Records and Data Management Specialist II Job at Wyoming Game and Fish Department (Cheyenne)

Care Management Specialist II (RN or LCSW)

The Care Management Specialist II utilizes clinical skills and training to perfo...

Location

United States , Los Angeles

Salary:

88854.00 - 142166.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Minimum of 3 years of recent care management experience with responsibilities of managing complex acute or chronic conditions in collaboration with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience as care manager in home health or hospice environments
Experience providing care management with complex/catastrophic conditions
Current knowledge of clinical standards of care and disease processes
Critical thinking skill
Excellent customer service skills
Ability to clinically analyze the most complex cases involving highly acute physical health, behavioral health, complex/catastrophic and/or psychosocial issues to determine and implement the most effective member-centered interventions
Ability to triage immediate member health and safety risks
Ability to sensitively manage member or family responses associated with high acuity cases and support effective coping
Strong verbal and written communications skills to consult effectively with interdisciplinary teams, coordinate care with members and their families, and other internal and external stakeholders
Ability to use a personal computer, and knowledge of medical information systems

Job Responsibility

Applies clinical knowledge and experience to evaluate information regarding prospective care management members referred by health risk assessment (HRA), risk stratification, predictive modeling, provider’s utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other data sources to determine whether care management intervention is necessary to meet the member's needs
Conducts Care Management services for the most complex and vulnerable members including: engaging in member centric communication which includes the interdisciplinary team, providers and family or authorized representatives
reviewing member claims histories and identifies intervention opportunities through the professional standards of practice
contacting and interviewing members to conduct a baseline assessment, assess self-care ability, assess knowledge and adherence deficits
conducting comprehensive clinical assessments as indicated
developing a member centric plan of care
Maintains assigned care management caseload for with a focus on the most complex, highest-risk members particularly those with advanced chronic conditions, co-occurring mental and/or substance abuse and complex social issues (e.g. homelessness, domestic violence)
Collaborates with primary care physician and other treating professionals as appropriate
Authorizes initiation of care management services and specialized program services for members and specific populations, and develops interventions designed to meet member or population desired outcomes
Provides comprehensive education and resources to members about accessing services, in-network use, national guidelines for care, community resources, and self-management skills and strategies

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Chemical Management Specialist II

1st Shift: 8:00AM to 4:30PM Monday to Friday. When you're part of the team at Th...

Location

United States , West Point

Salary:

Not provided

myGwork - LGBTQ+ Business Community

Expiration Date

Until further notice

Requirements

High school diploma or equivalent required
Minimum 1 year of customer-service experience in a laboratory, warehouse, or similar environment
Proficiency with Microsoft 365 applications (Excel, Outlook, Teams)
Strong attention to detail, organizational skills, and a safety-first approach
Ability to read and understand SDS documentation and DOT labeling requirements
Excellent verbal and written communication skills in English

Job Responsibility

Verify chemical inventory levels, locations, and expiration dates by performing bench audits and full-cycle counts using barcode scanners
Receive, inspect, label, and store incoming chemical shipments according to compatibility guidelines and DOT regulations
Pick, pack, and stage chemical orders for distribution or disposal, maintaining 100% accuracy and adherence to storage protocols
Read and interpret Safety Data Sheets (SDS) to apply accurate handling, storage, and spill-response procedures
Identify and help resolve discrepancies in chemical handling, storage conditions, or inventory records
Collaborate closely with Environmental Health & Safety (EHS) and team members to uphold safety standards, refine workflows, and train new team members
May perform other duties as assigned by management

What we offer

Comprehensive healthcare
Paid Holidays
Tuition reimbursement
Employee benefits

Fulltime

Care Management Specialist II

Established in 1997, L.A. Care Health Plan is an independent public agency creat...

Location

United States , Los Angeles

Salary:

88854.00 - 142166.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Associate's Degree in Nursing for Registered Nurses
Master's Degree in Social Work for Licensed Clinical Social Workers
Minimum of 3 years of recent care management experience with responsibilities of managing complex acute or chronic conditions in collaboration with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience as care manager in home health or hospice environments
Experience providing care management with complex/catastrophic conditions
Current knowledge of clinical standards of care and disease processes
Critical thinking skill
Excellent customer service skills
Ability to clinically analyze the most complex cases involving highly acute physical health, behavioral health, complex/catastrophic and/or psychosocial issues to determine and implement the most effective member-centered interventions
Ability to triage immediate member health and safety risks
Ability to sensitively manage member or family responses associated with high acuity cases and support effective coping

