Utilization Management Specialist

Join our team as a Utilization Management Specialist where you'll play a crucial role in ensuring efficient utilization of healthcare resources. In this position, you will assess medical necessity, review treatment plans, and collaborate with healthcare providers to optimize patient care.

Join our dynamic team as a Utilization Management Professional, where you will play a vital role in ensuring the effective use of healthcare resources. Your expertise will contribute to improving patient outcomes while optimizing operational efficiency.As a key member of our organization, you will engage with healthcare providers and patients to assess the appropriateness of medical services, collaborating to develop care plans that align with best practices. Your analytical skills will be essential in evaluating treatment requests and implementing utilization review processes.

Join Integrated Resources Inc. as a Utilization Management Professional in Miami, where your expertise will play a pivotal role in optimizing patient care and resource utilization. In this dynamic position, you will collaborate with healthcare providers to ensure that patients receive appropriate services while maintaining cost-effectiveness.As a key member of our team, you will be responsible for conducting reviews, developing care plans, and making recommendations that align with health guidelines and protocols. Your analytical skills and understanding of healthcare regulations will be essential in making informed decisions that benefit our clients and enhance patient outcomes.

Join our dynamic team at Integrated Resources, Inc. as a Utilization Management Professional. In this pivotal role, you will oversee and facilitate the effective utilization of healthcare services, ensuring that patients receive the highest quality care while managing costs efficiently.As a Utilization Management Professional, you will be responsible for reviewing clinical information, making informed decisions regarding patient care, and collaborating with healthcare providers to optimize treatment plans. Your expertise will play a crucial role in enhancing patient outcomes and ensuring compliance with regulatory standards.

Join our dynamic team at Integrated Resources, Inc. as a Data Management Specialist. In this pivotal role, you will be responsible for overseeing data processes, ensuring data integrity, and assisting in the development of data management strategies. Your expertise will help streamline our operations and enhance data-driven decision-making.

Join Integrated Resources, Inc. as a Data Management Specialist where your expertise will play a crucial role in optimizing our data operations. In this position, you will oversee the integrity and security of our data systems, ensuring that they are efficient and accurate.Your responsibilities will include analyzing and managing data flow, implementing data governance protocols, and collaborating with cross-functional teams to enhance data utilization.

Join our dynamic team at Integrated Resources Inc. as a Data Management Specialist. In this role, you will be responsible for managing and maintaining data integrity across various platforms. You will collaborate with cross-functional teams to ensure data is accurate, accessible, and secure. Your analytical skills will be vital in identifying trends and insights that will drive business decisions.

Kaseya is hiring a Renewal Specialist in Miami, FL. This role centers on managing customer renewals and supporting ongoing client relationships. The position plays a key part in ensuring customers remain satisfied and continue to use Kaseya’s technology solutions. Role overview The Renewal Specialist handles the full renewal process, working directly with clients to maintain and extend their contracts. Regular communication and attentive support are essential to help customers get the most from Kaseya’s offerings. What you will do Coordinate and manage customer renewal activities Communicate proactively with clients to address questions and concerns Support customers in using Kaseya’s technology solutions effectively Build and maintain strong, long-term client relationships

