed or required. Directs daily involvement in the following utilization management functions: Reviews all cases in which clinical determinations cannot be made by the Initial Clinical Reviewer. Discusses determinations with requesting physicians or ordering providers, when available, within the regulatory time frame of the request by phone or fax. Provides clinical rationale for standard and expedited appeals. Provides assistance and act as a resource to Initial Clinical Reviewers as needed to discuss cases and problems. Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process...

Maximus is seeking a Project Financial/Control Specialist to support our Internal Revenue Service (IRS) projects. The Project Financial/Control Specialist will support multiple IRS contracts in complying with all processes and procedures to monitor and track the financial health of the projects. The Project Control Specialist will also provide project support activities as needed to meet customer and project requirements. *The selected candidate can work primarily remotely in the DC metro area, and must be able to work periodically at the IRS facility in New Carrollton, MD and the Maximus office in McLean, VA. *As a large employer and Federal contractor, Maximus is subject to various vaccine mandates across our lines of business. Maximus is committed to complying with any applicable vaccine mandates. The specific vaccine requirements for this position will be outlined throughout the selection process. Individuals who believe they may qualify for a medical or religious...

Key member of the utilization management team, and provides timely medical review of service requests that do not initially meet the applicable medical necessity guidelines. Routinely interacts with physicians, leadership and management staff, other Physician Clinical Reviewers (PCR), and health plan members and staff whenever a physician`s input is needed or required. Directs daily involvement in the following utilization management functions: Reviews all cases in which clinical determinations cannot be made by the Initial Clinical Reviewer. Discusses determinations with requesting physicians or ordering providers, when available, within the regulatory time frame of the request by phone or fax. Provides clinical rationale for standard and expedited appeals. Provides assistance and act as a resource to Initial Clinical Reviewers as needed to discuss cases and problems. Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process...

Key member of the utilization management team, and provides timely medical review of service requests that do not initially meet the applicable medical necessity guidelines. Routinely interacts with physicians, leadership and management staff, other Physician Clinical Reviewers (PCR), and health plan members and staff whenever a physician`s input is needed or required. Directs daily involvement in the following utilization management functions: Reviews all cases in which clinical determinations cannot be made by the Initial Clinical Reviewer. Discusses determinations with requesting physicians or ordering providers, when available, within the regulatory time frame of the request by phone or fax. Provides clinical rationale for standard and expedited appeals. Provides assistance and act as a resource to Initial Clinical Reviewers as needed to discuss cases and problems. Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process...

Key member of the utilization management team, and provides timely medical review of service requests that do not initially meet the applicable medical necessity guidelines. Routinely interacts with physicians, leadership and management staff, other Physician Clinical Reviewers (PCR), and health plan members and staff whenever a physician`s input is needed or required. Directs daily involvement in the following utilization management functions: Reviews all cases in which clinical determinations cannot be made by the Initial Clinical Reviewer. Discusses determinations with requesting physicians or ordering providers, when available, within the regulatory time frame of the request by phone or fax. Provides clinical rationale for standard and expedited appeals. Provides assistance and act as a resource to Initial Clinical Reviewers as needed to discuss cases and problems. Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process...

Key member of the utilization management team, and provides timely medical review of service requests that do not initially meet the applicable medical necessity guidelines. Routinely interacts with physicians, leadership and management staff, other Physician Clinical Reviewers (PCR), and health plan members and staff whenever a physician`s input is needed or required. Directs daily involvement in the following utilization management functions: Reviews all cases in which clinical determinations cannot be made by the Initial Clinical Reviewer. Discusses determinations with requesting physicians or ordering providers, when available, within the regulatory time frame of the request by phone or fax. Provides clinical rationale for standard and expedited appeals. Provides assistance and act as a resource to Initial Clinical Reviewers as needed to discuss cases and problems. Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process...

Key member of the utilization management team, and provides timely medical review of service requests that do not initially meet the applicable medical necessity guidelines. Routinely interacts with physicians, leadership and management staff, other Physician Clinical Reviewers (PCR), and health plan members and staff whenever a physician`s input is needed or required. Directs daily involvement in the following utilization management functions: Reviews all cases in which clinical determinations cannot be made by the Initial Clinical Reviewer. Discusses determinations with requesting physicians or ordering providers, when available, within the regulatory time frame of the request by phone or fax. Provides clinical rationale for standard and expedited appeals. Provides assistance and act as a resource to Initial Clinical Reviewers as needed to discuss cases and problems. Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process...

This individual is responsible for delivering actionable customer survey data and insights. Specializing in data analytics, designs and creates engaging, high-impact and innovative visualizations and interactive graphics to illustrate compelling analytic stories. Query design and data preparation: Defines parameters for data queries and aggregation based on business requirements. Identifies opportunities for improving data quality through data cleaning and transformation procedures. Creates queries across multiple sources of data to aggregate datasets into a single visualization. Defines and documents data preparation procedures in line with CX Analytics team policies. Designs, documents, develops and deploys survey analyses and sampling frame creation using a variety of computing tools (e.g., SQL, Tableau Prep, Access, Excel). Visualization design: Designs engaging and user-friendly visualizations for senior leadership and executive audiences. Works closely with...

Job Description SUMMARY The Credit Analyst is responsible for managing all facets of credit and accounts receivable relationships with an assigned portfolio of Advance Auto Parts commercial customers. The Credit Analyst conducts high-level financial and/or public record credit analysis on new or existing customer accounts to provide credit and terms approvals.  Success in this area will involve delivering consistently current credit information regarding the financial status of their assigned portfolio, keeping credit files current for accounts with substantial credit exposures, and providing portfolio analytics to Credit Leadership.  The results of effective performance will be maximizing sales opportunities and minimizing credit losses while maintaining a high level of customer satisfaction. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Evaluate credit capacity of prospective customers by compiling financial...