Job Responsibility

Applies clinical knowledge and experience to evaluate information regarding prospective care management members referred by health risk assessment (HRA), risk stratification, predictive modeling, provider’s utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other data sources to determine whether care management intervention is necessary to meet the member's needs
Conducts Care Management services for the most complex and vulnerable members including: engaging in member centric communication which includes the interdisciplinary team, providers and family or authorized representatives
reviewing member claims histories and identifies intervention opportunities through the professional standards of practice
contacting and interviewing members to conduct a baseline assessment, assess self-care ability, assess knowledge and adherence deficits
conducting comprehensive clinical assessments as indicated
developing a member centric plan of care. Maintains assigned care management caseload for with a focus on the most complex, highest-risk members particularly those with advanced chronic conditions, co-occurring mental and/or substance abuse and complex social issues (e.g. homelessness, domestic violence)
Collaborates with primary care physician and other treating professionals as appropriate. Authorizes initiation of care management services and specialized program services for members and specific populations, and develops interventions designed to meet member or population desired outcomes. Provides comprehensive education and resources to members about accessing services, in-network use, national guidelines for care, community resources, and self-management skills and strategies
Employs engagement techniques to build relationships with members and their authorized representatives. Encourages participants to participate in their health care decisions and assists member with researching treatment options in order to communicate effectively with providers and to make informed decisions
Notifies Care Coordinators and CHWs of members needs including the need for special educational mailings, reminder calls, satisfaction surveys, incentives or any additional service needs according to specific program guidelines
Performs field assessment and care coordination functions in community settings with members, such as at the L.A. Care Community Resource Centers, medical clinics, and member homes

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Utilization Management Nurse Specialist RN II

The Utilization Management Nurse Specialist RN II facilitates, coordinates, and ...

Location

United States , Los Angeles

Salary:

88854.00 - 142166.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Associate's Degree in Nursing
At least 5 years of varied RN clinical experience in an acute hospital setting
At least 2 years of Utilization Management/Case Management experience in a hospital or HMO setting
Registered Nurse (RN) - Active, current and unrestricted California License
Must be computer literate, with expertise in Outlook, Word, Excel, PowerPoint
Provision of excellent customer service
Excellent time management and priority-setting skills
Maintains strict member confidentiality and complies with all HIPAA requirements
Strong verbal and written communication skills

Job Responsibility

Facilitates, coordinates, and approves medically necessary referrals that meet established criteria
Assures timely and accurate determination and notification of referrals and reconsiderations based on the referral determination status
Generates approval, modification and denial communications, to include member and provider notification of referral determination
Actively monitors for admissions in any inpatient setting
Performs telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers, member/family interaction to develop and implement a successful discharge plan
Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims medical review
Monitors and oversees the collection and transfer of data (medical records) and referral requests by Providers
Acts as a department resource for medical service requests /referral management and processes
Receives incoming calls from providers, professionally handles complex calls, researches to identify timely and accurate resolution steps
Follows up with caller to provide response or resolution steps

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Utilization Management Nurse Specialist RN II

The Utilization Management Nurse Specialist RN II facilitates, coordinates, and ...

Location

United States , Los Angeles

Salary:

88854.00 - 142166.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Associate's Degree in Nursing
At least 5 years of varied RN clinical experience in an acute hospital setting
At least 2 years of Utilization Management/Case Management experience in a hospital or HMO setting
Must be computer literate, with expertise in Outlook, Word, Excel, PowerPoint
Excellent time management and priority-setting skills
Strong verbal and written communication skills
Registered Nurse (RN) - Active, current and unrestricted California License

Job Responsibility

Facilitates, coordinates, and approves medically necessary referrals that meet established criteria
Assures timely and accurate determination and notification of referrals and reconsiderations
Generates approval, modification and denial communications
Actively monitors for admissions in any inpatient setting
Performs telephonic and/or onsite admission and concurrent review
Collaborates with onsite staff, physicians, providers, member/family to develop and implement a successful discharge plan
Works with the UM Manager and Physician Advisor on case reviews
Monitors and oversees the collection and transfer of data (medical records) and referral requests by Providers
Acts as a department resource for medical service requests /referral management and processes
Receives incoming calls from providers, professionally handles complex calls

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Appeals and Grievances Nurse Specialist RN II

The Appeals and Grievances (A&G) Nurse Specialist Registered Nurse (RN) II provi...

Location

United States , Los Angeles

Salary:

88854.00 - 142166.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Associate's Degree in Nursing
At least 5 years of experience in Clinical RN
At least 2 years in Medicare/ Medicaid in a managed care/ health plan environment
Excellent interpersonal and communication skills
Computer literacy and adaptability to computer learning
Time management and priority setting skills
Must be organized and a team player
Able to work effectively with various internal departments/service areas, L.A. Care's plan partners, participating provider groups, and other external agencies
Good working knowledge of regulatory requirements/standards
Registered Nurse (RN) - Active, current and unrestricted California License

