Jobs in Summit Illinois Remote
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Salary: $95,000
- $120,000 per year A bit about us: Decades-old US metals manufacturer offering terrific long-term stability, great team, and strong benefits.
If you are an experienced Reliability Engineer with a metals manufacturing background, please read on….
Why join us? $95K
- $120K Excellent benefits package Accelerated Career Growth! Great leadership and long-term stability Job Details Job Details: We are seeking a dynamic and experienced Reliability Engineer to join our team in the metals manufacturing industry.
This role will play a crucial part in ensuring the reliability and robustness of our manufacturing processes and products.
As a Reliability Engineer, you will be responsible for analyzing the performance of the manufacturing system, identifying issues, and implementing improvements.
You will be working in a fast-paced, high-tech environment where the work you do will directly impact the quality and reliability of our products.
Responsibilities: 1.
Conduct detailed failure analysis and root cause analysis on failed components, using statistical tools and methodologies.
2.
Develop and implement Failure Mode and Effects Analysis (FMEA) to identify potential failure modes, their causes, and their effects on the performance of the manufacturing system.
3.
Propose and implement process improvements to enhance product reliability and reduce manufacturing defects.
4.
Drive continuous improvement initiatives to increase efficiency, reduce costs, and improve the quality of products.
5.
Collaborate with cross-functional teams to ensure that the manufacturing process meets the required reliability standards.
6.
Develop and implement maintenance strategies and procedures to ensure the reliability of manufacturing equipment.
7.
Use AutoCAD to design, test, and validate manufacturing processes and equipment.
8.
Train and mentor junior engineers and technicians on reliability engineering principles and practices.
Qualifications: 1.
Bachelor's degree in Mechanical Engineering or a related field.
2.
A minimum of 5 years of experience in reliability engineering in the metals manufacturing industry.
3.
Proficient in root cause analysis, failure mode and effects analysis (FMEA), and process improvement methodologies.
4.
Strong knowledge of mechanical engineering principles and practices.
5.
Hands-on experience with AutoCAD or similar CAD software.
6.
Demonstrated ability to drive continuous improvement initiatives.
7.
Excellent problem-solving skills and attention to detail.
8.
Strong communication and teamwork skills.
9.
Ability to work in a fast-paced, high-pressure environment.
10.
Certified Reliability Engineer (CRE) or Certified Maintenance and Reliability Professional (CMRP) certification is a plus.
Join us and be a part of a team that works together to ensure the reliability and robustness of our manufacturing processes and products.
If you are passionate about reliability engineering and looking for a challenging role in the manufacturing industry, we would love to hear from you.
Interested in hearing more? Easy Apply now by clicking the "Apply Now" button.
Jobot is an Equal Opportunity Employer.
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- 5:00pm Monday
- Friday EST Post-training Hours: 8:00am
- 6:00pm EST, flexible shifts Transition to work from home after training with occasional office visits Responsibilities: Communicate with customers via telephone using strong communication skills, active listening, and empathy.
Drive solutions that best meet the customers needs.
Analyze and resolve complex customer issues regarding various product aspects, policy provisions, claim status, and basic procedures.
Ensure each customer experience is exceptional by leveraging effective listening skills and attention to detail.
Efficiently process transactions and refer requests for other policy modifications to appropriate areas.
Support special product and/or service campaigns as needed.
Efficiently access and navigate multiple electronic systems to provide a complete and integrated response to the customers inquiry.
Requirements: Must live within one hour commute of Warwick, RI.
Training will be in-office for a designated duration with no time off allowed during this period.
Required to work an assigned shift during hours of operation between 8:00am 6:00pm ET, Monday through Friday.
Able to work in a stationary position 75% of the time.
Strong home internet connection is required, at least 50 Mbps internet speed.
Required Skills: Suggested 2 years of experience in Customer Service; prior Call Center experience is highly preferred.
Strong computer/keyboard skills as well as analytical and problem-solving skills.
Quickly grasps information and efficiently solves verbal challenges with strategic thinking.
Communicates complex verbal and written concepts with ease.
A passion for serving customers and a personal commitment to following through in a dynamic, fast-paced environment.
Preferred Skills: High School diploma, GED, some college experience, trade, or professional certification.
A demonstrated ability to quickly learn and continuously develop functional knowledge and an understanding of company products.
