20176 management jobs found

John Hancock is currently transforming our Long Term Care business to help our customers age in place and receive the care that they need to live as independently as possible. This team focuses on providing access to high-quality and affordable long-term care providers to our customers when they need it. The Director, Provider Network Development & Relationship Management, is responsible for leading the development, optimization, and strategic oversight of our provider network. This role is responsible for ensuring network adequacy, driving value, and fostering strong relationships with healthcare providers, network partners, and internal stakeholders. The ideal candidate brings a blend of business development, contract negotiation skills, strategic thinking, and a passion for improving healthcare access and quality across diverse populations for our long-term care policyholders. Position Responsibilities Network Strategy & Design: Lead cross-functional team to...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for City of Columbus. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Data Management Coordinator (Vacancy) Print (https://www.governmentjobs.com/careers/columbusoh/jobs/newprint/5176494) Apply  Data Management Coordinator (Vacancy) Salary $37.96 - $56.98 Hourly Location Varies by position Job Type Full-time Job Number 25-0591-V3 Department 60 Columbus Water & Power Division Office of the Public Utilities Director Opening Date 12/23/2025 Closing Date 1/7/2026 11:59 PM Eastern Description Benefits Questions...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

Job Posting Title Supply Chain Management College Co-op Job Description Summary AAM is looking for a hardworking, self-motivated individual to fill our Supply Chain Co-op position. Job Description: Support Plant Supply Chain Management team. Review and update internal reports to support consolidation of plant metrics Improve and streamline reporting process as possible Ensures the integrity of plant data and monitors all applicable reports Assists with the resolution of supplier and customer issues Run projects as they are provided by the SCM team Supports the annual physical inventory and cycle-counting processes Work closely with other departments within the organization All other duties as assigned Required Skills and Education Must be enrolled full-time in an undergraduate or graduate Supply Chain/Business Administration Program Graduation date of December 2026 or later preferred Able to work a minimum of 25 hours per week Familiarity...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Elevance Health. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Director Global Security Operations Centers/Crisis Management Location: 220 Virginia Avenue, Indianapolis, IN . This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on...

Business Overview The Private Wealth Product Management team is newly established to serve as the backbone for operational excellence across Private Wealth products and service offerings. The team oversees all operational activities required to launch, maintain, and govern these products, partnering closely with Product Development, Operations, CIO, and COO teams to ensure robust governance and seamless execution. Position Overview This role will develop, maintain, and operationalize standardized readiness playbooks that bring Private Wealth products and programs to life. You will own client-facing agreements and product related documentation, coordinate cross-functional tasks, and ensure launches and changes are precise, compliant, and repeatable. This is an excellent opportunity to learn the fundamentals of product management and gain exposure to multiple business functions within Private Wealth. Primary Responsibilities Build and maintain product readiness...

JOB REQUISITION Workday Supply Chain Management Manager LOCATION CINCINNATI ADDITIONAL LOCATION(S) INDIANAPOLIS, PRO PITTSBURGH JOB DESCRIPTION You Belong Here The Protiviti Career provides opportunity to learn, inspire, and advance within a collaborative and inclusive culture.? We hire curious individuals for whom learning is a passion. We lean into our mission: We Care. We Collaborate. We Deliver . At every level, we champion leaders who live our values of integrity, inclusion, innovation, and commitment to success . Imagining our work as a journey, we believe integrity guides our way, inclusion moves us forward together, innovation creates new destinations, and our commitment to success empowers us to deliver on our vision to be the most trusted global consulting firm. Where We Need You Protiviti is looking for a Technology Consulting Manager to join our growing Workday team . What You Can Expect As a Manager , you'll partner with our clients to solve...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

BronxWorks helps individuals and families improve their economic and social well-being. From toddlers to seniors, we feed, shelter, teach, and support our neighbors to build a stronger community. In all aspects of our work, we strive for the highest ethical and performance standards and are guided by the belief that people are to be treated with dignity and respect regardless of their present situation or past experiences. Across our 60+ locations, we provide programs in a variety of service areas, including workforce development, children, youth, families, seniors and homeless prevention. Our family shelters are safe, welcoming spaces where families can stay temporarily while they work toward long-term stability. Program staff provide compassionate support, life-enhancing services, and community-based resources to help empower each family. Together, we guide families on their journey back to independence and into permanent housing. RESPONSIBILITIES Supervise case...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

