Your Role The clinical services coordinator (CSC) will report directly to the supervisor of care management support operations and will serves as initial point of contact for providers and members in the medical management process by telephone or correspondence. The CSC will interact telephonically with members as per established protocol or direction to ensure that membe

As a Contract Management Specialist, you will join a team responsible for overseeing the day to day management of our proposal and contract management process. You will be responsible for quality assurance reviews of customer proposals and/or Statements of Work. Ensuring accuracy, completeness and compliance with our internal control policies and quality standards (legal,

Your Role The Clinical Quality Analytics and Informatics team delivers best in class clinical quality analytics and informatics to enable high quality and affordable member centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst Senior will report to the Cli

Your Role The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care including clinical nurses and treating physicians. The Registered Nurse Case Manager will report to the FEP Department Ma

Your Role The Federal Employee Program (FEP) Care Management team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with their care including a multidisciplinary team and the member's treating physicians. The Registered Nurse Case Managemen

Under general supervision and direction, resolves moderately complex residential and commercial property claims by investigating losses, negotiating settlements, and presenting evidence in legal proceedings while maintaining adequate production levels. Responsibilities Examines claims forms, policies and endorsements, client instructions, and other records to determine co

DXL Group, the largest specialty retailer of men's Big + Tall apparel, is looking for a Retail Sales Associate, Key Holder who is committed to building long term relationships with our guests by providing an experience that is unmatched by other retailers. WHAT MAKES US DIFFERENT? We are committed to developing our people in order to promote from within We are located in

Cyber/eRisk Sr. Underwriter Job Locations US CA WOODLAND HILLS | US CA Remote | US AZ Remote | US UT Remote | US NV Remote | US WA Remote | US OR Remote Job ID 2024 3620 Category Underwriting Type Regular Division Comm Lines & Exec Risk Crum & Forster Company Overview Crum & Forster (C&F) , with a proud history dating to 1822, provides specialty and standard commercial li

Come be part of an amazing F&B team!

Conduct on site inspections and assessments of property damages for both residential and commercial claims Collaborate with policyholders, insurance agents, and other involved parties to gather information and resolve claims efficiently May occasionally require interacting with parties who express strong emotions or concerns about ongoing inspections or claim resolutions

Your Role The Clinical Services Coordinator (CSC) will report directly to the Supervisor of Promise Medi Cal Care Management. This individual will interact telephonically and electronically with members and providers as per established protocol or direction to ensure that members are effectively and efficiently managed through the outreach, engagement, and care management

Duties WHAT IS THE INFORMATION TECHNOLOGY (IT) DIVISION? A description of the business units can be found at The following are the duties of this position at the full working level. Provides direction for monitoring all program phases to integrate existing and future systems into new business systems, including identifying, acquiring, and allocating resources; ensuring ti

Your Role The Behavioral Health Utilization Management team performs prospective utilization review for our members and correctly applies the guidelines for nationally recognized levels of care. They collaborate directly with the Member, Member's Family, and Interdisciplinary Care Team to achieve consensus and promote positive Member health outcomes through the assessment

Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination o

Duties WHAT IS THE INFORMATION TECHNOLOGY (IT) DIVISION? A description of the business units can be found at Vacancies will be filled in the following specialty areas Information Technology The following are the duties of this position at the full working level. If this vacancy includes more than one grade and you are selected at a lower grade level, you will have the opp