Do you want to work 45-55 hours a week during busy-seasons with permanent remote growth and 5 weeks PTO? Join our team! This Jobot Job is hosted by: Josh Nix Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume. A bit about us: We are based just outside the DC area and we a rapidly growing CPA firm that offers a true startup lifestyle and culture! Our practice is built on the foundation that our people mean more to us than anything else! What that means for you, is that we expect you to enjoy a work-life balance that promotes personal health, well-being, and family life! We want you to be focused on providing amazing service to our local community and the clients you work with. If you are a Tax Manager with experience with HNWI, Real Estate, Partnerships or Corporate Tax looking to enjoy a promising work-life balance, then please read on..... Why join us? Do you want to work with some of the Nation's Best Clients and learn from Top...

Looking for a Remote Frontend Developer with 3+ years of JavaScript experience! This Jobot Job is hosted by: Miguel Vargas Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume. Salary: $130,000 - $150,000 per year A bit about us: Based in Washington, DC, we provide firearm accessories and analytics to professional security forces worldwide. With our proprietary high-tech systems, we provide National Defense, Law Enforcement, and Security Professionals with Embedded IoT Sensors, Intelligent Mobile Applications, and Cloud-Based Analytics Platforms. We are looking for a Remote Frontend Developer with 3+ years of JavaScript experience to join our growing team! Why join us? Competitive salary! The opportunity to join an amazing team! Excellent medical, dental, vision! Flexible vacation & sick leave! Potential for bonus and equity award! Job Details Bachelor’s or Master’s degree in Computer Science, Information...

Presently, we are offering Home Assistant positions that require no previous experience. The only required criteria is to be 21 years or above. No need to worry about resumes, just apply! IMMEDIATE OPENINGS! Work when you want and get paid daily! Quick Apply! $13 - $24 / HOUR Flexible hours available Job Requirements: Responsibilities: - Typing correspondence, filing, copying, data entry, sorting mail and other administrative tasks as assigned - Loading, unloading, and sorting of packages of various sizes - Pick-up and deliver mail, parcels, copy jobs and faxes to customers - Receive, unload and unpack shipments of products - Inspect all the contents for damages and volume - Handle time-sensitive material like confidential, urgent packages - Selects and receives incoming stock efficiently to effectively fulfill orders received from stores. - Relocates merchandise throughout the warehouse according to product handling guidelines. - Manage...

Earn $200 to $700+ weekly using your data entry clerk skills. Work remotely from home. For more information read our job posting and then visit our web site. * You must apply online only . We offer a unique opportunity for anyone looking to start working from home. Benefits Work when you want. Earn serious cash working part time or full time. Learn new skills that you can take anywhere. Ditch the commute & the high gas prices No degree required Supplement your existing job. No need to quit your current job, unless you really hate it. We provide training and tools to help you succeed in this industry Excellent gig for Stay at home moms, retired folks, disabled people and anyone looking to learn how to make income online. Much more... You'll be working remotely from your home or home office from any location you choose. Large companies are always looking for Customer Service Reps, Data Entry Clerks and Feedback Specialists...

Our progressive client is looking for a Software Developer to join their small team! You will immediately have significant ownership over product direction and engineering architecture, while working closely with the Director of Engineering on product strategy and execution. Client Details Our client utilizes their platform to connect progressive organizations and their supporters. They have helped thousands of nonprofits, unions, and political campaigns. Some organizations include Black Lives Matter, LGBTQIA+, Democratic campaigns, Climate Change, and Gun Violence. Description Develop software and architecture for products that help political campaigns, nonprofits, and other progressive organizations Prepare the platform to go from hundreds of users to hundreds of thousands of users in a short time frame Build out their internal platform and APIs Design and build products while working closely with product managers and designers Profile Technology Stack Includes:...

This position is responsible for designing and developing software integration's that are crucial to the mission and success of our client. You will ensure seamless integration of enterprise software systems by providing responsive, secure and function software. Client Details Our Boston Based client is a Care Management and Med Device Company that has the leading solution to help prevent diabetic foot amputation. This is a Series C, $45million dollar funded company that is rapidly growing and looking to add an eager, motivated individual to their Software Development Team. Description Collaborate with internal stakeholders to identify and document data flows. Design, document, develop and implement interfaces between enterprise systems to allow secure and real-time exchange of information. Develop an inventory of manual and automated integration's between Systems of Record. Evaluate tools and technologies required for integration projects. Incorporate best practices...

Job Description Data Entry Administrative Assistant - Online Remote Work At Home Position (Part Time / Full Time) - Be Part of Our Focus Group Panel Now! Are you data entry clerk or administrative assistant looking for a legit way to supplement your income from home? Our company is seeking motivated individuals to take part in nationwide & local paid Focus Groups and Clinical Trials. With most of our paid focus group studies, you have the option to participate online or in-person. This is a great way to earn additional income from the comfort of your home. If the thought of participating in group discussions and voicing your opinion about new consumer products, while being compensated to do so, gets you excited...we'd love to have you apply while spots are still available. Compensation: • $75-$150 (per 1 hour session) • $300-$750 (multi-session studies) Responsibilities: • Show up at least 10 mins prior to discussion start time....