Superb listening skills and professional oral & written communication skills with an ability to inspire trust and accountability.
on W2 Note: This is remote role, but may need to be onsite a few days during training Manger would like to expand the c andidate pool to include Springfield/Southern IL and Chicago/Chicagoland, IL Job Summary: · This position is responsible for discharge care coordination, episodic case management and pre-admission/post-discharge counselling for an acute condition.
· This position is responsible for handling duties in an independent manner and may assist other staff.
· Establish relationship with the member through the immediate post discharge follow-up period or until all short-term care needs are met.
· Provide education/local resource information and encourage member (self) education.
Determine case complexity and refer to other internal departments as needed.
Essential Functions: · Discharge care coordination, episodic case management and pre-admission/post discharge counselling and identification of alternate treatment options.
Consult with physicians, coordinators, and facility discharge planners to determine other resources and appropriate disposition of such cases.
· Provide education, counselling and referral to other resources to minimize re-admissions and emergency room episodes.
· Perform additional ongoing functions to support the member in the transition of care process including more than one of the following.
Consult with physicians, providers, members, and other resources, as appropriate, to assess, plan, facilitate implementation, coordinate, monitor and evaluate options and services required to meet an individual’s acute health needs, using communication and available resources to promote quality health outcomes.
Personalize outreach/engagement based upon attitudes/behaviours/risk assessment.
· Outreach to provider to coordinate the member’s care or to notify of risks/new conditions.
Reconcile, educate and monitor adherence to medication safety.
· Reinforce provider post-operative instructions for care, diet, activity level etc.
Address barriers to keeping follow-up appointments with appropriate provider and assistance with appointment scheduling.
Assistance finding a primary or specialist provider, a Client or any needed coordination with Customer Service.
Assist with getting to a provider if needed when all other options have been exhausted.
· Referral to other Client’s programs, or external resources? community-based organizations, transportation, home health etc.
Provide onsite face to face intervention in select cases.
· Education and recommendations to resolve conditions and risks, and support for behaviour change/ self-management.
Collaborate with the provider and member when appropriate to develop alternate plans of care if needed.
Assist members/providers to navigate the health care system.
· Assess cases for quality-of-care issues and refer cases to the QA/QI department for review and follow up.n.
Perform Transition of Care services for all assigned lines of business.
· Determine case complexity and may refer to Case Management/Disease Management/Enterprise Lifestyle Management department personnel as necessary.
· Practice within the Product of licensure.
Participate as preceptor for orientation of new employees.
· Maintain licensure and maintain and enhance knowledge for designated area of licensure and regulatory standards by attending seminars, training sessions, etc.
· Communicate and interact effectively and professionally with co-workers, management, customers, etc.
· Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
· Maintain complete confidentiality of company business.
Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.
Job Requirements: · Registered Nurse (RN) or Licensed Master Social Worker (LMSW) with current, active, unrestricted license in the state of operations (or reciprocity if applicable).2 years clinical experience.
1 year health insurance/managed care experience.
· Knowledge of medical management policies and procedures and database experience.
Verbal and written communication skills.
· Customer service skills and interpersonal skills to discuss pre/post admission care with physicians, hospital staff and members.
· Ability and willingness to occasionally travel within assigned location.
Possess transportation and current, valid driver’s license for applicable state.
• Ensure proper and accurate blending of customer’s formula.
• Select and route the proper fill lines from bulk tanks in the tank/gas farm.
• Drop valves manually by hand on lines where required.
• Perform weight checks regularly or at specified intervals.
• Perform product changeovers, size and height adjustments, equipment troubleshooting, securing correct parts, components, etc.
in a timely and efficient manner.
Requirements • Proficient in English writing and speaking • Mechanically inclined • Ability to machinery, tools in a safe manner.
• Experience with pneumatic pumps • Six months to one year experience in manufacturing • Ability to lift 50lbs throughout the shift 1st Shift – 6:00 am to 4:00 pm (Monday thru Thursday) Or 2nd Shift – 4:00 pm to 2:00 am (Monday thru Thursday) $22.00 to $25.00 depending on experience level.
Background/Drug Test Bridgeview, IL Please send resumes to All employees of Elite Staffing must be 18 years or older and authorized to work in the United States.
Elite Staffing, Inc.
is proud to be an equal opportunity employer.
