Prior-Authorization Coordinator Job at Robert Half (Englishtown)

New

Prior-Authorization Coordinator

Location

United States , Englishtown

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Knowledge of medical terminology and insurance requirements.

Job Responsibility

Obtain prior authorizations for procedures, medications, and diagnostic services
Verify patient insurance coverage, benefits, and eligibility
Communicate with insurance companies to submit and follow up on authorization requests
Review clinical documentation for completeness and accuracy prior to submission
Track authorization status and ensure approvals are received prior to scheduled services.

What we offer

paid time off
medical health insurance
dental
vision
life insurance

Behavioral Health Medical Director

The Behavioral Health (BH) Medical Director leverages clinical expertise to prov...

Location

United States

Salary:

189600.00 - 237000.00 USD / Year

Personify Health

Expiration Date

Until further notice

Requirements

MD or DO degree and 5+ years of direct clinical patient care experience post residency or fellowship including behavioral health environments
Current and ongoing Board Certification in psychiatry by the American Board of Psychiatry and Neurology (ABPN) required
Additional Board Certification in Child and Adolescent Psychiatry or Addiction Medicine
A current and unrestricted license in the state of California and willing to obtain additional license(s)
No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements
Minimum 5 years of Utilization Review or Hospital experience required
Minimum 3 years of compliance related experience preferred
Managed Care experience preferred in utilization review and case management
Expertise in behavioral health case management, utilization review and telehealth delivery
Ability to design and evaluate behavioral health programs, integrating evidence-based practices and holistic wellbeing approaches

Job Responsibility

Oversee and participate in behavioral health case management, including utilization review, telephonic care, and urgent response coordination for behavioral health and substance use disorder needs
Conduct reviews for medical necessity for prior authorization, continued stay, and post-service claims, applying medical policy, guidelines, and current research
Integrate behavioral health screening and interventions within physical health case management programs, utilizing standardized tools (e.g., PHQ2, PHQ9) and ensuring appropriate referrals
Support and monitor virtual behavioral health services, ensuring access, privacy, and continuity of care for all age groups, including children, teens, and adults
Supervise and provide clinical oversight for residential and outpatient behavioral health programs, including partial hospitalization and intensive outpatient services, with an emphasis on family engagement and comprehensive discharge planning
Lead the development and implementation of comprehensive behavioral health strategies, including program design, staff education, and quality improvement initiatives
Maintain compliance with national guidelines (e.g., MCG, InterQual, specialty college recommendations) and regulatory requirements (federal, state, ERISA) specific to behavioral health
Oversee the negotiation and implementation of cost management strategies to affect quality outcomes, reflecting data in monthly case management reviews
Participate in grievance and appeals processes, including escalated behavioral health issues
Collaborate with the VP of Care Management to establish work procedures and processes that support company and departmental standards, procedures, and strategic directives

What we offer

Comprehensive medical and dental coverage through our own health solutions
Mental health support and wellness programs designed by experts who get it
Flexible work arrangements that fit your life
Retirement planning support to help you build real wealth for the future
Basic Life and AD&D Insurance plus Short-Term and Long-Term Disability protection
Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage
Professional development opportunities and clear career progression paths
Mentorship from industry leaders who want to see you succeed
Learning budget to invest in skills that matter to your future
Unlimited PTO policy

Parttime

New

Executive Assistant, Marketing

A Well-known U.S.-based Specialty Insurance Platform is seeking a new Full-Time/...

Location

United States , New York

Salary:

110000.00 - 120000.00 USD / Year

Solomon Page

Expiration Date

Until further notice

Requirements

Minimum 3-7+ years of applicable administrative experience, ideally within marketing, business development, and/or a related department
Bachelor's degree required
Excellent interpersonal and communication skills (both verbal and written)
Strong MS Office Suite skills
Proactive, detail-oriented, and organized
Polished and professional
client-facing
Accustomed to multi-tasking in fast-paced, dynamic environments

Job Responsibility

Calendar & Meeting Management: Manage an extremely active calendar, scheduling and rescheduling meetings across time zones, while proactively resolving conflicts
Travel Coordination: Arrange complex domestic and international travel, including flights, hotels, and ground transportation, while navigating potential travel complications
LinkedIn Management: Coordinate social media activities, including drafting and posting LinkedIn updates for work anniversaries, firm-wide events, and holiday messages
Coordination: Assist with organizing and attending industry conferences and internal events
Administrative Support: Act as the primary gatekeeper for the Head of Business Development, handling correspondence and preparing meeting materials

What we offer

Medical
Dental
401(k)
Direct deposit
Commuter benefits

Fulltime

New

Vendor Management Associate & Office Administrative Coordinator

Our cliient is looking to fill the role of Vendor Management Associate & Office ...

Location

United States , Tampa

Salary:

70000.00 USD / Year ▼

Solomon Page

Expiration Date

Until further notice

Requirements

Bachelor's degree in Business Administration, Risk Management, or a related field
Minimum 2-3 years of experience in office and vendor management, procurement, third party risk, or a related discipline
Strong understanding of third-party risk management frameworks and information security principles
Requires 3-5 days per week on-site in a fast-paced office environment with regular interaction across all levels of staff
Excellent written and verbal communication skills
ability to present complex risk topics to diverse audiences
Highly organized with exceptional attention to detail and the ability to manage multiple priorities simultaneously
Proficient with Microsoft Office (Word, Excel, PowerPoint) and vendor risk management tools

Job Responsibility

Support day-to-day administrative operations and office management functions
Manage office supply inventory and coordinate procurement
Facilitate onboarding of new employees
Coordinate with building management, vendors, and service providers
Prepare and distribute correspondence, memos, reports, and presentation materials
Provide administrative and clerical support to the Chief Accounting Officer
Process and track expense reports
Serve as primary point of contact for internal staff and external parties
Support planning, coordination, and execution of corporate events
Perform additional duties as assigned

What we offer

medical
dental
401(k)
direct deposit
commuter benefits

Fulltime

New

Freelance Associate Sweater Designer

We are looking for a Freelance Associate Sweater Designer for a top fashion comp...

