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What We Do Milliman IntelliScript is a group of a few hundred experts in fields ranging from actuarial science to information technology to clinical practice. Together, we develop and deploy category-defining, data-driven, software-as-a-service (SaaS) products for a broad spectrum of insurance clients. We're a business unit within Milliman, Inc., a respected consultancy with offices around the world. Candidates who have their pick of jobs are drawn to IntelliScript's entrepreneurial and collaborative culture of innovation, excellence, exceptional customer service, balance, and transparency. Every single person has a voice in our company and we challenge each other to push the outer limits of our full, diverse potential. We've shown sustained growth that ensures you'll have room to grow your skillset, responsibilities, and career. Our team is smart, down-to-earth, and ready to listen to your best ideas. We reward excellence and offer competitive compensation and benefits. Visit our LinkedIn page for a closer look at our company and learn more about our cultural values here. Milliman invests in skills training and career development and gives all employees access to a variety of learning and mentoring opportunities. Our growing number of Milliman Employee Resource Groups (ERGs) are employee-led communities that influence policy decisions, develop future leaders, and amplify the voices of their constituents. We encourage our employees to give back to their varied professions, including leadership in professional organizations. Please visit our website to learn more about Milliman's commitments to our people, diversity and inclusion, social impact, and sustainability. What this position entails IntelliScript offers an innovative suite of products that interpret and deliver electronic medical data (such as prescription histories, diagnoses, and treatment data) to help our clients make effective underwriting and risk assessments. The Clinical Informatics Consultant is a vital part of IntelliScript's Clinical Services Team - a team that delivers the clinical intelligence and expertise needed for industry-leading clinical interpretation solutions. Working with various members of teams across the company, you will be instrumental as we continue to innovate, design, and maintain the clinical intelligence behind our decision support software and fulfill the specific needs of each client. Our proven interpretation engines (Irix and Curv) are being adapted to incorporate and interpret electronic health record data in addition to our existing pharmacy and medical claims data. In this role, the Clinical Informatics Consultant will bring professional experience and training from a variety of settings and perspectives, a passion for leveraging health-related data and performing complex analysis to solve business questions, as well as an entrepreneurial spirit. What you will be doing * Clinical condition interpretation: Translate complex clinical data elements into meaningful medical condition identification and severity insights to support our clients' decision-making processes. * Clinical value set creation: Develop and maintain groupings of clinical codes. These building blocks create the foundation of our clinical interpretation insights. You will leverage terminologies such as GPI, RxNorm, ICD-10, CPT, HCPCS, REV, SNOMED, and LOINC codes to facilitate our client's risk assessments. * Clinical terminology management: Oversee the organization, standardization, and maintenance of clinical terminologies to ensure up-to-date, consistent, and accurate results from our interpretation solutions. * UAT and impact testing: Conduct user acceptance testing and impact analysis to validate the functionality and effectiveness of new features and enhancements in our clinical products. * Research and development: Engage in research activities to identify emerging trends in clinical practice and our products, contributing to the development of interpretation solutions. * Model consultation: Consult with data science team to align predictive model features with clinical data concepts and medical knowledge. * Innovation collaboration: Participate in brainstorming and whiteboarding sessions to drive the creation of enhancements for our clinical interpretation solutions and innovative new products. * Clinical data solutions consulting: Provide expert consulting services on clinical data solutions, guiding internal and external clients through the effective design and use of our systems. What we need * Current licensure in good standing as a healthcare professional * Minimum three years of experience in clinical informatics * Experience analyzing electronic health record, medical claims, and pharmacy claims data * Experience enhancing EHR systems and/or clinical decision support software What you bring to the table * Focused on results and able to explain clinical concepts in a way that answers business questions * Adept at ascertaining client needs, conducting an analysis, and presenting solutions * Ability to shift communication styles for clinical, technical, or business audiences * Strong eye toward quality and an acumen for peer review as part of the development process * Capacity to work with and analyze medical data for extended periods of time * Demonstrated "let's find a way to do it" attitude-conviction that no task is too big or too small, quick to approach an issue and find the optimal solution, ready to adapt in any situation * Detail oriented with excellent verbal and written communication skills * Professional when interacting with clients and colleagues * Able to work independently and thrive on a small team * Adaptable and willing to pitch in wherever needed * Skilled in understanding complex systems and thinking abstractly to identify patterns, connections, and opportunities * Proficient in identifying and gathering the information needed to diagnose and solve problems * Capable of generating, developing, and evaluating a wide range of creative ideas, concepts, and solutions * Effective in maintaining performance when faced with uncertain, unclear, or incomplete information Wish list * Continued education and/or advanced degree(s) * Advanced degree or certification in clinical informatics * Experience in software-as-a-service industry * Experience in clinical practice in addition to clinical informatics * Published thought leadership articles, past speaking engagements, etc. * Experience presenting to management-level decision-makers Location The expected application deadline for this job is March 31, 2026. This position is open to remote work. Applicants must be willing to travel to the Milliman office in Brookfield, WI as needed and travel nationwide for meetings, conferences, and team events (up to 10%). Compensation The overall salary range for this role is $93,700 - $199,065 For candidates residing in: * Alaska, California, Connecticut, Illinois, Maryland, Massachusetts, New Jersey, New York City, Pennsylvania, Virginia, Washington, or the District of Columbia: * $107,755 - $177,675 if overall experience is less than 5 years; and * $120,635 - $199,065 for experience greater than 5 years. * All other states: * $93,700 - $154,500 if overall experience is less than 5 years; and * $104,900 - $173,100 for experience greater than 5 years. A combination of factors will be considered, including, but not limited to, education, relevant work experience, qualifications, skills, certifications, etc. Milliman Benefits We offer a comprehensive benefits package designed to support employees' health, financial security, and well-being. Benefits include: * Medical, Dental and Vision - Coverage for employees, dependents, and domestic partners. * Employee Assistance Program (EAP) - Confidential support for personal and work-related challenges. * 401(k) Plan - Includes a company matching program and profit-sharing contributions. * Discretionary Bonus Program - Recognizing employee contributions. * Flexible Spending Accounts (FSA) - Pre-tax savings for dependent care, transportation, and eligible medical expenses. * Paid Time Off (PTO) - Begins accruing on the first day of work. Full-time employees accrue 15 days per year, and employees working less than full-time accrue PTO on a prorated basis. * Holidays - A minimum of 10 paid holidays per year. * Family Building Benefits - Includes adoption and fertility assistance. * Paid Parental Leave - Up to 12 weeks of paid leave for employees who meet eligibility criteria. * Life Insurance & AD&D - 100% of premiums covered by Milliman. * Short-Term and Long-Term Disability - Fully paid by Milliman. Equal Opportunity All qualified applicants will receive consideration for employment, without regard to race, color, religion, sex, sexual orientation, national origin, disability, or status as a protected veteran.