Our policy of equal employment opportunity is to recruit, hire, train and promote persons without regard to race, color, religion, national origin, sex, age, disability, handicap or any other protected status.
All employees of Elite Staffing must be 18 years or older and authorized to work in the United States.
Elite Staffing, Inc.
is proud to be an equal opportunity employer.
Our policy of equal employment opportunity is to recruit, hire, train and promote persons without regard to race, color, religion, national origin, sex, age, disability, handicap or any other protected status.CB3
Document the shipment of hazardous materials by labeling cartons correctly and completing necessary paperwork.
Prepares orders for shipment, palletizes and wrapping orders; loads pallets and pieces into trucks; places packing list in last skid Qualifications: Previous experience using a sitdown forklift.
Previous RF Scanner experience Previous pick/packer experience Ability to complete routine paperwork.
Monday-Friday 1st shift: $20.00/hr 2nd shift: $22.00/hr Background/ drug test Everify Long Term Alsip, IL Please send resumes to All employees of Elite Staffing must be 18 years or older and authorized to work in the United States.
Elite Staffing, Inc.
is proud to be an equal opportunity employer.
Our policy of equal employment opportunity is to recruit, hire, train and promote persons without regard to race, color, religion, national origin, sex, age, disability, handicap or any other protected status.
Elite Staffing offers the following benefit programs for your participation: Medical, Dental, Vision, Voluntary Benefits, 401k Retirement Plan, and Commuter benefits.
All employees of Elite Staffing must be 18 years or older and authorized to work in the United States.
Elite Staffing, Inc.
is proud to be an equal opportunity employer.
Our policy of equal employment opportunity is to recruit, hire, train and promote persons without regard to race, color, religion, national origin, sex, age, disability, handicap or any other protected status.CB3
Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful.
The Opportunity
We are looking for a SIU Investigator (mid-level). This is a Desk position. Within defined guidelines and framework, protects USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance with state insurance fraud-related laws and regulations and policies and procedures. The selected candidate will have a strong multi-line SIU investigation background.
This position is remote eligible. However, you must currently live in California.
What you'll do:
Applies knowledge and understanding of fraud schemes and investigation strategies on any questionable or suspect first or third part claims.
Participates in the development of fraud prevention strategies.
Applies knowledge of P&C insurance industry products, services, and processes in investigating claims to include P&C insurance policy contracts, coverages and internal claims handling process and procedures.
Applies knowledge of state laws and regulations pertaining to insurance fraud in investigating claims.
Collects evidence of potential fraud through field or remote interviews and thorough searches of investigative databases, internal resources, Internet resources, public records, and forensic tools.
Makes recommendations within defined authority guidelines.
Prepares and presents detailed and comprehensive verbal and written investigative reports summarizing the results of the investigation and recommended outcome.
Develops and maintains external relationships with industry, law enforcement and other contacts involved in fraud investigation, detection, and prevention.
May serve as a resource team member on specific matters through demonstrated skill or training.
Assists with the delivery of fraud awareness training initiatives in a defined environment.
Handles CAT duty responsibilities as business requires.
Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.
Minimum High School Diploma or General Equivalency Diploma (GED).
2+ years claims adjusting experience, or P&C SIU/Fraud Investigation experience OR 4+ years prior investigative law enforcement (to include military) or relevant fraud industry investigation experience.
Proven investigatory skills.
Experience obtaining statements from various parties to incidents, witnesses, and suspects.
Ability to gather broad range of evidence and draw conclusions based on the objective details related to the applicability of fraud.
Demonstrated ability to organize and prioritize workload, performing multiple tasks and devising solutions to problems.
Familiarity with using computers and various software packages to enter and extract data for analysis from relevant data sources and systems.
Knowledge of city, state and local regulations, legal concepts, understanding of contracts, case law, medical treatment, and medical terminology.
SIU experience conducting low to complex P&C fraud investigations OR a combination of Claims and Law Enforcement Investigations OR Military Investigative experience.
Strong multi-line SIU experience
Designations such as CFE, CIFI, SCLA, ACLS, FCLS, LPCS, AIC, CPCU, CCLS, or other.
US military experience through military service or a military spouse/domestic partner
Compensation range: The annualized range for this position is: $77,120 - $147,390. However, this is an hourly position.
Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.