Job Responsibility

Conducts intake/triage and appropriate classification of Clinical A&G, and Pharmacy requests and makes accurate judgment on appeal, grievance, Provider Claim Disputes, medical records or other issues and follows procedures on how to handle each type of request and route to the appropriate area within the department
Investigation, and resolution of clinical member complaints (grievances/appeals) utilizing all regulatory requirements
Investigation, and resolution of clinical Provider Complaints/ Provider Data Resolution (PDR) (grievances/appeals) utilizing regulatory and internal guidelines and Service Level Agreement (SLA)
Identification of Expedited Cases and resolution within 72 hours
Works with the external providers and Participating Physician Group's (PPG) representatives to obtain relevant medical records and communication documentation
Prepares resolved complaint files for Centers for Medicare and Medicaid Services (CMS), DMHC, and external review organization (QIO or IRE)
Process the case thru to effectuation and final case documentation in the A&G system of record
Investigation and preparation of State Fair Hearing cases as assigned
Prepares resolved complaint files for CMS external review organization - Quality Improvement Organization (QIO) or Independent Review Entity (IRE)
Conducts reviews and presents to physicians, provider disputes which would be based on medical necessity reviews

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Lending Specialist II

We are looking for a detail-oriented Lending Specialist II to support commercial...

Location

United States , Morristown

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma or equivalent required
3–5 years of experience in a Lending Assistant, Loan Processor, or similar loan administration role
Strong verbal and written communication skills with the ability to build effective working relationships across teams and with external contacts
Demonstrated ability to apply policies, procedures, and process controls consistently, even in challenging situations
Proficiency with Microsoft Office applications and comfort using banking platforms, core systems, and loan origination tools such as nCino
Strong organizational, data entry, customer service, and time management skills in a high-volume environment with firm deadlines
Ability to manage multiple tasks simultaneously while maintaining accuracy and attention to detail
Knowledge of commercial real estate and C&I loan documentation is preferred

Job Responsibility

Oversee the progression of lending transactions by working closely with Relationship Managers and coordinating next steps with internal teams to keep closings on schedule
Organize, examine, and track closing packages and supporting materials to confirm due diligence, insurance, compliance, and operational requirements are satisfied before funding
Support transaction execution by identifying issues early, escalating concerns when needed, and helping implement practical solutions that reduce risk and maintain control standards
Request and assemble outstanding file documentation and prepare supplementary materials required to complete loan packages accurately and efficiently
Collaborate with closing, servicing, and other operations partners to confirm loans are booked correctly, accruals are balanced, and daily cash activity is reflected appropriately
Monitor funding events at closing as well as post-closing loan activity, including advances, payments, and payoffs, to ensure all items are processed and recorded properly
Review loan documents thoroughly for completeness and accuracy and complete closing activities directly when required
Keep lenders and other stakeholders informed of any matters that may affect closing readiness or transaction completion timelines

What we offer

Medical, vision, dental, and life and disability insurance
Enrollment in company 401(k) plan

Fulltime

Associate Regulatory Specialist II

Ecolab is seeking to hire an Associate Regulatory Specialist II/Engineer located...

Location

Poland , Kraków

Salary:

Not provided

Edgerton Dental Clinic

Expiration Date

Until further notice

Requirements

Bachelor’s degree in electrical/Electronics/Industrial/Mechanical or Telecommunication Engineering
2+ years of professional work experience working at a certification agency, testing lab or coordinating regulatory approvals
Able to clearly explain project status and hurdles
Experience in navigating cross functional teams to obtain results
Comfortable to perform administrative tasks like documentation collection, organizing files, and creating record documents
Project management experience
Familiar with extracting information from SAP, Excel, and Power Point
Used to work in virtual environment like Microsoft Teams and lead virtual meetings in English
Fluency in English

Job Responsibility

Lead and coordinate efforts to ensure equipment satisfies appropriate testing standards mandatory for placing in the market
Obtain Drinking Water Directive and local Drinking Water Approvals
Create and maintain equipment technical files documenting equipment regulatory compliance meeting Machine Regulation requirements
Support Packaging & Packaging Waste Regulation (PPWR) by identifying requirements through building technical files
Define equipment in scope for WEEE and report of sales data to the authorities
Collect compliance documentation from suppliers (Reach, RoHS, EU DoC, Drinking Water)
Will work in close collaboration with larger EU Team to complete projects across all divisions
Organize laboratories and product certification agencies for testing equipment

What we offer

Competitive Compensation: Attractive salary (Base pay & Variable Plan) and benefits package (private medical care, life insurance, stock purchase, lunch subsidy, sport cards)
Work-Life Balance: Flexible working arrangements with hybrid model of work (approx. 60% from the office and 40% from home)
Matrix Organization: Thrive in our matrix organization, working across Europe with various teams and cultural backgrounds
Collaborative Environment: Strong teamwork and diverse interactions
Development Opportunities: Personalized plans with rapid progression
Versatile Career Paths: Professional growth supported by active committee for different career levels
Supportive Culture: High employee satisfaction and responsive feedback
Learning and Innovation: Continuous learning and technical training incl. subject matter experts’ trainings, soft skills and management trainings and LinkedIn learning
Relocation Support: Assistance for international candidates and candidates living outside of Krakow
Social events such as family events and charity auctions

Fulltime

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Records and Data Management Specialist II

Job Description

Job Responsibility

Requirements

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