54 jobs found

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...

Become a part of our caring community and help us put health first Are you a transitioning military service member or a military spouse looking for an internship that supports the goal to put health first? The DOW SkillBridge Internship and Military Spouse Fellowship Programs will provide you with key training to perform your internship. You will partner with your team to support members, projects, and to meet goals impacting business outcomes. The professionals you work with at Humana will depend on the type of internship you select. They may include healthcare professionals, HR, and IT, to name a few. The objective is to support and facilitate care for members. To be eligible for this internship, you must either be a transitioning military service member or a military spouse, and you must obtain eligibility to participate in these DOW sponsored programs. The Utilization Management Behavioral Health Registered Nurse (RN) Intern will report to a manager of the National...

Job Description The Executive Director of Capital Planning and Project Management is responsible for leading the strategic planning, design, and execution of both capital construction initiatives and enterprise-wide business transformation projects. This position ensures the successful delivery of infrastructure and organizational initiatives that align with institutional goals, regulatory standards, and operational efficiency. This position reports to the Vice President for Finance & Administration. Key Responsibilities: Capital Planning, Design, and Construction Direct and manage the formulation and execution of strategic capital projects aligned with institutional priorities Supervise 3 direct reports: 2 x Architects/Project Managers and 1 x Office Assistant Manage the creation of feasibility and engineering studies Oversee architectural and engineering design processes, ensuring compliance with state laws and policies, relevant codes, and institutional...

Dynamic Opportunity: Corporate Director of Revenue Management at Gibson Hotel Management Inc. - Drive Financial Success Today! Now Hiring: Corporate Revenue Manager 📍 Location: Gibson Hotel Management, Inc. (GHMI) Corporate Office 💼 Department: Sales & Revenue Management 🕰️ Full Time | Exempt | Salaried Are you a data-driven strategist with a passion for maximizing hotel revenue and performance? Gibson Hotel Management, Inc. is looking for a Corporate Director of Revenue Management to join our dynamic team and help drive financial success across a diverse hotel portfolio. As Corporate Director of Revenue Management, you will work directly with our VP of Sales and Marketing to support assigned properties through weekly revenue calls, forecasting, and strategic consultation. This high-impact role requires sharp analytical skills, strong communication abilities, and a collaborative mindset. Benefits to include:  Health Insurance Vision Insurance...

Clinical Quality Management Program Manager (Part-time) Fully Remote-United States Job Type Part-time Description Overview Tanaq Management Services (TMS) delivers professional, scientific, and technical services and information technology (IT) solutions to federal agencies in health, agriculture, technology, and other government services. TMS is a subsidiary of the St. George Tanaq Corporation, an Alaskan Native Corporation (ANC) committed to serving Federal customers while also giving back to the Tanaq native community and shareholders. About the Role We are seeking a part-time Clinical Quality Management Program Manager to serve as the primary point of contact for all contractual, technical, and administrative matters supporting the Clinical Quality Management (CQM) Program at the Defense Health Agency (DHA). The Clinical Quality Management Program Manager will provide day-to-day leadership, planning, coordination, and oversight of project staff and...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: Use most up to date job description. To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo...

Intern - Service Delivery ManagementRemote - United StatesJR012789 At Ensono, our Purpose is to be a relentless ally, disrupting the status quo and unleashing our clients to Do Great Things! We enable our clients to achieve key business outcomes that reshape how our world runs. As an expert technology adviser and managed service provider with cross-platform certifications, Ensono empowers our clients to keep up with continuous change and embrace innovation. We can Do Great Things because we have great Associates. The Ensono Core Values unify our diverse talents and are woven into how we do business. These five traits are the key to achieving our purpose: Honesty, Reliability, Collaboration, Curiosity, Passion About the role and what you'll be doing: We are looking for potential participants for our 2026 Summer Internship Program and are excited to invite driven and self-motivated candidates to apply! Ensono is dedicated to cultivating talented individuals with...

Sector Knowledge and Expertise: Demonstrates a clear understanding of client’s business, its objectives, strategy and industry where they operate. Supports the Portfolio Leader in the development of portfolio/sector strategy. Demonstrates a strong knowledge of BPO and Technical Services associated with their allocated accounts and industry sector. Leverages expertise and communication skills to speak at forums both internally and externally. Account Management and Business Growth: Builds and maintains strong, long-term relationships with assigned clients. These relationships should reflect coverage of the client’s comprehensive buyer personas, including but not limited to the CIO, CMO, CTO and CXO ensuring a partnership charter with their team. Develops sustainable and profitable strategic account plan that addresses whitespace planning, cross-selling and up-selling opportunities and incorporates the full extent of Concentrix services. Ensures Financial KPIs...