Flexible Independent Contractor (1099) Opportunity Required State Medical License in Florida or Oregon Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally recognized Independent Review Organization (IRO) specializing in technology-driven utilization management and clinical medical review solutions. We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement. THE OPPORTUNITY: We are currently seeking Board-Certified physicians in Rheumatology to conduct independent Utilization Reviews. This is a flexible, fully remote opportunity requiring just 1-2 hours per week-with no minimum commitment. ADDITIONAL INFORMATION: Work remotely from anywhere in the US (Per HIPPA Regulations patient records cannot leave the US). Covered under MRIoA's Errors and Omissions policy. Independent Contractor (1099) opportunity. Workers are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding the confidentiality, privacy, and security of sensitive health information. California Consumer Privacy Act (CCPA) Information (California Residents Only): Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social Security number, signature, online identifier, Internet Protocol address, driver's license number, or state identification card number, and passport number. Data Access and Correction: Applicants can access their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at ************. Must have a Medical Degree MD or DO Must have a current STATE unencumbered medical license in Florida or Oregon Current Board Certification in Rheumatology Must have 5 years of clinical experience residency to be included Daytime availability is required for peer-to-peer conversations

Become a part of our caring community and help us put health first Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Conviva, a wholly-owned subsidiary of Humana, Inc., we want to help people everywhere, including our team members, lead their best lives. We support our team members to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our team members fresh perspective, new insights, and exciting opportunities to enhance their careers. At Conviva, we're seeking innovative people who want to make positive changes in their lives, the lives of our patients, and the healthcare industry as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent service to others. Preferred Locations: Daytona, FL, Louisville, KY, San Antonio, TX Use your skills to make an impact Role Essentials Active Unrestricted RN license Possession of or ability to obtain Compact Nursing License A minimum of three years clinical RN experience; Prior clinical experience, managed care experience, DME, Florida Medicaid OR utilization management experience Demonstrates Emotional Maturity Ability to work independently and within a team setting Valid driver's license and/or dependable transportation necessary Travel for offsite Orientation 2 to 8 weeks Travel to offsite meetings up to 6 times a year as requested Willing to work in multiple time zones Strong written and verbal communication skills Attention to detail, strong computer skills including Microsoft office products Ability to work in fast paced environment Ability to form positive working relationships with all internal and external customers Available for On Call weekend/holiday rotation if needed Role Desirables Education: BSN or bachelor's degree in a related field Experience with Florida Medicaid Experience with Physical Therapy, DME, Cardiac or Orthopedic procedures Compact License preferred Previous experience in utilization management within Insurance industry Previous Medicare Advantage/Medicare/Medicaid Experience a plus Current nursing experience in Hospital, SNF, LTAC, DME or Home Health. Bilingual Additional Information We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k with company matching, tuition reimbursement, 3 weeks paid vacation time, paid holidays, work-life balance, growth, a positive and fun culture and much more. To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 02-18-2026 About us About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

The purpose of this position is to conduct initial, concurrent, retrospective chart review for clinical financial resource utilization. Coordinates with healthcare team for optimal/efficient patient outcomes, while decreasing length of stay (LOS) and avoid delays and denied days. They are accountable for a designated patient caseload and provides intervention, coordination to decrease avoidable delays, denial of reimbursement. Specific functions within this role include: Screens pre-admission, admission process using established criteria for all points of entry. Facilitates communication between payers, review agencies, healthcare team. Identify delays in treatment or inappropriate utilization and serves as a resource. Coordinates communication with physicians. Identify opportunities for expedited appeals and collaborates to resolve payer issues. Ensures/Maintains effective communication with Revenue Cycle Departments. Estimated salary range for this position is $73860.80 - $96019.04 / year depending on experience. Degrees: * Associates. Licenses & Certifications: * MCG Care Guidelines Specialist. * Registered Nurse. Additional Qualifications: * RNs hired prior to 2-2012 (10/1/2017 at Bethesda or 7/1/2019 at BRRH) with an Associates Degree in Nursing are not required to have a BSN to continue their non-leadership role as an RN. however, they are required to complete the BSN within 3 years of job entry date. * MCG Specialist Certification ISC/HRC required within 12 months of job entry date. * 3 years of Nursing experience preferred. * Excellent written, interpersonal communication and negotiation skills. * Strong critical thinking skills and the ability to perform clinical/chart review abstract information efficiently. * Strong analytical, data management and computer skills. * Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components. * Current working knowledge of payer and managed care reimbursement preferred. * Ability to work independently and exercise sound judgment in interactions with the health care team and patients/families. * Knowledgeable in local, state, and federal legislation and regulations. * Ability to tolerate high volume production standards. Minimum Required Experience: 3 Years of Utilization Review in an acute care setting required

A government contract requires that this position be restricted to U.S. citizens or legal permanent residents. You must provide documentation that you are a U.S. citizen or legal permanent resident to qualify. The Psychiatrist provides comprehensive psychiatric care as a Practitioner and Consultant, with emphasis on low- to moderate-acuity patients, primarily using virtual platforms. Responsibilities include evaluating, diagnosing, and treating patients with a variety of mental health conditions, including chronic disorders, psychosis, substance abuse, and other complications. The incumbent develops and implements treatment plans, makes recommendations for major diagnostics, and provides follow-up care. Collaboration with other medical and mental health professionals, military leadership, and case management teams is required to ensure coordinated, high-quality care. Compensation & Benefits: Estimated Starting Salary Range for Psychiatrist: Commensurate with experience. Pay commensurate with experience. Full time benefits include Medical, Dental, Vision, 401K, and other possible benefits as provided. Benefits are subject to change with or without notice. Psychiatrist Responsibilities Include: Conduct psychiatric evaluations, interpret laboratory and clinical findings, and prescribe treatment or refer to specialty services as needed. Provide virtual outpatient care for low- and moderate-acuity patients, maintaining high standards of clinical judgment and patient safety. Participate in Quality Assurance activities, making decisions impacting patient care, including hospitalization recommendations, Medical Evaluation Board (MEB) evaluations, and fitness-for-duty assessments. Prepare and maintain patient records, case summaries, and reports according to regulations and SOPs; update patient charts within 72 business hours or by COB for high-visibility cases. Collaborate with multidisciplinary teams, including physicians, psychologists, nurses, social workers, and military command, to ensure comprehensive care. Attend staff meetings, continuing education sessions, and quality improvement initiatives. Communicate TRICARE and DoD healthcare requirements to patients and ensure safe, effective therapeutic outcomes. Performs other job-related duties as assigned Psychiatrist Experience, Education, Skills, Abilities requested: Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.). Completion of accredited Psychiatry internship, residency, and/or fellowship. Minimum of 2 years providing psychiatric care via virtual platforms; experience within the Military Health System preferred. Current certification from the American Board of Psychiatry and Neurology or the American Osteopathic Board of Psychiatry and Neurology. Current, full, active, unrestricted license to practice Psychiatry. Basic Life Support (BLS) required. Advanced certifications do not replace BLS. Must obtain and maintain appropriate clinical privileges and fulfill credentialing requirements. Must pass pre-employment qualifications of Cherokee Federal Company Information: Cherokee Nation Integrated Health (CNIH) is a part of Cherokee Federal - the division of tribally owned federal contracting companies owned by Cherokee Nation Businesses. As a trusted partner for more than 60 federal clients, Cherokee Federal LLCs are focused on building a brighter future, solving complex challenges, and serving the government's mission with compassion and heart. To learn more about CNIH, visit cherokee-federal.com. #CherokeeFederal #LI #LI-REMOTE Cherokee Federal is a military friendly employer. Veterans and active military transitioning to civilian status are encouraged to apply. Similar searchable job titles: Staff Psychiatrist Clinical Psychiatrist Telepsychiatrist Military Psychiatrist Outpatient Psychiatrist Keywords: Mental health treatment Patient evaluation Virtual care Diagnostic assessment Care coordination Legal Disclaimer: All qualified applicants will receive consideration for employment without regard to protected veteran status, disability or any other status protected under applicable federal, state or local law. Many of our job openings require access to government buildings or military installations. Please Note: This position is pending a contract award. If you are interested in a future with Cherokee Federal, APPLY TODAY! Although this is not an approved position, we are accepting applications for this future and anticipated need.