Location

United States , New York

Salary:

35.00 USD / Hour

Solomon Page

Expiration Date

Until further notice

Requirements

Bachelor's Degree in Fashion Design or related field
Prior experience in sweater and knit design
Advanced knowledge of Adobe Suite
Must be able to create technical packages
Able to adapt to a fast paced ever changing environment

Job Responsibility

Creating sketches of seasonal concepts for the women's sweaters line
Contribute to seasonal trend and concept brainstorm
Translating sketches into technical packages for production
Working with cross-functional teams to ensure a final products that represents the brand aesthetic
Perform other duties as required

What we offer

medical
dental
401(k)
direct deposit
commuter benefits
medical, dental, 401(k), direct deposit and commuter benefits to our employees, including freelancers

Fulltime

New

Senior Electrical Engineer

CTP TEAM is an international engineering company based in Bergamo (Lallio) Italy...

Location

Italy , Lallio

Salary:

45000.00 - 55000.00 EUR / Year

CTP Team

Expiration Date

Until further notice

Requirements

All candidates must already be legally resident on Italian soil
at least 6+ years prior experience in electrical engineering gained within technical departments of companies operating in the electrical, mechanical, automation, industrial plant engineering, or similar sectors
appropriate educational qualification such as a degree in Electrical Engineering, Industrial Automation, Mechatronics, or a post-diploma technical qualification supported by relevant experience
good working knowledge of the English language
mandatory availability for frequent short on-site trips within Italy and abroad (up to 40% of working time especially during the site activity period)
Design of electrical systems: medium-voltage installations, MV/LV transformers, LV switchboards, motor control centres (MCC), single-line diagrams, supervision and control systems for electrical plants
Knowledge of power generation systems
Preparation of procurement requests for MV/LV electrical systems and switchboards
Technical alignment with suppliers to obtain consolidated offers for MV/LV switchboards
Management and development of MV/LV electrical system and switchboard projects

Job Responsibility

Will manage the electrical scope of supply within assigned projects, maintaining a proactive and direct relationship with clients and suppliers
Will identify all opportunities to reduce electrical supply costs
Will ensure that the project scope is completed in accordance with contractual obligations, coordinating closely with the procurement department and external suppliers
Will be responsible for anticipating potential risks related to the electrical portion of the project and defining corrective actions where needed
Will review layouts and technical drawings, verifying compatibility with the mechanical design and monitoring the proper execution of development activities
Will manage the preparation of all key project documentation, including single-line diagrams, lists (consumption lists, cable lists, etc.), layouts, and any additional schematics required for the successful progress of the project
Will be proactively involved from the bidding phase through project delivery, commissioning, and final handover to clients
Will provide support to the after-sales department when required
Will assist the sales department during tendering activities by estimating costs and timelines for potential projects

What we offer

Smart Working up to 1 day a week available for the position after probation
Flex Time, 07.00-10.00 /16.00-19.00 Monday to Friday
Electronic Ticket Restaurant: € 8
Extra Care-giving Hours: 16 hours a year paid leaves for caregiving/volunteering activities
Welfare Plan: € 250,00 a year net value as current Regulation
Medical examinations: paid leave up 2 hours for medical examination
daily travel allowance when away

Fulltime

New

Urgent Care Nurse Practitioner/Physician Assistant

Come experience an exceptional primary care delivery model at One Health! One He...

Location

United States , Rural Hall

Salary:

54.90 - 82.35 USD / Hour

Advocate Aurora Health

Expiration Date

Until further notice

Requirements

Board Certified/Board Eligible Nurse Practitioners
Board Certified/Board Eligible Physician Assistants
Board Certified/Board Eligible Nurse Midwives
Passionate about providing patient-centered care across the wide spectrum of primary care conditions within a practice
Focused on collegiality, professionalism, compassion, personal growth and leadership development
Ability to perform common outpatient procedures desired

Job Responsibility

Delivery of patient-centered primary care throughout the Piedmont of North Carolina
Imbedded urgent care clinics providing care 7 days/week
Outpatient primary care with telephone call that averages once every 30 days

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions
Opportunity for annual increases based on performance

Fulltime

New

Freelance Handbag Designer

We are looking for a Freelance Handbag Designer for a top fashion brand in NYC S...

Location

United States , New York

Salary:

Not provided

Solomon Page

Expiration Date

Until further notice

Requirements

5+ years of relevant experience
Specific Knowledge of Handbag Construction
Proficient in Adobe Suite and MS Office

Job Responsibility

Trend Research
Sketching
Color CADs
Creating Technical Specs
Setting up Brand Rooms and Decks
Making Corrections

What we offer

medical
dental
401(k)
direct deposit
commuter benefits

Fulltime

Select Country

Prior-Authorization Coordinator

Job Responsibility

Requirements

What we offer

Looking for more opportunities?

Prior-Authorization Coordinator

Prior-Authorization Coordinator

Behavioral Health Medical Director

Executive Assistant, Marketing

Vendor Management Associate & Office Administrative Coordinator

Freelance Associate Sweater Designer

Senior Electrical Engineer

Urgent Care Nurse Practitioner/Physician Assistant

Freelance Handbag Designer

Our AI answers in your language