For more details on our outstanding benefits, visit our benefits page on
Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.
USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Remote working/work at home options are available for this role.
Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful.
The Opportunity
The Intermediate Life Solutions Specialist helps to ensure the financial security of our membership by assessing member life insurance needs, providing advice and / or referrals for advice, and making the appropriate recommendations based on members’ individual needs and goals. May provide support to Health Solutions acquisition and retention based on member demand.
We offer a flexible work environment that requires an individual to be in the office 5 days per week, with the opportunity to move to a hybrid schedule after 6 months. This position will be based at the following locations: San Antonio, TX, Colorado Springs, CO Campus . Relocation assistance is not available for this position.
What you'll do:
Receives request for advice from current and prospective members through various channels, including inbound and outbound phone calls, emails, faxes, and video telephony. Special Acquisitions Team employees will primarily place outbound calls triggered from underwriting work items.
Asks questions to discover key information, including life events, and to understand member needs. Documents relevant information.
Uncovers and recognizes life events, understands and assesses the member's needs, financial situation, and goals.
Develops and understands appropriate life insurance strategies based on individual member needs. Provides intermediate protection planning advice, including insurance protection, estate planning and enhanced solutions like long term care products.
Recommends relevant life insurance product and solutions and refers members who may need financial advice to the respective department.
Motivates member to take action on recommendation(s) and resolves objections using intermediate sales techniques and intermediate persuasion skills. Implements recommendation(s).
Monitors legislative initiatives that may impact economy, society, and personal financial situation.
Educates membership on implications of economic, industry trends and tax law changes, as well as USAA's
products and services.
May conduct outbound follow-up calls to complete member acquisition of products and services previously discussed.
Serves as a resource to less experienced team members on escalated issues of a routine nature.
Guides and influences less experienced team members.
Work Hours:
Monday – Friday / 7:30am – 7:00pm (Central)
An 8 hour shift will fall within these hours
This role is required to be in office, with potential hybrid opportunity after 6 months.
What you have:
High School diploma or GED
Required maintenance of Life/Health license
Required annual completion of AHIP and Broker/Carrier appointments when applicable.
1 year of financial industry and/or life sales experience
Experience delivering frequent written and oral communication
Experience acquiring and applying new concepts and information
Experience processing and analyzing information
Experience fulfilling requests and meeting deadlines
Experience resolving conflict and negotiating
Experience multi-tasking in an operating systems environment
Experience participating in or leading teams
Successful completion of a job-related assessment may be required
What sets you apart:
2+ years experience working in Sales with life insurance
1+ years experience working in a call center environment
CLU® - Chartered Life Underwriter or comparable designation
US military experience through military service or a military spouse/domestic partner
Compensation range: The salary range for this position is: $48,340.00 - $84,110.00.
Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.
For more details on our outstanding benefits, visit our benefits page on
Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.
USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Remote working/work at home options are available for this role.
Provides direct and indirect nursing care to patients in the Ambulatory setting in accordance with UH policies and standards. Supports and promotes University Health System values to ensure patient/guest relations. Performs the nursing process in a safe therapeutic manner in a designated clinic setting. Maintains, facilitates and promotes department policies and standards.
EDUCATION/EXPERIENCE
At least one year experience in direct patient care is preferred. Current American Heart Association, Basic Cardiac Life Support and Healthcare Provider card required. ACLS certification may be required based on site location. Various certifications may be required based on location site.
LICENSURE
Must possess a current license to practice Vocational Nursing in the State of Texas. Must have a current AHA BLS Healthcare Provider or AHA BLS Instructor Provider card.
Remote working/work at home options are available for this role.
Why USAA?
At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.
Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful.
The Opportunity
As a dedicated Property Adjuster Specialist, you will work within established guidelines and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes coverage, recognize liability exposure and negotiate equitable settlements in compliance with all state regulatory requirements.
Property Adjuster Specialist focus on using technology and desk adjusting for a virtual first approach to inspections and claims handling. USAA also provides a company vehicle to physically inspect losses within your locally assigned territory. Field Adjusters may travel outside of their local territory to respond to claims in other regions when needed. This is an hourly, non-exempt position with paid overtime available.
This is a field-based role for the area of Tacoma, WA and Olympia, WA. Candidates currently living in does location or willing to self-relocate are encouraged to apply.