The Senior Clinical Consultant, Cardiology shall be responsible for providing clinical consulting for the project, report configuration, workflow analysis, end-to-end testing, and go-live support to the implementation projects. In addition, provide clinical support for development, sales and company team members with respect to the use of the company's products and serving as a consultant on behalf of customers and company personnel in compliance with the company's quality procedures. Company Overview At FUJIFILM Healthcare Americas Corporation, we're on a mission to innovate for a healthier world, and we need passionate, driven people like you to help us get there. Our cutting-edge healthcare solutions span diagnostic imaging, enterprise imaging, endoscopic and surgical imaging, as well as in-vitro diagnostics. But we don't stop at healthcare; our Non-Destructive Testing (NDT) team harnesses advanced radiography solutions to keep transportation infrastructure, aerospace, and oil and gas assets safe and running smoothly. Ready to innovate, collaborate, and make a difference? Join us and bring your big ideas to life while working in a dynamic, flexible environment that fuels your creativity and drive. Our headquarters is in Lexington, Massachusetts, an inspiring healthcare research hub in a historic town. Fujifilm is globally headquartered in Tokyo with over 70,000 employees across four key business segments of healthcare, electronics, business innovation, and imaging. We are guided and united by our Group Purpose of “giving our world more smiles.” Visit: *************************************************** Job Description Duties and Responsibilities: Serve as consultant on behalf of customers and company personnel. Provide advanced clinical expertise, workflow analysis, report configuration, end to end testing for conversions, upgrades and new projects. Provide product feedback and feature requests to the development team to further enhance the product based due to clinical expertise. Participate in Clinical Validations Testing for each software release of the product to further enhance the overall accuracy of the release. Work closely with development of documentation for software releases and training to the teams. Drive process change to improve efficiency and customer satisfaction. Ensure compliance with all applicable requirements of the company's quality management system. All other functions and responsibilities that may be assigned by management. Comply with all applicable U.S. Food and Drug Administration (U.S. FDA) medical device regulatory requirements, applicable ISO 13485 standard requirements and all other applicable laws, regulations, and standards. Qualifications: Advanced Cardiac Sonographer. Technologist or Nurse 5+ years of progressive experience in medical technology, devices, or healthcare industry, experience in Cardiology discipline preferred. Bachelor's degree business related field and/or equivalent work experience Registered in one or more of the following: Registered Diagnostic Cardiac Sonographer RDCS experience in: Transthoracic Echo Transesophageal Echo Stress Echo Dobutamine Stress Echo Pediatric Echo Fetal Echo ECG Registered Vascular Technologist RVT experience in: Non-invasive Registered Nuclear Medicine Technologist experience in: MPI MUGA PET Registered Nurse Cardiac experience in: Cath, Peripheral Angiography, Electrophysiology Lab experience ECG Registered Radiology Technologist experienced in: Experience in the Cardiovascular PAC's environment Experience in digital imaging Professional presence Proven ability to prioritize and handle multiple functions. Successful experience in related field. Healthcare or software application or IT industry background a plus. Medical imaging background. Excellence in written and verbal communication skills. Demonstrated ability to work comfortably with end-users and clinical supervisors. Demonstrated end-user computer skills. Competence with Microsoft Office tools (Word, Excel, and PowerPoint). Excellent interpersonal skills. Strong technical support experience with excellent troubleshooting skills. Ability to address and/or translate workflow requirements to product features. Ability to work in a fast-paced environment. Extensive travel required. In addition to the above, all employees are expected to: Promote teamwork and cooperative effort. Help train and give guidance to other employees. Provide customers with the highest quality products and services. Understand and apply appropriate quality management system processes. Promote Company standards of business conduct. The above description is intended to include the general content of and requirements for the performance of this job. The position will perform other related duties and assignments as required. Physical Requirements: The position requires the ability to perform the following physical demands and/or have the listed capabilities: The ability to sit up 75-100% of applicable work time. The ability to use your hands and fingers to feel and manipulate items, including keyboards, up to 100% of applicable work time. The ability to stand, talk, and hear for 75% of applicable work time. The ability to lift and carry up to ten pounds up to 20% of applicable work time. Close Vision: The ability to see clearly at twenty inches or less. Travel Up to 75% travel required, based on business need. * #LI-REMOTE FUJIFILM is an equal opportunity and affirmative action employer. All qualified applicants will receive consideration without regard to race, color, national origin, sex, gender identity, sexual orientation, religion, disability, protected veteran status or any other characteristic protected by applicable federal, state or local law. In the event that COVID-19 vaccine mandates issued by the federal government, or by state or local government become effective and enforceable, the Company will require that the successful candidate hired for positions covered under relevant government vaccine mandate(s) be fully vaccinated against COVID-19, absent being granted an accommodation due to medical or sincerely held religious belief or other legally required exemption. Applicants to positions where vendor credentialing or other similar requirements exist to enter facilities will be required to comply with the credentialing requirements of the facilities, including complying with vaccine requirements. For all positions, the Company encourages vaccination against COVID-19 and requires that the successful candidate hired be willing to test for the COVID-19 virus periodically and wear a face covering indoors as required, absent being granted an accommodation due to medical or sincerely held religious belief or other legally required exemption. EEO Information Fujifilm is committed to providing equal opportunities in hiring, promotion and advancement, compensation, benefits, and training regardless of nationality, age, gender, sexual orientation or gender identity, race, ethnicity, religion, political creed, ideology, national, or social origin, disability, veteran status, etc. ADA Information If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to our HR Department (****************************** or ***************.