We continually strive for a workforce that reflects the growing diversity within the State of Illinois. A variety of employee backgrounds, perspectives, ideas and experiences are crucial to our ability to most effectively serve the public. Bilingual skills welcome Reasonable Accommodation Statement The State of Illinois is committed to working with and providing reasonable accommodations to people with disabilities. Further, federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job, interview for a job, or for any other activity related to the hiring process. Examples of reasonable accommodation include, but are not limited to, making a change to the application process (if possible), providing documents in an alternate format, using a sign language interpreter, or using specialized equipment. To be provided a Reasonable Accommodation during...

Introduction If you are looking for an exciting career with great benefits, pension, generous leave, competitive salary, and the opportunity for advancement and professional growth, apply to join the DPSCS team today! The Department of Public Safety and Correctional Services (DPSCS) is seeking dedicated candidates to fill important roles within our department. We are one of the largest departments in Maryland with nearly 12,000 employees and a budget of more than $1 billion. In order to fulfill our mission of promoting safety, we have increased security at our institutions while leading the way in innovative restorative justice projects that will help offenders reintegrate into society upon release. As a member of the DPSCS team, you can have a fulfilling career, while also enjoying a wide range of benefits such as medical and dental coverage, paid time off (i.e. vacation, sick leave), becoming vested in the State pension, supplemental retirement options, and even...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

JOB REQUISITION Workday Supply Chain Management Manager LOCATION CHICAGO ADDITIONAL LOCATION(S) ATLANTA - PEACHTREE RD, DALLAS, DENVER, HOUSTON, PHOENIX, WASHINGTON DC - MCLEAN JOB DESCRIPTION You Belong Here The Protiviti Career provides opportunity to learn, inspire, and advance within a collaborative and inclusive culture.? We hire curious individuals for whom learning is a passion. We lean into our mission: We Care. We Collaborate. We Deliver . At every level, we champion leaders who live our values of integrity, inclusion, innovation, and commitment to success . Imagining our work as a journey, we believe integrity guides our way, inclusion moves us forward together, innovation creates new destinations, and our commitment to success empowers us to deliver on our vision to be the most trusted global consulting firm. Where We Need You Protiviti is looking for a Technology Consulting Manager to join our growing Workday team . What You Can Expect As a...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

NY HELP Yes Agency Mental Health, Office of Title Health Facility Management Assistant (NY HELPS), Creedmoor Psychiatric Center, P26042 Occupational Category Health Care, Human/Social Services Salary Grade 18 Bargaining Unit PS&T - Professional, Scientific, and Technical (PEF) Salary Range From $66951 to $85138 Annually Employment Type Full-Time Appointment Type Contingent Permanent Jurisdictional Class Non-competitive Class Travel Percentage 0% Workweek Mon-Fri Hours Per Week 40 Workday From 6 AM To 6 PM Flextime allowed? No Mandatory overtime? No Compressed workweek allowed? No Telecommuting allowed? No County Queens Street Address Creedmoor Psychiatric Center 79-25 Winchester Blvd. City Queens Village State NY Zip Code 11427 Duties Description Do you have experience in administration in a health-related facility? Creedmoor Psychiatric Center is recruiting for a Health Facility Management Assistant to assist in the review...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

Quality Assurance/Risk Management Specialist Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5178153) Apply ? Quality Assurance/Risk Management Specialist Salary $59,345.00 - $90,211.00 Annually Location Lackawanna County, PA Job Type Civil Service Permanent Full-Time Job Number CS-2025-38966-43393 Department Department of Military & Veterans Affairs Division MV Comdnts Off Gjmvc Opening Date 12/29/2025 Closing Date 1/12/2026 11:59 PM Eastern Job Code 43393 Position Number 00277473 Union Non Union Bargaining Unit A3 Pay Group ST07 Bureau / Division Code 00134700 Bureau / Division Gino J. Merli Veterans' Center Worksite Address 401 Penn Avenue City Scranton, Pennsylvania Zip Code 18503 Contact Name Patti Ziminskas Contact Phone 570.961.4306 Contact Email paziminska@pa.gov Description Benefits Questions THE POSITION Help us honor those who served by...