For new hires starting, we are offering a signing bonus of $4,000. Bonus will be paid in one lump sum (minus applicable taxes) after 45 days of employment.
What you'll do:Proactively manages assigned claims caseload comprised of complex damages that require commensurate knowledge and understanding of claims coverage including potential legal liability.
Partners with vendors and internal business partners to facilitate complex claims resolution. May also involve external regulatory coordination to ensure appropriate documentation and compliance.
Investigates claim damages by conducting research from various sources, including the insured, third parties, and external resources. May identify and resolve potential discrepancies and identifies subrogation potential resulting from unusual characteristics.
Identifies coverage concerns, reviews prior loss history, determines and creates Special Investigation Unit (SIU) referrals, when appropriate. Determines coverage through analyzing information involving complex policy terms and contingencies.
Determines and negotiates complex claims settlement within authority limits. Develops recommendations and collaborates with management for determining settlement amounts outside of authority limits and accurately manages claims outcomes.
Maintains accurate, thorough, and current claim file documentation throughout the claims process.
Advance knowledge of estimating technology platforms and virtual inspection tools. Utilizes platforms and tools to prepare claims estimates to manage complex property insurance claims.
Supports workload surges and catastrophe (CAT) response operations as needed, including mandatory on-call dates and potential evening, weekend, and/or holiday work outside normal work hours.
May be assigned CAT deployment travel with minimal notice during designated CATs.
Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed.
Works independently solving complex problems with minimal guidance; acts as a resource for colleagues with less experience.
Adjusts complex claims with attorney involvement.
Recognizes and addresses jurisdictional challenges such as applicable legislation and construction considerations.
May require travel to resolve claims, attend training, and conduct in-person inspections.
Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.
High School Diploma or General Equivalency Diploma required.
2 years of relevant property claims adjusting experience of moderate complexity losses that includes writing estimates, involving dwelling and structural damages.
Advanced knowledge of estimating losses using Xactimate or similar tools and platforms.
Proficient knowledge of residential construction.
Proficient knowledge of property claims contracts and interpretation of case law and state laws and regulations.
Proficient negotiation, investigation, communication, and conflict resolution skills.
Proven investigatory, analytical, prioritizing, multi-tasking, and problem-solving skills.
Ability to travel 50-75% of the year (local & non-local) and/or work catastrophe duty when needed.
Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.
US military experience through military service or a military spouse/domestic partner
5 years of prior field experience handling higher severity/complex losses (i.e. vandalism, malicious mischief, foreclosures, earth movement, collapse, liability, etc.)
Prior experience adjusting property claims using virtual technologies
Prior property field adjuster experience handling DWG, APS and ALE adjustments
Industry designations such as AINS, CPCU, AIC, SCLA (or actively pursuing)
Xactimate Level 1 and/or Level 2 certification
Prior deployments in support of catastrophes
Currently hold an active Adjuster License
Currently reside within or have the ability to self-relocate to Tacoma, WA or Olympia, WA
May require the ability to crouch and stoop to inspect confined spaces, to include attics and go beneath homes into crawl spaces.
May need to meet all USAA safe driving requirements including verification of driving record through MVR & possession of valid driver’s license.
May require the ability to lift a minimum of 35 pounds to include lifting a ladder in and out of the trunk of a car.
May require the ability to climb ladders and traverse roofs, this includes the ability to work at heights while inspecting roofs and attics.
Compensation range: The salary range for this position is: $69,920.00 - $133,620.00.
USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).
Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.
The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.
Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.
For more details on our outstanding benefits, visit our benefits page on
Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.
USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Remote working/work at home options are available for this role.
Identifies Community First Health Plan members with specific health care needs and provides case management interventions. Analyzes, approves health care services and monitors outpatient care planning for Community First Health Plans members based on established criteria, plan policies and procedures. Formulates and communicates case management plans that efficiently utilize health care services to move the member along the continuum of care towards optimum outcomes in the safest, most cost effective manner.
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing is required, BSN preferred. Master’s degree is preferred. Minimum three years’ acute care experience or managed care experience is required. Minimum one-year of concurrent review experience is required. Candidate must have utilization management and/or quality assurance experience. Basic knowledge of Medicaid, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD-9 and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current Registered Nurse license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required. Active Certification in Case Management (CCM) designation is preferred.
Remote working/work at home options are available for this role.
