Medical Management Specialist - Providence, United States - Absolute Staffing & Consulting Solutions

Absolute Staffing & Consulting Solutions Providence, United States

3 weeks ago

Description

Absolute Staffing is searching for a Medical Management Specialist to work with our client.

Job Location: Providence, RI

Medical Management Specialist I

The Medical Management Specialist I is responsible for providing non-clinical support to the Medical Management and/or Operations areas. Primary duties may include, but are not limited to:

Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization management, case management, QI, Med Review).
Provides information regarding network providers or general program information when requested.
May assist with complex cases.
May act as liaison between Medical Management and/or Operations and internal departments.
Maintains and updates tracking databases.
Prepares reports and documents all actions.
Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information.

Minimum Requirements:

Requires a high school diploma and a minimum of 1 year experience or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

Strong working knowledge of Microsoft office products (especially Excel and Teams) strongly preferred.
Understanding of managed care or Medicaid/Medicare strongly preferred.

For URAC accredited areas, the following professional competencies apply:

Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Medical Management Specialist

2 weeks ago

Absolute Staffing & Consulting Solutions Providence, United States

Job Description · Job DescriptionAbsolute Staffing is searching for a Medical Management Specialist to work with our client. · Job Location: Providence, RI · Medical Management Specialist I · The Medical Management Specialist I is responsible for providing non-clinical support t ...
Medical Management Specialist

2 weeks ago

Absolute Staffing & Consulting Solutions Providence, United States

Job Description · Job DescriptionAbsolute Staffing is searching for a Medical Management Specialist to work with our client. · Job Location: RI, MA or CT · Responsible for providing non-clinical support to the Medical Management and/or Operations areas. · Primary duties may incl ...
Data Management Specialist

3 weeks ago

Brown University Providence, United States

Job Description: · The Center for Gerontology & Health Care Research is seeking a data management specialist. This position will develop, execute, and maintain core data management services for large-scale, data-intensive research within the Center for Gerontology & Health Care R ...
IT Asset Management Specialist

6 hours ago

IGT Providence, United States

IGT (NYSE:IGT) is a global leader in gaming. We deliver entertaining and responsible gaming experiences for players across all channels and regulated segments, from Lotteries and Gaming Machines to Sports Betting and Digital. Leveraging a wealth of compelling content, substantial ...
Inventory Management Specialist- New England

2 weeks ago

Global Partners Providence, United States

Job Description: The Inventory Management Specialist drives operational excellence through researching physical inventories, monitoring related programs, corrective actions, training and reports. This role supports creating a culture of 100% compliance with inventory policies, pr ...
IT Asset Management Specialist

2 days ago

International Game Technology, plc Providence, United States

The IT Asset Management Specialist establishes and implements hardware and software acquisition, protection, maintenance and retention policies, standards and procedures that are aligned with IT standards and strategy. Investigates available hardware IT, Management, Specialist, T ...
Nursing specialist as residential area manager

3 weeks ago

Radiant Innovations New Kent, United States

Are you passionate about helping people in your nursing profession and value joy in your work? · ▸ If respectful interaction in the workplace is important to you · ▸ If you are looking for a strong team and a good working atmosphere · ▸ If appreciation and recognition motivate ...
Nursing specialist as residential area manager

3 weeks ago

Nexus Innovations New Kent, United States

Are you passionate about helping people in your nursing profession and value joy in your work? · ▸ If respectful interaction in the workplace is important to you · ▸ If you are looking for a strong team and a good working atmosphere · ▸ If appreciation and recognition motivate yo ...
ERP Data Management Specialist

3 weeks ago

Matouk Fall River, United States

Schedule: Monday - Friday (8:00am - 4:30pm). · **Summary**: · The ERP Data Management Specialist will work closely with the ERP team and the Director of ERP Operations to create and maintain data within the company's ERP system. · **Main Duties amp; Responsibilities**: · - Collab ...
Hardware Equipment Specialist

2 weeks ago

Brown University Providence, United States

Job Description: · Hardware Equipment Specialist · Office of Information Technology · The Hardware Equipment Specialist plays a pivotal role in the logístical operations of the Network Technology organization. This involves collaborating with diverse teams within the organization ...
Retirement Benefits Specialist

2 weeks ago

Care New England Providence, United States Full time

**Job Summary**:The Retirement Specialist will assist in managing the daily operations of Care New England's retirement plans providing support to employees, retirees, and beneficiaries. The Retirement Specialist will be responsible for overseeing multiple active and frozen defin ...
Clinical Laboratory Assistant

3 weeks ago

Rhode Island Hospital Providence, United States

Summary: · The Clinical Lab Assistant reports to a senior tech or manager. Under general supervision and with appropriate training and documented competency can perform various complex laboratory testing in the assigned lab section. The CLA may have tasks in all phases of lab tes ...
Youth Development Specialists for Arts, Gym, Stem

3 weeks ago

Boys & Girls Clubs of Providence Providence, United States

Youth Development Specialist · Summer 2024 (part-time seasonal) · - Must be available from June 24 through August 23 (off on July 4 & 5, August 9 & 12) · - No weekends · - Work schedule: Monday through Thursday 12:00 Noon to 5:00 PM, Friday 8:30 AM to 5:00 PM · - Payrate: $17/hou ...
Quality Assurance Analyst I

3 weeks ago

AAA Northeast Providence, United States

The Quality Assurance Specialist is the critical front-end member voice for eBusiness, working cross-functionally and responsible for the creation and execution of test cases, and management of issues discovered during the testing process. The Quality Assurance Specialist will al ...
Grants and Financial Specialist

3 weeks ago

Brown University Providence, United States

Job Description: · The Grants and Financial Specialist independently manages all matters pertaining to grants administration, both financial and administrative, and has financial oversight and administrative responsibility for the sponsored projects. This position provides high-l ...
Shipping Specialist

2 weeks ago

Carlisle Companies Incorporated Providence, United States

Carlisle Weatherproofing Technologies is a global leader in the building materials industry. The company has been in operation since 1917 and has experienced a growth of nearly 70% in the past six years. Currently, we are seeking a Shipping Specialist (Day Shift) to join our Prod ...
Lead Pharmacy Tech

3 weeks ago

Rhode Island Hospital Providence, United States

**Summary**: · This position is in the Rhode Island Hospital Pharmacy Retail location. Under supervision of Pharmacy Supervisor or Pharmacist-in-charge coordinates activities and functions of pharmacy technicians students and support personnel in assigned areas of the department. ...
Faculty Appointment Specialist

2 weeks ago

Brown University Providence, United States

Job Description: · The Faculty Appointment Specialist (FAS) serves as a key member of the Faculty Administrative team within the Office of the Dean of the Faculty (DOF). The position is responsible for creating and processing a high volume of faculty appointment letters and relat ...
Clinical Documentation Integrity

3 weeks ago

Care New England Providence, United States

**Job Summary**: · The Care New England Clinical Documentation Integrity (CDI) Specialist is responsible for concurrently reviewing medical records to facilitate the accurate representation of the severity of illness by improving the quality of the physicians' clinical documentat ...
Asst. Service Manager

3 weeks ago

Route 24 Auto Group East Providence, United States

**Position Title**: · Assistant Service Manager · **Job Code**: · **Department**: · Service · **Department #**: · 0213 · **Reports To**: · Service Manager · **FLSA Status**: · Exempt · **Assistant Service Manager **needed for our busy service department at **Stateline Nissan** of ...