Senior Pharmacy PA/Appeals Technician Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by
Essential Duties and Responsibilities: - Oversee and manage the Projects financial performance, including budgeting, forecasting, and analyzing profit and loss statements to ensure financial targets are met and profitability is maintained. - Act as the primary
Planate Management Group (PMG) is a Service-Disabled Veteran-Owned Small Business (SDVOSB) headquartered in Alexandria, Virginia, and Orlando, Florida USA with a technical support center in South East Asia and East Africa, that provides program management and facilities
Essential Duties and Responsibilities: - Responsible for reviewing favorable and partially favorable determinations in accordance with applicable regulations. - Render determinations for cases assigned. - Resolve all other technical issues within reconsideration assigned. - Review cases
Essential Duties and Responsibilities: - Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments. - Provide written clinical rationales for CA Workers Compensation
Essential Duties and Responsibilities: - Perform hands-on data analysis and modeling with huge data sets. - Apply data mining, NLP, and machine learning (both supervised and unsupervised) to improve relevance and personalization algorithms. - Work side-by-side
Essential Duties and Responsibilities: - Perform hands-on data analysis and modeling with huge data sets. - Apply data mining, NLP, and machine learning (both supervised and unsupervised) to improve relevance and personalization algorithms. - Work side-by-side
Essential Duties and Responsibilities: - Responsible for producing accurate project financial reporting and submit on a monthly basis to Corporate Finance. - Track financial status by monitoring variances from forecasts. - Organize monthly Finance Calendar activities.
Essential Duties and Responsibilities: - Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations. - Render medical necessity determinations for Medicare State East cases assigned. - Resolve all other technical issues within
Essential Duties and Responsibilities: - Research and resolve discrepancies with provider documents. - Review information keyed into the system to verify the accuracy of data. - Monitor data/image quality of scanned documents. - Follow established policies and
Essential Duties and Responsibilities: - Determines security requirements by assessing business strategies and requirements, researching information security standards, conducting system security and vulnerability analyses and risk assessments, studying architecture/platform, and identifying integration points and issues -