Found in CareerBuilder - Management Office projects. Define quality... Decompose high-level business/user reqs & create functional/tech reqs for banking company?s Project Management Office projects. Define quality...Jobs Business Systems Analyst (SLC, Utah) »
Tampa, FL (us)
Found in Wide_Offers - frames required by regulatory agencies. Adheres to quality standards and confidentiality policies POSITION TITLE:  Pre-Certification Reviewer JOB NUMBER: 700-023 DEPARTMENT:  Utilization Management     ________________________________________________________________________   GENERAL PURPOSE: The Pre-Certification Reviewer is responsible for the pre-certification of Plan determined procedures utilizing approved criteria. ESSENTIAL DUTIES AND RESPONSIBILITIES: Evaluates requested services following Plan approved criteria. Demonstrates effective communication methods and skills, using lines of authority appropriately. Establishes a relationship with providers in order to determine/provide needed services for members Arranges discharge planning services prior to pre-planned admissions when available. Acts as liaison and member advocate between the member/family, physician and facilities/agencies. Maintains accurate record of pre-certification decisions. Performs decisions within time frames required by regulatory agencies. Adheres to quality standards and confidentiality policies and procedures. Ensures compliance with all state and federal regulations and guidelines in day-to-day activities. Adapts to changes in policies, procedures, new techniques and additional responsibilities. Performs other duties as assigned. QUALIFICATIONS AND REQUIREMENTS:  To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. EDUCATION and/or EXPERIENCE: Florida licensed RN or LPN required; minimum of two to three years varied clinical experience required; managed care experience preferred; or an equivalent combination of education, training and experience. NECESSARY KNOWLEDGE, SKILLS AND ABILITIES:  Ability to: work from designated office for collaborative/interactive fulfillment of duties; concentrate in an open-office ?cubicle? environment; appropriately and directly interact with other staff members and/or outside associates; perform telephone and/or computer work for extended periods of time; operate office equipment such as computer, telephone, and copy/scan/fax machine; attend and participate in meetings via phone, computer, or in person. Ability to read and interpret documents and calculate figures and amounts.  Excellent oral and written communication skills including good grammar, voice and diction.  Proficient in MS Office with basic computer and keyboarding skills.   Excellent customer service skills (friendly, courteous and helpful).   LICENSING AND CERTIFICATION: CurrentFlorida licensed RN or LPN required. PHYSICAL DEMANDS:  The physical demands described here are representative of those that should be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit.   The employee frequently is required to manipulate or use objects, equipment, tools, and/or controls. May require specific vision abilities to perform this job.   Ability to lift, carry or exert items or objects of reasonable weight. WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Attendance at employer worksite is an essential job requirement. The noise level in the work environment is usually moderate. For the most part ambient room temperatures, lighting and traditional office equipment as found in a typical office environment. ADDITIONAL INFORMATION:  The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change. The duties listed above are intended only as illustrations of the various types of work that may be performed.  The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position.  We are proud to be an EEO/AA employer M/F/D/V. We maintain a drug-free workplace and perform pre-employment substance abuse testing.
Salary: N/AJobs Pre-Certification Reviewer Nurse* »
Kansas City, KS (us)
Found in Wide_Offers - include monitoring production and quality, recruiting, interviewing, hiring, coaching employees, meeting Staff Management | SMX, a TrueBlue company, is a recognized leader in innovative workforce management solutions that deliver best talent, drive compliance, yield tangible savings and build sustainable value. Staff Management | SMX is one of Staffing Industry Analysts' Global 100 and won Inavero's 2014 Best of Staffing Client Award. The company has been ranked a top Managed Service Provider worldwide by buyers on HRO Today's Baker's Dozen for Managed Service Programs since 2010 and its StaffTrack software won a 2013 TekTonic Award for innovation in HR technology. Staff Management | SMX has been a charter member in the U.S. Immigration and Customs Enforcement IMAGE Program since 2006 and holds Workers' Compensation Risk Certification. For more information, please visit www.staffmanagement.com. We have a great opportunity with growth potential to work at our busy manufacturing facility in Kansas City, KS. The Account Manager is responsible for managing the onsite account team and overseeing all staffing and employee operations. Account Managers must remain focused on the strategic leadership of the account while at the same time supervise day-to-day activities. Responsibilities include monitoring production and quality, recruiting, interviewing, hiring, coaching employees, meeting performance objectives and more. In this position, most of your time would be spent interacting with the client and employees, so exceptional communication and customer service skills are a must. The ideal candidate for this position will have previous management and manufacturing/production. Our exciting, fast-paced environment is a good fit for candidates with excellent multi-tasking skills. In this position, most of your time would be spent interacting with the client and employees, so exceptional communication and customer service skills are a must. The typical hours for this position are 8am to 6pm Monday through Friday, but you must be willing to work outside of these hours when necessary. Responsibilities: Provide immediate front line customer service to management team, associate and clients. Manage weekly schedules for all employees. Participates in our client’s meetings. Make associate hiring and firing decisions. Handle order requests and changes from client contacts. Handle associate relations activities, communications, and investigations. Handle safety inspections. Work on special projects and performance incentive programs to help meet operational goals. Maintain time clock database up-to-date in order to process payroll. Assist with reports by using MS Office applications. This is a hands-on leadership position willing to be on the floor training associates.
Salary: N/AJobs On-Site Manager »