SummaryThe Interventional Clinical Consultant (ICC) provides clinical and technical leadership throughout the sales process, demonstrating GE HealthCare's full suite of interventional products and services. This dynamic role blends strategic clinical consulting with hands-on product expertise, enabling you to influence key decision-makers, support product innovation, and elevate GE HealthCare's presence in the interventional space.Job Description About Us GE HealthCare is a global leader in medical technology and diagnostics, committed to advancing precision health. Our mission is to improve lives in the moments that matter by innovating at the forefront of healthcare. When you join our team, you're not just building a career-you're making a meaningful impact on global health. Together, we make every moment matter. Role Overview The Interventional Clinical Consultant (ICC) provides clinical and technical leadership throughout the sales process, demonstrating GE HealthCare's full suite of interventional products and services. This dynamic role blends strategic clinical consulting with hands-on product expertise, enabling you to influence key decision-makers, support product innovation, and elevate GE HealthCare's presence in the interventional space. Key Responsibilities Clinical Strategy & Engagement - Build and maintain strong clinical credibility with new and existing accounts. - Develop and nurture relationships with Key Opinion Leaders (KOLs). - Share insights on clinical trends, emerging procedures, and new technologies. Product Expertise & Demonstration - Showcase GE HealthCare's full range of interventional products and services. - Conduct AW and product demonstrations at trade shows (e.g., RSNA, SIR) and customer sites. - Match software and hardware solutions to procedural and patient outcome needs. Training & Support - Provide clinical training to internal teams (TM/RML, IAM, VASO). - Assist in customer presentations by adding clinical depth and expertise. - Support customer visits at reference and national show sites. Innovation & Collaboration - Evaluate new software, systems, and options from a clinical perspective before release. - Collaborate with Product Managers and regional teams to identify and develop reference sites. - Ensure clinical needs are translated into technical and performance specifications. - Resolve conflicts between product functionality and clinical application requirements. - Participate in user meetings and Medical Advisory Boards. Market Intelligence - Stay informed on competitive offerings and industry developments. - Complete strategic projects as assigned by management. Qualifications/Requirements - Minimum 5-8 years of clinical experience in Interventional or CT (strong medical background with high emphasis on clinical knowledge). - Proven ability to build relationships and develop programs. - Located in the Eastern or Western U.S. - Willingness to travel extensively (80-100%). - Excellent interpersonal, influencing, and communication skills. - Proficiency in Microsoft Office Suite (Outlook, Excel, Word, PowerPoint). Desired Characteristics - Clinical Applications experience. - Healthcare business and process knowledge. - Familiarity with Lean Methodologies. We will not sponsor individuals for employment visas, now or in the future, for this job opening. GE HealthCare offers a great work environment, professional development, challenging careers, and competitive compensation. GE HealthCare is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age, disability, protected veteran status or other characteristics protected by law. GE HealthCare will only employ those who are legally authorized to work in the United States for this opening. Any offer of employment is conditioned upon the successful completion of a drug screen (as applicable). While GE HealthCare does not currently require U.S. employees to be vaccinated against COVID-19, some GE HealthCare customers have vaccination mandates that may apply to certain GE HealthCare employees. Relocation Assistance Provided: Yes

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse is responsible for ensuring the receipt of high quality, cost efficient medical outcomes for those enrollees with a need for inpatient/ outpatient authorizations. This position receives and reviews prior authorization requests for specific inpatient and outpatient medical services, notification of emergent hospital admissions, completes inpatient concurrent review, establishes discharge plans, coordinates transitions of care to lower/higher levels of care, makes referrals for care management programs, and performs medical necessity reviews for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies as well as specified clinical guidelines/criteria to guide medical necessity reviews and will use effective relationship management, coordination of services, resource management, education, patient advocacy and related interventions to ensure members receive the appropriate level of care, prevent or reduce hospital admissions where appropriate. Job Description PRIMARY DUTIES AND RESPONSIBILITIES Employees are expected to work consistently to demonstrate the mission, vision, and core values of the organization. Key Outcomes: * Review prior authorization requests (prior authorization, concurrent review, and retrospective review) for medical necessity referring to Medical Director as needed for additional expertise and review. * Utilize evidenced-based criteria, governmental policies, and internal guidelines for medical necessity reviews. * Manage the review of medical claims disputes, records, and authorizations for billing, coding, and other compliance or reimbursement related issues * Collaborates with other members of the team, the MPHC Medical Directors, healthcare providers, and members to promote effective utilization of resources. This collaboration includes timely communications with in and out of network hospitals, post-acute care facilities, other providers, and internal departments to authorize services, establish discharge plans, assist to coordinate effective, efficient transitions of care. * Coordinates referrals to Care Management, as appropriate. * Manages health care within the benefits structures per line of business and performs functions within compliance, contractual and accreditation regulations, e.g. Department of Defense, Centers for Medicaid and Medicare, NCQA, Employer contracts and state insurance regulations, as applicable. Maintains knowledge of applicable regulatory guidelines. * Completes all documentation of reviews and decisions, in appropriate systems, according to process/ compliance requirements and within timeliness standards. * Participates as a member of an interdisciplinary team in the Health Management Department * May be responsible for maintaining a caseload for concurrent cases/ assisting in caseload coverage for the team * Establishes and maintains strong professional relationships with community providers. * Acts as a liaison to ensure the member is receiving the appropriate level of care at the appropriate place and time * Mentors new staff as assigned. * Meets or exceeds department quality audit scores. * Meets or exceeds department productivity standards. * Assists in creation and updating of department policies and procedures. * Participates in quality initiatives, committees, work groups, projects, and process improvements that reinforce best practice medical management programming and offerings. * Participates in the review and analysis of population data and metrics to inform development of programs and improved health outcomes. * Demonstrates flexibility and agility in working in a fast-paced, team-oriented environment, able to multi-task from one case type to another. * Assumes extra duties as assigned based on business needs * Responsible for weekend coverage on a rotating basis. POSITION QUALIFICATION Education/Experience There are additional competencies linked to individual contributor, provider, and leadership roles. Please consult with your leader to discuss additional competencies that are relevant to your position. Education * Associate's degree in nursing * Bachelor's degree in nursing preferred Licensure/certification * Compact RN license Experience * 3+ years of clinical nursing experience as an RN, preferably in a hospital setting * 2+ years Utilization Management experience in a health plan UM department * Certification in managed care nursing or care management (CMCN or CCM) preferred * Coding/CPC preferred Knowledge * Demonstrates an understanding of and alignment with Martin's Point Values. * Maintains current licensure and practices within scope of license for current state of residence. * Maintains knowledge of Scope of Nursing Practice in states where licensed. * Thorough understanding of healthcare policies, insurance guidelines, and regulatory standards (e.g., Medicare, NCQA, TRICARE) * Familiarity with coding systems like ICD-10 and CPT preferred Skills * Proficiency in conducting prospective, concurrent, and retrospective reviews using standardized criteria and guidelines like MCG * Ability to review and interpret medical records, treatment plans, and clinical documentation, with a keen eye for detail and compliance with healthcare standards * Technically savvy and can navigate multiple systems and screens while working cases * Excellent interpersonal, verbal, and written communication skills. * Critical thinking: can identify root causes and understands coordination of medical and clinical information. * Computer proficiency in Microsoft Office products including Word, Excel, and Outlook. Abilities * Ability to analyze data metrics, outcomes, and trends. * Ability to prioritize time and tasks efficiently and effectively. * Ability to manage multiple demands. * Ability to function independently. This position is not eligible for immigration sponsorship. We are an equal opportunity/affirmative action employer. Martin's Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact ***************************** Do you have a question about careers at Martin's Point Health Care? Contact us at: *****************************

