A staffing agency is searching for a person to fill their position for a Telecommute Health and Benefits Actuarial Consultant. Candidates will be responsible for the following: Functioning as lead strategist to clients responsible for Strategic Benefit Planning.
Writing reports for submissions of class I and class II orthopedic devices. Must meet the following requirements for consideration: Experience writing CERs (start to finish) Scientific/clinical background. Medical writing experience. Submissions to health Canada. Orthopedics experience.
Representing HEDIS team in collaboration with internal departments. Qualifications for this position include: Bachelor’s with a concentration in healthcare related field. 1+ year HEDIS experience. 5+ years work experience in healthcare and/or managed care. SQL and/or SAS experience.
Assisting in preparation for the HEDIS audit. Position Requirements Include: Bachelor’s degree with a concentration in healthcare related field. 5+ years of work experience in healthcare and/or managed care Other skills. SQL and / or SAS experience.
Supporting business initiatives and solve business problems. Required Skills: Bachelor’s degree required with a concentration in healthcare related field. 5 years of work experience in healthcare and/or managed care. SQL and / or SAS experience.
Experience in HealthCare, Marketing, or Database application systems. Experience with big data technologies. Application QA testing management. Quality Management - Oversight for delivery against quality metrics. Must be proficient in Microsoft Project. Experience with Cost Management.
A staffing company is searching for a person to fill their position for a Telecommute Group Health Sales Executive. Candidates will be responsible for the following: Leveraging his or her's existing network of employee benefits brokers. Targeting, developing, and closing accounts.
Review of appropriateness of healthcare services. Implement effective utilization management strategies. Qualifications for this position include: UM Experience. InterQual experience. 2-5 years' experience in outpatient, home health, or DME. Current DE or Compact State RN License.
Reviewing the clinical care and treatment plans. Taking unlisted codes and associating them to pricing. Position Requirements Include: 5 years of clinical RN experience. Experience determining medical necessity and appropriateness of care. Currently licensed in state of MN.
Conducting quality audits related to health insurance. Helping to develop and maintain an effective QA program. Position Requirements Include: High school diploma required. Ability to communicate effectively using telephone, email, and IM. Ability to type at least 40 words per minute.