About UsNubank stands as one of the largest digital financial platforms globally, boasting over 122 million customers across Brazil, Mexico, and Colombia. Committed to our mission of combating complexity and empowering individuals, we are transforming the financial services landscape in Latin America. And this is only the beginning of the vibrant future we are creating.As a publicly traded company on the New York Stock Exchange (NYSE: NU), we leverage proprietary technology, data intelligence, and a streamlined operational model to provide financial products that are straightforward, accessible, and human-centric.Our impact is acknowledged by prestigious global rankings such as Time 100 Companies, Fast Company’s Most Innovative Companies, and Forbes World’s Best Bank. For more details, visit our careers page at https://international.nubank.com.br/careers/.About the Team:At Nubank, we view Compliance as a strategic partner rather than a mere checkpoint. We believe that effective Risk Management and Compliance are the driving forces that sustain agility and foster rapid, responsible growth across diverse global markets. Our team collaborates closely with internal stakeholders, applying a targeted approach to address the most pertinent regulatory risks and integrating compliance directly into product design from the outset.The Global Compliance function acts as the Second Line of Defense, overseeing the comprehensive regulatory lifecycle: monitoring new regulations, advising product and technology teams, testing controls, coordinating regulatory inspections, and ensuring the effective resolution of regulatory issues.Your Responsibilities:Provide independent guidance to business partners on new product initiatives, marketing strategies, servicing processes, and systems implementations to identify and alleviate compliance risks prior to deployment.Challenge the First Line of Defense (Business Operations, Marketing, Product) regarding the design and adequacy of compliance controls, policies, and procedures.Interpret and apply federal and state consumer protection laws to varied and intricate business scenarios, delivering actionable compliance solutions rather than mere risk flags.Evaluate the compliance and regulatory implications of internal operational occurrences (e.g., system errors, process failures, vendor issues), audit findings, and external regulatory shifts; formulate and implement remediation strategies for compliance-related challenges in collaboration with the First and Third Lines of Defense.Convert complex regulatory requirements into clear, comprehensible guidance for cross-functional teams and business leadership, ensuring alignment and understanding.

Join our dynamic team at Sonsoft Inc. as an Informatica PIM Specialist. In this vital role, you will leverage your expertise in Informatica Product Information Management (PIM) to enhance our data management processes. Collaborate with cross-functional teams to streamline product data workflows and ensure accuracy across various platforms.

Join hellogov as an AI Escalation Specialist in Miami, Florida, where you'll play a crucial role in managing and resolving complex AI-related issues. This position requires a strong understanding of artificial intelligence technologies and exceptional problem-solving skills. As part of our dynamic team, you will enhance our AI systems and ensure optimal performance, contributing significantly to our mission of providing innovative solutions.

Join CGS Federal as a Senior Data Specialist, where you will play a pivotal role in the eDiscovery department, contributing your expertise in litigation discovery processes to support a significant initiative for a Federal agency.As a member of our dynamic team, you will engage with advanced technologies to tackle government challenges, fostering innovation and collaboration.We are dedicated to creating an environment that encourages professional growth, teamwork, and a proactive approach to anticipating the needs of our clients.

Role overview The Area Health Information Specialist II at Datavant plays a key part in managing and analyzing health data. The position centers on supporting efforts to improve patient outcomes by working with healthcare providers and partner organizations. This role involves helping to ensure that health information technologies are used effectively. Collaboration with a range of stakeholders is essential for success in this position. Key responsibilities Support the management and analysis of health data. Work closely with healthcare providers and partner organizations. Promote effective use of health information technologies. Location This position is based in Miami, FL 33136.

As a Lead Health Information Specialist at Datavant, you will spearhead initiatives to optimize the management and utilization of health data. You will collaborate with cross-functional teams to ensure data integrity, compliance, and accessibility, ultimately enhancing patient care and outcomes. Your expertise will drive strategic decisions and innovations in health information systems, guiding the organization towards data-driven excellence.

About UsAt Perk, we are revolutionizing travel and expense management through our innovative platform. Our mission is to eliminate the burdensome manual tasks that hinder productivity, allowing organizations to focus on what truly matters. By automating travel bookings, expense tracking, and invoice processing, we are committed to enhancing productivity and fostering innovation in the workplace.With over 10,000 satisfied clients, including renowned companies like Wise, On Running, Breitling, and Fabletics, we are addressing the staggering $1.7 trillion problem of lost productivity caused by shadow work. Founded in 2015, Perk has expanded globally with more than 1,800 employees across 12 offices, including our headquarters in London and Boston. We pride ourselves on our values of ownership, delivering excellence, and teamwork. Join us in transforming the work experience for millions around the globe.To learn more, visit www.perk.com.