$40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. pay rate is $40/hour This position is responsible for performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness and quality of medical/surgical services and serving as liaison between providers and medical and network management divisions. Collects clinical and non-clinical data. Verifies eligibility. Determines benefit levels in accordance to contract guidelines. Provides information regarding utilization management requirements and operational procedures to members, providers and facilities. Registered Nurse (RN) with valid, current, unrestricted license in the state of operations. * 3 years of clinical experience in a physician office, hospital/surgical setting or health care insurance company. * Knowledge of medical terminology and procedures. * Verbal and written communication skills. PREFERRED JOB REQUIREMENTS: * Utilization management experience * MCG or InterQual experience

We are seeking a dedicated and compassionate Wound Care Nurse, Telehealth Coordinator within the skilled nursing environment. The Wound Care Nurse, Telehealth Coordinator is the link between healthcare providers and patients while providing dressing changes to wounds, under direct supervision, utilizing real-time, imaging technologies. If you are passionate about excellent wound care and recognize the role telehealth has for consistent, convenient attention to patients in need, we encourage you to apply for the Telehealth Coordinator position and join our dedicated team. Responsibilities: Act as the in-person, hands on assistant to conduct weekly virtual wound rounds using technology under the guidance of wound care specialists, nurses, or healthcare providers. Photograph wounds using designated telehealth technology and ensure accurate documentation of images for clinical review. Aid patients in navigating telehealth platforms, troubleshoot technical issues, and ensure a seamless virtual connection for appointments. Facilitate patient telehealth scheduling, provide education on virtual visits to patients and staff as needed. Administer all aspects of wound care as per evidence based practice and facility policies, including dressing changes and rounds. Maintain strict adherence to patient confidentiality and privacy regulations, including HIPAA compliance, during all telehealth interactions and documentation processes. Submit orders for wound care products. Qualifications: Graduate of an accredited school of nursing required. Must possess current CPR certifications. Minimum of one (1) year of Wound Care experience required, (2) years preferred. Wound care certification is preferred. Must possess a current, unencumbered, active license to practice as a RN or LPN in state of practice. Excellent communication skills with the ability to convey medical information clearly to physicians, staff, patients and family Empathy, patience, and a genuine desire to provide quality healthcare services to patients at the bedside as well as through telehealth technology. Commitment to maintaining patient confidentiality, privacy, and data security in accordance with healthcare regulations (e.g., HIPAA). Ability to multitask, and adapt to changing telehealth workflows, job requirements, and patient populations. Prior experience in SNF, LTC, or Assisted Living preferred. Travel to assigned facilities using your personal car, valid driver's license, and mileage reimbursement offered. Role starts out Part-Time with the opportunity to be Full-Time.

RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. JOB RESPONSIBILITIES: This position is responsible for performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness, and quality of medical/surgical services, and serving as liaison between providers and medical and network management divisions. Collects clinical and non-clinical data. Verifies eligibility. Determines benefit levels in accordance to contract guidelines. Provides information regarding utilization management requirements and operational procedures to members, providers, and facilities. JOB QUALIFICATIONS (Required): Registered Nurse (RN) with a valid, current, unrestricted license in the state of operations. 3 years of clinical experience in a Physician's office, Hospital/Surgical setting, or Health Care Insurance Company. Knowledge of medical terminology and procedures. Verbal and written communication skills. JOB QUALIFICATIONS (Preferred): MCG or InterQual experience Utilization management experience LOCATION: REMOTE in Texas (Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties). POSITION: 6-month assignment SALARY: $38 - $40 hourly HOURS PER WEEK: 40 HOURS PER DAY: 8