Location: Knoxville, TN Open Date Aug 1, 2025 Description The Department of Biosystems Engineering & Soil Science (BESS) at the University of Tennessee https://bess.tennessee.edu/ invites applications for a tenure-track faculty position at the rank of Assistant or Associate Professor (12-month appointment; 75% teaching/25% Extension). The responsibilities of this position include delivering coursework in the pre-construction curriculum within the Construction Science and Management Program and developing an outreach program in stormwater management with a focus on construction site applications. Housed in BESS, the Construction Science and Management Program, which began in 2010, has an undergraduate population of approximately 390 students and has a short-term goal of increasing the student numbers to 400. This program has become nationally recognized for providing graduates with the background and critical thinking skills needed to contribute to the construction...

Data Center Infrastructure Management InternRemote - United StatesJR012791 At Ensono, our Purpose is to be a relentless ally, disrupting the status quo and unleashing our clients to Do Great Things! We enable our clients to achieve key business outcomes that reshape how our world runs. As an expert technology adviser and managed service provider with cross-platform certifications, Ensono empowers our clients to keep up with continuous change and embrace innovation. We can Do Great Things because we have great Associates. The Ensono Core Values unify our diverse talents and are woven into how we do business. These five traits are the key to achieving our purpose: Honesty, Reliability, Collaboration, Curiosity, Passion About the role and what you'll be doing: We are looking for potential participants for our 2026 Summer Internship Program and are excited to invite driven and self-motivated candidates to apply! Ensono is dedicated to cultivating talented individuals...

ERP Federal Financial Management Analyst (Sr.) - U.S. Citizenship Required Category: ERP/CRM/Tools Main location: United States, Virginia, Fairfax Alternate Location(s): United States, Louisiana, Lafayette United States, Virginia, Lebanon United States, Tennessee, Knoxville Position ID: J0326-1042 Employment Type: Full Time U.S. - CGI Federal roles - What we do matters (https://youtu.be/cT09CQZNzt4) By playing this video you consent to Google/YouTube processing your data and using cookies -Learn more (xweb.asp?clid=21001&page=cookiespolicy#integrationofyoutube) . Position Description: CGI is seeking an experienced ERP Federal Financial Management Analyst with expertise in federal financial management to join our team. The ideal candidate will have a deep understanding of federal financial processes and regulations and will play a key role in analyzing, documenting, and improving financial management systems and practices. The successful...

Job Description We are seeking a dynamic and results driven Senior Manager to lead and develop a high-performing team while driving strategic initiatives that align with our organizational goals. This role requires a strong leader with expertise in change management financial accountability for a portion of revenue and/or margin, excellent communication skills, and a passion for fostering collaboration and innovation. If you thrive in a fast-paced environment excel and managing budgets and resources and are committed to driving operational and financial success, we invite you to join our team. To be successful in this role: Ability to motivate, coach and develop team members Experience in building a high-performing team and fostering collaborative culture Strong decision-making and problem-solving skills Proven ability to set goals, measure progress and drive results Experience in revenue and/or margin management, resource allocation, and...

The Manager, Digital Solutions Account Management is a foundational leader within FedEx’s Digital Portfolio, responsible for building and scaling a new Account Management function from the ground up. In this highly strategic, customer-facing role, you will establish the playbook, hire and develop a high-performing team, and ensure our Healthcare and B2B enterprise customers realize the full value of FedEx Digital Solutions. Your mandate is to drive long-term customer success, retention, and expansion while creating a culture of accountability, collaboration, and innovation. Essential Functions: Build and scale a world-class Account Management team through recruiting, onboarding, coaching, and performance management. Design and implement account management frameworks (e.g., renewal playbooks, QBR processes, customer success metrics) to drive retention and growth. Develop trusted relationships with C-level executives and key stakeholders at enterprise customers, acting as...

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 Actalent. 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. Job Title: Assistant Project Management Job Description The Project Management Assistant plays a vital role in supporting the project management team by coordinating schedules, tracking material and logistical needs, facilitating communication with subcontractors, and assisting with documentation and reporting. This role ensures that daily project activities run efficiently and align with project timelines and quality expectations. Responsibilities Assist with material...

About the Role The Project Management Coordinator provides administrativesupport to the project management team leading construction projects. Duties include project documentationpreparation, escalation for commitment, invoice & pay applicationprocessing, and financial reconciliations. This job is part of the Project Management function responsiblefor the management of projects from initiation through completion. The PMCoordinator will play a key role implementing vendor invoicing in our EnterpriseResource Planning (ERP) platform. What You'll Do Process vendorinvoicing in D365 business platform. Assist the project closeoutprocess including turnover documentation and financial reconciliation. Process documentation forproject commitments. Obtain external quotes for processing. Coordinate change orders,change directives and contemplative change notices with consultants andvendors. Schedule meetings andcommunication plans regarding projects amongst teams and...

Southwest Tennessee Community College is a comprehensive, multicultural, public, open-access college. Southwest has four campuses/centers from which it offers over 100 programs and over 20 technical certificate programs. We foster student success, transform lives, and increase the educational level of a growing community in Shelby County. Southwest is a Tennessee Board of Regents institution, accredited by the Commission on Colleges of the Southern Association of Colleges and Schools. We invite you to become a part of the Southwest Team! Title: Adjunct Faculty Pool - Athletic Training Employee Classification: Faculty Institution: Southwest Tennessee Community College Department: Social and Behavioral Sciences Campus Location: STCC - Multiple Campus Locations Job Summary This is a part-time, Adjunct Faculty position in the Social and Behavioral Sciences Department. THIS POSTING IS NOT A GUARANTEE OF AN OPEN POSITION....

