-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Boise, US-ID
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:32
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Tallahassee, US-FL
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:32
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Atlanta, US-GA
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:29
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Savannah, US-GA
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:26
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Jacksonville, US-FL
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:25
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Dover, US-DE
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:24
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Tampa, US-FL
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:24
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Miami, US-FL
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:23
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Hartford, US-CT
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:20
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Bridgeport, US-CT
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:19
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Wilmington, US-DE
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:19
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Colorado Springs, US-CO
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:18
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Denver, US-CO
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:17
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: San Francisco, US-CA
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:17
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Sacramento, US-CA
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:16
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Little Rock, US-AR
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:15
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Los Angeles, US-CA
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:13
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Fort Smith, US-AR
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:10
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: San Diego, US-CA
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:10
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Phoenix, US-AZ
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:09
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Tucson, US-AZ
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:08
-
Essential Duties and Responsibilities:
- Collaborate with project staff, client office personnel, and community agencies to address and resolve project-related issues effectively.
- Deliver public speaking sessions and educational programs to community agencies and local office staff.
- Engage actively in community health fairs and conduct group presentations aligned with the project's promotion.
- Report concerns, problems, and issues to the Leadership promptly.
- Supervise and oversee the activities of Outreach Client Service Representatives.
- Maintain a professional demeanor representing the organization and advocating for the program.
- Distribute program materials to diverse community groups.
- Exceed established performance objectives while ensuring compliance with company Wage & Hour policies, including the provision of rest and meal breaks for non-exempt employees.
- Adhere strictly to all company policies, procedures, and mandated training.
Additional Essential Duties and Responsibilities:
- Peer Support and Counseling Networks: Organize and oversee peer support networks for assigned commands; recruit active duty and family member peer support counselors; and ensure counselors are vetted and trained in accordance with USSOCOM CRC standards.
- Program Assessment and Reporting: Collect, document, and report program/service needs, activity data, and evaluation results to support formative and outcome evaluations of peer support and community-based programs.
- Data Collection: Collect original and secondary-source data to support program assessments, including information from focus groups, unit meetings, POTFF Family Resilience Program evaluations, and trend information from POTFF psychologists, chaplains, ombudsmen, or Family Readiness Group staff.
- Command Support: Support commands at multiple levels and locations; serve as the Commander's liaison for community and family support matters; and communicate on behalf of the Command using approved and vetted media or social media.
- Needs-Based Programming: Develop programming tailored to specific demographic groups, geographic locations, and identified community needs.
- Resource Expertise: Maintain extensive knowledge of DoW resources, including Military OneSource, Military Family Life Counselors, Personal Financial Counselors, and the Military Crisis Line.
- Coordination and Outreach: Lead or support CRC official processes, functions, and networking opportunities for supported populations, including family orientation, information, outreach, referrals, deployment preparation, reintegration, decompression, and family relational enhancement activities.
- Service Member and Family Programs: Conduct or contribute to single Service member enhancement activities and unit-level career transition programs for military members and spouses.
- Resilience and Behavioral Health Awareness: Conduct or contribute to Social and Family and Psychological Program implementation, includi...
....Read more...
Type: Permanent Location: Rock Springs, US-WY
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:08
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Birmingham, US-AL
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:07
-
Essential Duties and Responsibilities:
- Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations.
- Render medical necessity determinations for Medicare State East cases assigned.
- Resolve all other technical issues within Medicare reconsideration assigned.
- Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
- May perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Be the Subject Matter Expert (SME) for project.
- Perform other duties as assigned by management.
- Demonstrated skill in understanding diagnoses to assist clients in optimizing their level of function and self-care.
- Demonstrated knowledge of client education principles and the management of complex medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff.
- Knowledge and skills in the use of VA/DoW Clinical Practice Guidelines to support an evidence based, standardized process of care for military beneficiaries.
- Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources.
- Skill in the use of research tools to critically evaluate existing practices, opportunities, and outcomes.
- Knowledge of pharmaceuticals, including desired effects, side effects, and complications, to gauge their effect on clients and recovery.
- Knowledge of community resources, client entitlement and benefit eligibility, and the ability to access these resources to assist clients and families in optimizing function and self-care.
- Use of pre-established utilization and review criteria, and the ability to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance.
- Use of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to stakeholders.
- Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings.
Minimum Requirements
- Bachelor's degree with 5-7 years of experience consulting within designated function.
- Advanced degree preferred.
- Develop solutions to highly complex problems which require a high degree of ingenuity and innovation.
- Ensure solutions are consistent with organization objectives.
- Solutions may serve as precedent for future decisions.
- Develop advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills.
- Develop new applications based on professional principles and theories.
- Viewed as exp...
....Read more...
Type: Permanent Location: Mobile, US-AL
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:06
-
Essential Duties and Responsibilities:
- Collaborate with project staff, client office personnel, and community agencies to address and resolve project-related issues effectively.
- Deliver public speaking sessions and educational programs to community agencies and local office staff.
- Engage actively in community health fairs and conduct group presentations aligned with the project's promotion.
- Report concerns, problems, and issues to the Leadership promptly.
- Supervise and oversee the activities of Outreach Client Service Representatives.
- Maintain a professional demeanor representing the organization and advocating for the program.
- Distribute program materials to diverse community groups.
- Exceed established performance objectives while ensuring compliance with company Wage & Hour policies, including the provision of rest and meal breaks for non-exempt employees.
- Adhere strictly to all company policies, procedures, and mandated training.
Additional Essential Duties and Responsibilities:
- Peer Support and Counseling Networks: Organize and oversee peer support networks for assigned commands; recruit active duty and family member peer support counselors; and ensure counselors are vetted and trained in accordance with USSOCOM CRC standards.
- Program Assessment and Reporting: Collect, document, and report program/service needs, activity data, and evaluation results to support formative and outcome evaluations of peer support and community-based programs.
- Data Collection: Collect original and secondary-source data to support program assessments, including information from focus groups, unit meetings, POTFF Family Resilience Program evaluations, and trend information from POTFF psychologists, chaplains, ombudsmen, or Family Readiness Group staff.
- Command Support: Support commands at multiple levels and locations; serve as the Commander's liaison for community and family support matters; and communicate on behalf of the Command using approved and vetted media or social media.
- Needs-Based Programming: Develop programming tailored to specific demographic groups, geographic locations, and identified community needs.
- Resource Expertise: Maintain extensive knowledge of DoW resources, including Military OneSource, Military Family Life Counselors, Personal Financial Counselors, and the Military Crisis Line.
- Coordination and Outreach: Lead or support CRC official processes, functions, and networking opportunities for supported populations, including family orientation, information, outreach, referrals, deployment preparation, reintegration, decompression, and family relational enhancement activities.
- Service Member and Family Programs: Conduct or contribute to single Service member enhancement activities and unit-level career transition programs for military members and spouses.
- Resilience and Behavioral Health Awareness: Conduct or contribute to Social and Family and Psychological Program implementation, includi...
....Read more...
Type: Permanent Location: Cheyenne, US-WY
Salary / Rate: Not Specified
Posted: 2026-08-05 10:09:06