Pharmacy Clinical Consulting Advisor Internal Job Title - Clinical Account Manager (CAM) Area of Operation - Colorado, Utah, Pacific Northwest As part of Cigna Pharmacy Management, the Pharmacy Sales Advisor is a licensed clinician who serves as the primary pharmacy benefits subject matter expert supporting Cigna Integrated Pharmacy clients within an assigned geographical market(s) and client size band. The Pharmacy Sales Advisor position will be responsible for developing and maintaining relationships with internal stakeholders including the medical sales teams and pharmacy underwriting organization as well as external brokers and consultants. The primary objective of this position is supporting long-term client retention and growth, while achieving Cigna's corporate strategic goals. The Pharmacy Clinical Consulting Advisor also provides pharmacy product and clinical expertise in support of the Medical Sales teams as well as the Pharmacy Implementation organization. This position is responsible for working with the Cigna Medical teams to support the Pharmacy component of an integrated benefit, which typically includes Medical, Pharmacy, and Behavioral. This includes service support, reporting, pricing, and/or other performance guarantees - while working with multiple internal stakeholders at Cigna and Evernorth, as well as external influencers (e.g. consultants, producers and decision makers in the benefits organization or financial and/or C-Suite of our clients). The primary roles of the Pharmacy Clinical Consulting Advisor are: Retain the assigned book of business through proactive portfolio management, including an understanding of available performance guarantees and pricing strategies in order to renew clients and preserve earnings. Participate in client meetings and presentations to review client performance and sell in the suite of pharmacy management programs and solutions that align to Cigna's overall value proposition of lowering total healthcare costs. Act as Pharmacy Sales support for renewals involving consultants. Cultivate meaningful, productive, mutually beneficial relationships internally and externally by gaining the confidence and trust of key stakeholders through honesty, integrity and reliability. Educate and consistently advance the knowledge of pharmacy within the Cigna Medical sales organization. This includes deep dives on our products and services, as well as championing an understanding of the clinical integration points across benefits. Communicate effectively, delivering multi-modal messages that convey a clear understanding of the unique needs of the different audiences requiring interaction. Proactively anticipates communication needs in order to remove ambiguity. Actively participate in finalist meetings for existing business where necessary. Gather and share relevant competitive intelligence in support of retention and new sales efforts. Acts as the clinical subject matter expert supporting medical sales team or the pharmacy Implementation team with escalated pharmacy benefit issues, when necessary. Manages complexity, by analyzing and making sense of a considerable volume of sometimes contradictory information to effectively solve problems. Asks the right questions and attentively listens to others. Stays abreast of clinical pharmacy practice guidelines, including the new drug pipeline, biosimilars, gene therapies, upcoming patent expirations, etc. Additional Responsibilities: Facilitate meetings with clients and brokers to resolve service concerns; act as the escalated issue contact for pharmacy issues when contacted by the medical sales teams. Support detailed ad-hoc analysis of pharmacy claims utilization in order to provide clients with proactive consultation, as well as manage follow-up questions that may arise. Provide executive support for pricing, audit, and contract questions, as requested by internal partners managing these efforts. Translate pharmacy coverage rules and formulary decisions based on Cigna policies with support from Clinical program development partners. Any other tasks as defined by management and/or client needs not named above, as required to support our internal and external stakeholders, clients, and partners. Qualifications: Clinical pharmacy background required; R.Ph. or Pharm.D. 5 years or more of Pharmacy Benefit Management (PBM) experience supporting client expectations Mid to Large Employer account management experience preferred Experience with consultative client management methodologies Proven ability to manage thru a renewal independently with minimal supervision Ability to work through the organizational processes needed to support clients (especially those that are clinical in nature, considering exceptions, etc.) A self-motivated individual displaying ownership, accountability and responsibility Operational understanding and competence with PBM business model Understanding the financial and pricing strategy of PBM Technical skills using all Microsoft programs Ability to travel up to 50% of the time depending on candidate's location with little or no advance notice Competencies: Clinical understanding of PBM space Customer Focus Organizational Agility Network Building Verbal & Written Communication Skills Presentation Skills Financial Acumen Negotiation skills Executive presence If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 107,000 - 178,300 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Utilization Review Registered Nurse, Case Management, FT, 08A-4:30P Local Remote-155662Description The purpose of this position is to conduct initial, concurrent, retrospective chart review for clinical financial resource utilization. Coordinates with healthcare team for optimal/efficient patient outcomes, while decreasing length of stay (LOS) and avoid delays and denied days. They are accountable for a designated patient caseload and provides intervention, coordination to decrease avoidable delays, denial of reimbursement. Specific functions within this role include: Screens pre-admission, admission process using established criteria for all points of entry. Facilitates communication between payers, review agencies, healthcare team. Identify delays in treatment or inappropriate utilization and serves as a resource. Coordinates communication with physicians. Identify opportunities for expedited appeals and collaborates to resolve payer issues. Ensures/Maintains effective communication with Revenue Cycle Departments.Qualifications Degrees:Associates.Licenses & Certifications:MCG Care Guidelines Specialist.Registered Nurse.Additional Qualifications:RNs hired prior to 2-2012 (10/1/2017 at Bethesda or 7/1/2019 at BRRH) with an Associates Degree in Nursing are not required to have a BSN to continue their non-leadership role as an RN. however, they are required to complete the BSN within 3 years of job entry date.MCG Specialist Certification ISC/HRC required within 12 months of job entry date.3 years of Nursing experience preferred.Excellent written, interpersonal communication and negotiation skills.Strong critical thinking skills and the ability to perform clinical/chart review abstract information efficiently.Strong analytical, data management and computer skills.Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components.Current working knowledge of payer and managed care reimbursement preferred.Ability to work independently and exercise sound judgment in interactions with the health care team and patients/families.Knowledgeable in local, state, and federal legislation and regulations.Ability to tolerate high volume production standards.Minimum Required Experience: 3 YearsJob Case Management/Home HealthPrimary Location Boca RatonOrganization Boca Raton Regional HospitalSchedule Full-time Job Posting Jan 7, 2026, 5:00:00 AMUnposting Date Ongoing Pay Grade R21EOE, including disability/vets

Telephonic Case Manager - Rare Opportunity! EK Health is now hiring for a Telephonic Nurse Case Manager (RN) for our Case Management Team! This role includes assessing, planning, implementing, coordinating, and evaluation of service options. The goal of the Case Manager is to assist the injured worker in receiving appropriate, cost-effective medical care for their injury in a timely manner, and to expedite their return to work. Position Logistics: Monday - Friday, 8:30am -5:30pm local time, Full-time Remote. NOTE: Requires a Compact RN license in good standing. Workers Compensation experience is preferred but not required. Wage is based on experience, education, certifications and location (may be either hourly or salary based on individual state requirements). Benefits & Perks: Base pay $35-42/hr ($72,800 - $87,360 annually). Wage is based on experience, education, certifications and location (may be either hourly or salary based on individual state requirements). Medical, Dental and Vision Insurance 401K Paid Time Off Paid holidays Equipment is provided Monthly internet stipend Here's a snapshot of what you'll be doing (not all-inclusive): Communicate with medical providers, employers and with injured workers Perform a complete nursing evaluation to determine needs of patient Review and evaluate all medical correspondence, provider reports, & treatment plan history Evaluate clinical status of claimant and research for alternative options to treatment as warranted Communicate with the claims examiners regarding directives, and provide updates on file status Arranging transportation services when necessary and authorized Evaluating therapy facilities and their progress on specific cases Prepare comprehensive notes following any discussions had with injured worker, medical providers, claims examiners, and employers in the case file Discuss the analyzed data and the comprehensive plan of care with the insurance representative prior to implementation Upon authorization, implement this plan of care with patient, physician and health care providers Arrange for care/services as needed (home care, procedures, medication, equipment or supplies) Monitor the plan of care with modifications or changes suggested to the patient and physician as the need arises Coordinate information between all parties (injured worker, physicians, employer, other providers, such as therapists, and attorney, if any is involved) Requirements Graduate of an accredited school of nursing 3-5 years clinical experience as an RN outside of school Valid Compact RN license in good standing with no restrictions Valid state-appropriate RN license in good standing with no restrictions Possesses and can demonstrate the professional and technical skills of a Registered Nurse Experience in Case Management, Workers' Compensation experience preferred, but not required Experience in Home Health Care, Occupational Health considered a plus Excellent Written and Oral Communication Skills Excellent Interpersonal & Organizational Skills High comfort level with computers and computer programs (MS Word, MS Excel, Email)