Southwest Tennessee Community College is a comprehensive, multicultural, public, open-access college. Southwest has four campuses/centers from which it offers over 100 programs and over 20 technical certificate programs. We foster student success, transform lives, and increase the educational level of a growing community in Shelby County. Southwest is a Tennessee Board of Regents institution, accredited by the Commission on Colleges of the Southern Association of Colleges and Schools. We invite you to become a part of the Southwest Team! Title: Adjunct Faculty Pool - Hospitality Management (Culinary) Employee Classification: Faculty Institution: Southwest Tennessee Community College Department: Business and Legal Studies Campus Location: STCC - Multiple Campus Locations Job Summary This is a part-time, Adjunct Faculty position in the Business and Legal Studies Department. THIS POSTING IS NOT A GUARANTEE OF AN OPEN POSITION....

Job Title: Technical Project Management Support Location: Arnold AFB, Tullahoma, TN Canvas is seeking a qualified individual to provide advisory and assistance services to the Air Force in engineering support of program management efforts associated with specific test needs at the Arnold Engineering Development Center (AEDC) at Arnold AFB, TN. The candidate will provide a wide range of services including procurement support, contract administration assistance, and records management/administrative support, as well as supporting virtually any and all aspects of various projects, planned or underway. Duties: Provide technical and engineering support including, but not limited to, the following: Develop Technical Requirements for capital improvement efforts and procurements Review and Evaluate Procurement Packages for technical soundness Make recommendations for best technical COAs(Course of Action) Provide procurement support including, but not limited 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 CoreCivic. 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. At CoreCivic, our employees are driven by a deep sense of service, high standards of professionalism and a responsibility to better the public good. CoreCivic is currently seeking a Director, Energy Management . Come join a team that is dedicated to making an impact for the people and communities we serve. This is a hybrid position requiring 3days onsite in Brentwood, TN. The Director, Energy Management provides primary leadership in managing utility related activities...

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 UnitedHealth Group. 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. UnitedHealth Group is a health care and well-being company that's dedicated to improving the health outcomes of millions around the world. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a team that shares your passion for helping others. Join us to start Caring....

Requisition ID: 292556 Relocation Authorized: National/International - Family Telework Type: Full-Time Office/Project Work Location: Oak Ridge, TN, Knoxville, TN, Ogden, UT, Reston, VA, Richland, WA Extraordinary teams building inspiring projects: Since 1898, we have helped customers complete more than 25,000 projects in 160 countries on all seven continents that have created jobs, grown economies, improved the resiliency of the world's infrastructure, increased access to energy, resources, and vital services, and made the world a safer, cleaner place. Differentiated by the quality of our people and our relentless drive to deliver the most successful outcomes, we align our capabilities to our customers' objectives to create a lasting positive impact. We serve the Infrastructure; Nuclear, Security & Environmental; Energy; Mining & Metals, and the Manufacturing and Technology markets. Our services span from initial planning and investment,...

Dentsply Sirona is the world’s largest manufacturer of professional dental products and technologies, with a 130-year history of innovation and service to the dental industry and patients worldwide. Dentsply Sirona develops, manufactures, and markets a comprehensive solutions offering including dental and oral health products as well as other consumable medical devices under a strong portfolio of world class brands. Dentsply Sirona’s products provide innovative, high-quality and effective solutions to advance patient care and deliver better and safer dentistry. Dentsply Sirona’s global headquarters is located in Charlotte, North Carolina. The company’s shares are listed in the United States on NASDAQ under the symbol XRAY. This position is located in Johnson City which is the largest city in the Tri-Cities area, located in the north eastern region of Tennessee at the foothills of the Appalachian Mountains. The city is a growing metropolis with invigorating music, enchanting...

Southwest Tennessee Community College is a comprehensive, multicultural, public, open—access college. Southwest has four campuses/centers from which it offers over 100 programs and over 20 technical certificate programs. We foster student success, transform lives, and increase the educational level of a growing community in Shelby County. Southwest is a Tennessee Board of Regents institution, accredited by the Commission on Colleges of the Southern Association of Colleges and Schools. We invite you to become a part of the Southwest Team! Title: Adjunct Faculty Pool – Athletic Training Employee Classification: Faculty Institution: Southwest Tennessee Community College Department: Social and Behavioral Sciences Campus Location: STCC - Multiple Campus Locations Job Summary This is a part-time, Adjunct Faculty position in the Social and Behavioral Sciences Department. THIS POSTING IS NOT A GUARANTEE OF AN OPEN POSITION. Applications for part-time faculty...

Location: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. PLEASE NOTE: This position is not eligible for current or future visa sponsorship. Carebridge Health is a proud member of the Elevance Health family of companies within our Carelon business. Carebridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through home care...