REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. JOB RESPONSIBILITIES This position is responsible for performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness, and quality of medical/surgical services, and serving as liaison between providers and medical and network management divisions. Collects clinical and non-clinical data. Verifies eligibility. Determines benefit levels in accordance to contract guidelines. Provides information regarding utilization management requirements and operational procedures to members, providers, and facilities. JOB QUALIFICATIONS (Required) Registered Nurse (RN) with a valid, current, unrestricted license in the state of operations. 3 years of clinical experience in a Physician's office, Hospital/Surgical setting, or Health Care Insurance Company. Knowledge of medical terminology and procedures. Verbal and written communication skills. JOB QUALIFICATIONS (Preferred) MCG or InterQual experience Utilization management experience LOCATION REMOTE in Texas (Austin area – Travis/Williamson Counties or Richardson area – Dallas/Collin Counties). POSITION 6-month assignment SALARY $38 - $40 hourly HOURS PER WEEK 40 HOURS PER DAY 8 #J-18808-Ljbffr
The State of Tennessee is hiring an Entry-Level Emergency Management District Coordinator to support emergency management programs. Based in Nashville, TN, the position offers a full-time role with the possibility of working remotely up to 40%. The salary range is between...
We are currently seeking freelance translators with proven and solid experience in subtitling for the TV and Movie industry for multiple language combinations to join our global localization network. Requirements If you would like to pursue freelance translation ...
...MS-Bartender Fresh ingredients, the best tequila in the business, and sultry showmanship are the key ingredients for a Mexican Sugar Bartender. Sound like you or someone you know? Mexican Sugar is looking for a smart, stylish, and experienced bartender to transport...
...basis, while maintaining all department and food safety / sanitation standards. Key... ...Tracks seasonal record when appropriate Market: Cuts, trims, and prepares meat for service... ...responsibilities may be modified at any time based on business needs. Employees may be...
...NYS Licensed Notary Public Associates The UPS Center NYS Licensed Notary Public Associates are responsible for providing NYS Notarial... ...Continuously practices good listening skills with customers, UPS Store team members, and leadership Takes ownership of the customer's...