AirStrip is adding a Clinical Consultant to our team. In this role, you serve as one of AirStrip's clinical workflow and informatics SME's during technology implementations with clients. You engage directly with clients' clinical champions, end users, including both nurses and physicians, clinical IT staff and partner vendors to optimize the value of AirStrip's tech solutions. Drawing upon your previous clinical experience and expertise, you'll assist as an internal resource for pre-sales activities, implementation, training support and strategic product discussions. Please note, this position requires 75-80% travel. You are regularly traveling Monday-Friday to client locations across the United States, multiple weeks in a row. Day-to-day activities include, but are not limited to: Employ clinical knowledge and understanding of clinical workflow design / redesign to propose AirStrip solutions that improve and optimize client's workflow and processes Conduct clinical workflow design sessions at project sites, gathering data and working with the client's clinical staff in developing new processes and workflow improvements Develop drafts of clinical documentation and assist with clinical marketing and support of new products and services Conduct hospital level training or facilitate client team meetings prior to or during initial deployment of solutions to ensure that physicians and nurses drive key use cases within their workflows to generate value and data required for clinical effectiveness. Participate with AirStrip innovation, engineering, and operations teams to ensure an efficient and comprehensive interaction with clients at the assessment, testing, validation, initial deployment, and steady state phases of the client relationship Interact with client physicians and nursing champions through planning, go-live, and post-deployment to enable adoption of AirStrip solutions and communicate feedback Deliver AirStrip solutions focused presentations to groups and demo how AirStrip solutions will meet prospect and customer needs Lead and coach customers to success through ADPIE methodology including workflow “day in the life” positioning , go live support and ongoing education Manage multiple, simultaneous projects from assessment through clinical implementation Assist Sales team with sales calls and clinical discovery sessions to accelerate new account development and expansions Develop leading clinical practices and tools for project execution, management, training and support Design and present user stories, use cases, site assessments, clinical requirements, and workflow diagrams Education & Experience Requirements: Bachelor's of Science in Nursing (or other health care related BS AND MSN), along with an active RN license Recent clinical experience (within last 5 years) in adult critical care, Telemetry, or Emergency Department 5+ years or more overall clinical experience in one or more of the above-mentioned areas. 2+ years of experience supporting clinical workflow initiatives in a hospital system involving clinical informatics, deployment of new technologies with successful adoption among physician and nurse users, including EMR, Monitoring alarms and mHealth technologies (strongly preferred) Required Knowledge, Skills, and Abilities: Demonstrable advanced clinical skills and knowledge in cardiac and critical care nursing and standards of care for critical care patients. Solid clinical workflow knowledge, including how departments relate to one another and process flows in between them Excellent verbal and written communication skills, including demonstrated ability to develop and deliver presentations, workflow designs, and training materials Strong ability to explain data and insights concepts to non-technical audiences and to communicate clinical informatics concepts and tasks to cross-functional teams Ability to instill confidence and persuade customers and coworkers Deep knowledge and experience with electronic medical records and workflow of medical and nursing staff around use of EMRs and other automated systems. Demonstrated project management, organizational and interpersonal skills Self-assured and results oriented, able to work independently as well as collaboratively. Strong analytical skills - understands how to collect, analyze, and leverage data to achieve clinical/business objectives Experienced knowledge of computer operations and ability to competently use MS Office - i.e. Word, Excel, Outlook, Visio, and other applications. The salary range for applicable US-based applicants to this position is below. The specific rate will depend on the successful candidate's qualifications, prior experience as well as geographic location. $90,000 - $115,000 base salary.

Compensation: $80,000-$95,000 + equity This salary range reflects multiple experience levels and locations. Actual compensation within the range will be determined based on factors such as experience, skills, qualifications, and geographic location. Schedule: Full-time, 5 days a week, Tuesday-Saturday Location: Remote Role Type: Full-time | Bilingual Spanish preferred but not required About Bariendo Bariendo is on a mission to cure obesity. Founded by Harvard Medical School professors, we are pioneering quick, non-surgical weight loss procedures that are 7x safer than surgery and more effective and affordable than the best medications. Our digital health platform combines telehealth, distributed clinics, and an expert care team in endoscopic weight loss to deliver lasting, affordable results for the 40% of Americans struggling with obesity. We're growing rapidly-now in 8 cities after just 6 quarters of operations-with a vision to become the one-stop shop for obesity management, offering the most comprehensive set of interventions available online and via our distributed partner clinics. Join us to help patients reclaim their lives. About This Role We are looking for a people-centered, professional, and organized Nurse Patient Concierge to join our team and deliver Bariendo's signature 6-star care. You'll be the first point of contact for patients and a crucial part of making their weight loss journey feel smooth, supported, and stress-free. This is a role for someone who thrives in a fast-paced environment, has a concierge mindset, and finds joy in turning complex coordination into calm execution. In this role, you will: Deliver 6-Star Service: Be the warm, welcoming presence patients first encounter. Whether by phone, text, or email, you'll create a calm, organized, and exceptional experience that reflects Bariendo's high standards of care. Be a Trusted Clinical Guide: Act as a primary point of contact for patients on clinical and care-related questions, escalating appropriately to providers and ensuring clear, timely communication so patients feel confident and supported throughout their treatment. Ensure Clinical & Procedural Readiness: Partner closely with Bariendo's procedure centers to confirm accurate bookings, review patient charts for completeness and readiness, and coordinate outstanding requirements so every patient arrives fully prepared for their procedure. Be a Concierge for Every Concern: Monitor incoming communications, answer phone calls, and anticipate patient needs before they arise. You'll be a responsive, empathetic problem-solver who builds trust with every interaction. Drive Administrative Excellence: Maintain accurate records across our systems, ensure compliance with regulations like HIPAA, and support documentation workflows that enable smooth care delivery. What We're Looking For Clinical, Service-Driven Experience: Active RN license with 3+ years of patient-facing clinical experience, including experience delivering care or care coordination virtually (phone, text, telehealth). Ideally in procedural, ambulatory, or concierge-style settings where high-touch, white-glove support is the norm. Experience in Weight Management or Bariatric Care (preferred): Prior exposure to obesity medicine, bariatric surgery, endoscopy, or medical weight-loss clinics is a strong plus, particularly in patient education, pre-procedure readiness, or longitudinal care coordination. Fluent in Spanish (preferred, not required): Able to communicate clearly and professionally with Spanish-speaking patients across phone, email, and text. Detail-Oriented & Reliable: Comfortable juggling complex logistics with accuracy. You stay organized, catch errors before they happen, and keep things moving smoothly under pressure. Warm, Clear Communicator: You build trust quickly, make patients feel at ease, and bring empathy and professionalism to every interaction. Operationally Sharp & Adaptable: Confident discussing pricing and payment options in a direct-pay model, comfortable navigating EHRs and new software, and energized by fast-paced, ever-evolving environments where proactive problem-solving is key. What Makes This Job Amazing Mission: Join a team of Harvard Medical School professors and healthcare innovators transforming thousands of lives. Watch our patient's stories. Foundational Role in a Growing Startup: Be part of a fast-growing, mission-oriented team. Collaborate closely with teams like Product to help shape and innovate our virtual care experience. Total Rewards Competitive salary with equity in a high growth, seed-stage startup Comprehensive health benefits (medical, dental, vision) 11 paid holidays, 15 personal vacation days, 10 wellness days