About UsAt Perk, formerly known as TravelPerk, we have revolutionized travel and spend management through our innovative platform. Our solutions are designed to streamline labor-intensive tasks—from travel bookings to expense management and invoice processing—empowering businesses to focus on what truly matters. Our mission is to eliminate inefficiencies that hinder productivity, boost morale, and drive innovation, ultimately enabling real work with meaningful impact.We proudly serve over 10,000 companies globally, including renowned brands such as Wise, On Running, Breitling, and Fabletics, addressing the staggering issue of lost productivity—7 hours per employee each week—resulting in a $1.7 trillion challenge.Founded in 2015, Perk has evolved into a global entity with a workforce of more than 1,800 across 12 offices, with our headquarters situated in London and Boston. Our approach marries innovation, control, and simplicity to transform workplace dynamics and enhance employee satisfaction.Driven by core values such as ownership, delivering a 7-star customer experience, and fostering teamwork, we prioritize curiosity, purpose, and mindset over mere knowledge. Our diverse talent pool spans over 70 countries, bringing together the brightest minds in the travel and SaaS sectors. If you are passionate about making a significant impact and enhancing the work experience for millions, we invite you to join our team.Explore more at www.perk.com.

We are seeking a highly motivated and detail-oriented Implementation Specialist to join our dynamic team at Firm Pilot A Law Firm Marketing. As an Implementation Specialist, you will play a crucial role in ensuring our clients successfully adopt our innovative marketing solutions. Your expertise will help guide clients through the implementation process, ensuring they achieve optimal results.

Job OverviewAs a Compliance Operations Specialist at CashQ, you will play a crucial role in facilitating the onboarding process for our customers and partners.Key Responsibilities:Execute KYC onboarding processes for clients and partners, ensuring all documentation is complete, accurate, and legitimate.Utilize various systems, databases, and online resources for thorough research pertinent to investigations.Detect red flags and suspicious activities, analyze patterns, and propose effective solutions.Conduct checks for sanctions, Politically Exposed Persons (PEP), and adverse media.Perform both basic and enhanced KYC due diligence for new and existing clients.Stay informed on relevant BSA and OFAC laws and regulations.Collaborate with internal teams to update KYC/AML policies and procedures.Effectively escalate compliance issues to management as necessary.Implement policies and procedures to ensure regulatory compliance.

As a proud partner of the Leavitt Group, FBMC is looking to enrich our team with a talented Benefits Education Specialist at our client site, Jackson Health Systems, located in beautiful Miami, FL.With a legacy spanning over 40 years, FBMC is dedicated to providing employees with affordable, top-notch benefits. Our commitment to fostering strong relationships with clients, delivering outstanding service, and contributing positively to the communities we serve reflects our core values of integrity, collaboration, and a shared vision for a secure and thriving future.Position OverviewThe Benefits Education Specialist (BES) is instrumental in offering premium support to client employees by facilitating personalized benefits education sessions, both virtually and in person. You will empower employees to comprehend their core and voluntary benefits options, support their decision-making process, and ensure precise and compliant enrollment procedures.This position suits individuals who relish the opportunity to educate others, excel in dynamic environments, and are driven to assist individuals in making significant financial and healthcare choices.Key ResponsibilitiesConduct personalized benefit education and review sessions utilizing employer-provided census data.Educate and guide employees on core and voluntary benefit options while ensuring compliance with all licensure and regulatory mandates.Manage inbound inquiries and perform outbound follow-ups related to benefits education and enrollment.Diligently document and process employee enrollment selections.Identify and escalate complex issues or concerns as necessary.Assist with annual open enrollment activities, including extended hours or travel as required.Maintain active insurance licensure (when applicable).Execute additional duties as assigned to further team and organizational objectives.QualificationsWe are looking for an individual who possesses a blend of strong technical expertise and exceptional interpersonal communication skills. The ideal candidate will demonstrate:Adaptability and willingness to learn.Outstanding verbal and written communication abilities.Exceptional customer service and consultative skills.

Join our dynamic team as a Medical Billing Specialist. In this pivotal role, you will manage billing processes, ensuring accuracy and compliance with healthcare regulations. Your expertise will contribute to the financial health of our organization, while providing top-notch service to our clients.