pay rate is ***/hour fully remote, but must reside in one of our plan states: IL, TX, NM, OK, MT, TN Evaluates clinical service requests made by an organization's members and providers. Uses clinical judgment in conjunction with organization's criteria to adjudicate these requests. May also provide clinical leadership in other areas of the organization. Identifies opportunities to manage members' clinical situations with a view toward creative problem solving and anticipation of possible future clinical problems for the member. Participates in the process to evaluate clinical service requests. Practices anticipatory case management for members whose cases come for review, in partnership with case managers. Participates in the Physician Review Units' appeal process of service denials. Participates in the development of Physician Review Units' policies and procedures. Actively participates in all unit continuous quality improvement activities. Other duties as assigned by the Medical Director. Board Certified (ABMS) M.D. or D.O, unrestricted and active license to practice medicine requested and 5 years clinical experience to include inpatient experience, or any combination of education/experience that would provide an equivalent background. Must have understanding of managed care and demonstrate PC proficiency, as file review will be done via computer in most cases. (Note: Position does not provide direct patient care or medical diagnosis.) Required hours: Monday through Friday, 8a-6p - intermittent coverage of weekend shifts EEO: "Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans."
Customer Service Nonprofit Arts/EntertainmentJob Title: House ManagerOverview Do you love live performance and the thrill of opening night? Are you a people person? Are you proactive, positive, selfmotivated, conscientious, mature, and enthusiastic about ensuring audiences...
...Warehouse Worker UPS Quick Apply Applying for this role online is quick and easy - you could even get a job offer in 10 minutes... ...first day of work. UPS Warehouse Workers Also known as package handlers, many of our warehouse workers load/unload packages in...
Job Opportunity Spherion is offering a permanent position with a salary range of $28.00 to $35.00 per hour. The work schedule is from 7:00 AM to 4:00 PM. Spherion
...The BJC RN Career Ladder differentiates BJC as the place for nurses to work in the greater St. Louisarea! This is a tool to empower... ...Center West County is a satellite location that features an outpatient treatment area for patients to come in for scheduled appointments...
...Security officers needed for Part-time positions. These positions consistof the following but not limited to: security of clients... ...to detail and accuracy, we are looking for you!Pay is $15.00per hour. Paidtraining. Candidatewillwork independently. Candidates...