Company Details Berkley Medical Management Solutions (BMMS) provides a different kind of managed-care service for W.R. Berkley Corporation. We believe focusing on an injured worker's successful and speedy return to work is good for people and good for Berkley's insurance operating units. BMMS was first started in 2014 by reimagining the relationship between medical need and technology to deliver the best outcome for injured workers and Berkley's operating units. Our goal was clear: combine solid clinical practices, proven return-to-work strategies and robust software into one system for seamless management of workers' compensation cases. To get it right, we started with a flexible technology platform that allowed for impressive customization without sacrificing the ability for expansion and continued innovation. We deploy integrated systems to give W.R. Berkley Companies recommendations and professional services for managing each individual case in an efficient and appropriate manner. The power of our technology takes medical bill-review services and clinical advisory services to a new level. Our unique marriage of technology, software platforms, data analytics and professional services ensures we provide Berkley's operating units with reliable results, and reduced time and expenses associated with case management. Responsibilities As a Telephonic Nurse Case Manager, you will assess, plan, coordinate, monitor, evaluate and implement options and services to facilitate timely medical care and return to work outcomes of injured workers. Coordinate and implement medical case management to facilitate case closure Timely and comprehensive communication with with employers, adjusters and the injured workers. Assess appropriate utilization of medical treatment and services available through contact with physicians and other specialist to ensure cost effective quality care Review and analyze medical records and assess data to ensure appropriate case management process occurs while providing recommendations to achieve case progress and movement to closure Responsible for assigned caseloads, which may vary in numbers, territory and/or by state jurisdiction Acquire and maintain nursing licensure for all jurisdictions as business needs require Coordinate services to include home services, durable medical equipment, IMEs, admissions, discharges, and vocational services when appropriate and evaluate cost effectiveness and quality of services Document activities and case progress using appropriate methods and tools following best practices for quality improvement Reviewing job analysis/job description with all providers to coordinate and implement disability case management. This includes coordinating job analysis with employer to facilitate return to work. Engage and participate in special projects as assigned by case management leadership team Occasionally attend on site meetings and professional programs Foster a teamwork environment Maintaining and updating evidence based medical guidelines (such as Official Disability Guidelines, MD Guidelines and all required state regulated guidelines) in reference to the injured worker treatment plan and work status. Obtain and maintain applicable state certifications and/or licensures in the state where job duties are performed. Obtain case management professional certification (CCM) within 2 years of hire Qualifications Minimum 2 years of experience in workers compensation insurance and medical case management preferred Minimum of 4 years medical/surgical clinical experience required Ability to work standard business hours in the either Central Standard Time, Mountain Standard Time or Pacific Time Zone (Monday through Friday, 8:00 AM to 5:00 PM CST/MST/PST). Exhibit strong communication skills, professionalism, flexibility and adaptability Possess working knowledge of medical and vocational resources available to the Workers' Compensation industry Demonstrate evidence of self-motivation and the ability to perform case management duties independently Demonstrate evidence of computer and technology skills Oral and written fluency in both Spanish and English a plus Education Graduate of an accredited school of nursing and possess a current RN license. A Compact Nursing License is strongly preferred. A California license is ideal but not mandatory. Candidates must be willing and able to obtain a California license within 90 days of their start date. Additional Company Details ****************** The Company is an equal employment opportunity employer We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees • Base Salary Range: $80,000 - $88,000 • Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Additional Requirements • Domestic U.S. travel required (up to 10% of time) Sponsorship Details Sponsorship not Offered for this Role

* Review approximately 20 cases a day for medical necessity. * Advocate for and protect members from unnecessary hospital admissions. * Follow established procedures and processes to complete authorizations. * Collaborate with a team of nurses to assist each other and complete cases. Qualifications: * 3+ years of utilization management, concurrent review, prior authorization, utilization review, case management, and discharge planning is must * Active RN Compact License is Must If you are Interested , Kindly give a call : ************** Job Type & Location This is a Contract position based out of Fort Worth, TX. Pay and Benefits The pay range for this position is $35.00 - $40.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Jan 21, 2026. About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

If you're a registered nurse looking for a new opportunity to work in a fast-paced, professional environment where your talent contributes to our competitive edge, Liberty Mutual Insurance has the opportunity for you. Under general technical direction, responsible for medically managing assigned caseload and by applying clinical expertise ensure individuals receive appropriate healthcare in order to return to work and normal activity in a timely and cost effective manner. Caseload may include catastrophic/complex medical/disability cases, lost time, and/or medical only claims. Also act as a clinical resource for field claim partners. This is a remote position, however, you will be required to report into the office twice a month per business requirements if you reside within 50 miles of the following offices: Lake Oswego, OR, Chandler, AZ, Hoffman Estates, IL, Suwanee, GA, Indianapolis, IN, Plano, TX, Boston, MA, Westborough, MA, Las Vegas, NV, and Weatogue, CT . Please note this policy is subject to change. Responsibilities: Follows Liberty Mutual's established standards and protocols to effectively manage assigned caseload of medical/disability cases and by applying clinical expertise assist to achieve optimal outcome and to facilitate claim resolution and disposition. Effectively communicates with injured employees, medical professionals, field claims staff, attorneys, and others to obtain information, and to negotiate medical treatment and return to work plans using critical thinking skills, clinical expertise and other resources as needed to achieve an optimal case outcome. Utilizes the Nursing Process (assessment, diagnosis, planning, intervention and evaluation) to facilitate medical management to attain maximum medical improvement and return-to-work (RTW) per state jurisdictional requirements. Appropriately utilizes internal and external resources and referrals i.e., Utilization Review, Peer Review, Field Claims Specialists, Regional Medical Director Consults, and Vocational Rehabilitation to achieve best possible case outcome. Follows general technical direction from nurse manager, senior medical and disability case manager and/or CCMU staff to resolve highly complex medical and/or RTW issues and/or successfully manage catastrophic injuries. Documents all RN activities accurately, concisely and on a timely basis. This includes documenting the medical and disability case management strategies for claim resolution, based on clinical expertise. Adheres to confidentiality policy. Appropriately applies clinical expertise to claims and delivers services in an efficient and effective manner. Accurately and appropriately documents time tracking for work performed. Achieves annual time tracking goal. Handles special projects as assigned. Qualifications Ability to analyze and make sound nursing judgments and to accurately document activities. Strong communication skills in order to build relationships with injured employees, medical professionals, employers, field claims staff and others. Good negotiation skills to effectively establish target return to work dates and coordinate medical care. Knowledge of state, local and federal laws related to health care delivery preferred. Personal computer knowledge and proficiency in general computer applications such as Internet Explorer and Microsoft Office (including Word, Excel and Outlook). Degree from an accredited nursing school required (prefer Bachelor of Science in Nursing). Minimum of 3 to 5 years of clinical nursing experience; prefer previous orthopedic, emergency room, critical care, home care or rehab care experience. Previous medical case management experience a plus. Must also have current unrestricted registered nurse (R.N.) license in the state where the position is based and other assigned states as required by law. Must have additional professional certifications, such as CCM, COHN, CRRN, etc., where required by WC law. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.