Information Technology Jobs in Corona Remote
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Executive Producer / Head of Digital Project Management
About the Role
A large digital transformation marketing agency is seeking a dynamic Head of Project Management to lead the delivery organization responsible for large‐scale digital transformation initiatives. This executive‐level role oversees complex programs spanning CMS modernization, enterprise website redesigns, marketing technology implementations, and multi‐channel content ecosystems. You'll shape the operational backbone of the organization—elevating delivery frameworks, strengthening Agile maturity, and empowering teams to execute with precision and innovation.
This is a pivotal leadership position for someone who thrives at the intersection of digital strategy, technology, and operational excellence.
Key Responsibilities
Digital Program & Delivery Leadership
• Oversee the successful delivery of enterprise‐level digital initiatives, including CMS replatforming, website redesigns, personalization programs, and martech ecosystem enhancements.
• Serve as the senior delivery leader across cross‐functional teams—engineering, UX/UI, content, data, and marketing operations.
• Establish scalable Agile delivery frameworks, governance models, and communication structures that support transparency and predictable outcomes.
• Translate business and technical requirements into actionable roadmaps, sprint plans, and release strategies.
• Drive risk management, dependency mapping, and issue resolution across multi‐workstream programs.
• Ensure rigorous QA, UAT, and launch readiness processes for all digital products and platforms.
Operational Excellence & Financial Stewardship
• Build and refine outcome‐based scopes, delivery models, and commercial structures that support digital transformation at scale.
• Oversee project financials, ensuring accurate forecasting, budget tracking, and scope alignment across all programs.
• Partner with finance and executive leadership on quarterly reconciliation, reporting, and long‐range planning.
• Develop and maintain resource management frameworks to optimize team allocation, utilization, and capacity planning.
• Champion continuous improvement across delivery processes, Agile practices, tooling, and operational workflows.
Leadership & Team Development
• Lead, mentor, and grow a high‐performing Project Management organization, fostering a culture of accountability, collaboration, and innovation.
• Define career paths, performance expectations, and development plans for Project Managers and Program Managers.
• Assign programs based on skill sets, capacity, and strategic priorities to ensure balanced workloads and strong outcomes.
• Promote best‐in‐class communication, documentation, and stakeholder engagement across all delivery teams.
Required Qualifications
• 10+ years of digital project or program management experience, with at least 4+ years leading teams or departments.
• Proven success overseeing large‐scale digital transformation initiatives such as CMS migrations, enterprise website redesigns, martech platform implementations, or customer experience modernization.
• Deep understanding of Agile methodologies (Scrum, Kanban, SAFe) and hands‐on experience with Agile delivery tools (Jira, Confluence, Asana, etc.).
• Strong knowledge of web technologies, UX/UI principles, content operations, and modern martech stacks.
• Exceptional communication and stakeholder management skills, with the ability to influence at all levels of the organization.
• Demonstrated ability to lead cross‐functional teams and manage complex, multi‐workstream programs.
• Strong analytical, organizational, and problem‐solving capabilities.
• Bachelor's degree in a relevant field or equivalent experience.
· As the representative of The Organization, your primary responsibility is to conduct exceptional Open enrollment and customer events that set The Organization apart from competitors.
· In this customer-facing position, you will educate customers about The Organization’s products, services, and programs through various methods, including formal presentations, benefit fairs, and health fairs.
· Your goal is to create a highly satisfying and positive customer experience, demonstrating knowledge, competence, and professionalism.
· This is an “ as needed ,” variable hour role ; hours are not guaranteed and will fluctuate based on event demand (including occasional last-minute requests).
Background & Context: · Role involves customer-facing benefits education and event representation across multiple U.S.
markets.
Key Responsibilities: · Lead and deliver virtual, onsite, or prerecorded presentations in group settings as assigned to existing and prospective customers · Represent The Organization at customer events, ensuring a professional and positive image while effectively communicating products, programs, and solutions · Maintain current knowledge in all products, programs, solutions, and initiatives Follow established guidelines and procedures of customer events as assigned · Refer customer service inquiries, administrative functions , implementation, billing questions, and other customer, client and producer matters to appropriate internal partners · Coordinate, track, and update event meetings, including attendance , and top insights via data entry system ( ) by assigned deadlines Qualification & Experience: · High School Diploma or GED required · Current and active Health & Life License · Must be available during peak season (August-December) · Experience explaining and presenting employer-sponsored benefits and health insurance · Excellent communication and presentation skills · Proficiency in Microsoft Programs (PowerPoint, Word), CRM system ( ), and virtual learning platforms (WebEx, MS Teams, & Allego) · Ability to travel to local/remote trainings/meetings as assigned—75-100% · This role must be located within the assigned territory/market to drive or fly to client locations, local offices in and outside of the regional territory · Ability to utilize and maintain a personal, company-approved device (smartphone, tablet, etc.
with compatible operating system), keep required software and system access up to date, and adapt to evolving technology tools and systems Working Conditions & Physical Demands: · Extensive travel required within assigned territory · Variable-hour schedule; may include last-minute event assignments Additional Information: · This is an as-needed role; flexibility is essential Applicant Notices & Disclaimers For information on benefits, equal opportunity employment, and location-specific applicant notices, click here At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws.
This position's pay is: $30.58/hr.
Key Responsibilities: · Lead and deliver virtual, onsite, or prerecorded presentations in group settings as assigned to existing and prospective customers · Represent The Organization at customer events, ensuring a professional and positive image while effectively communicating products, programs, and solutions · Maintain current knowledge in all products, programs, solutions, and initiatives Follow established guidelines and procedures of customer events as assigned · Refer customer service inquiries, administrative functions, implementation, billing questions, and other customer, client and producer matters to appropriate internal partners · Coordinate, track, and update event meetings, including attendance, and top insights via data entry system ( ) by assigned deadlines
Job Title: Merchandising Designer III
Location: Hybrid in New York, NY
Contract duration: 9 month contract with potential for extension or conversion
Job Summary
We are seeking a highly organized and execution-focused Visual Merchandising professional with 5+ years of experience in retail beauty, specifically within prestige environments. This individual will support heavy in-store merchandising execution, ensuring brand standards, planograms, and fixture updates are flawlessly implemented across locations. The ideal candidate comes with a strong background in visual retail beauty execution, understands the language of the industry, and can work autonomously in a high-volume, fast-paced environment. In addition to store execution, this role requires intermediate digital proficiency to support reporting and communication needs. Success in this role requires adaptability, resilience, and a thick skin—someone who is receptive to constructive feedback, easy to collaborate with, and comfortable executing against established direction rather than leading strategy. A detail-oriented mindset, strong organizational skills, and a team-first attitude are essential.
Typical task breakdown:
Heavy store merchandising execution is key
Intermediate in digital execution
5+ years of experience
Will be executing primarily for store merchandising
Needs to have a strong background in visual retail beauty execution - comes in knowing the language, ability to work autonomously
Soft Skills:
-adaptable and receptive to constructive feedback
-easy to work with, no chip on the shoulder, not arrogant, okay with executing vs being strategic and creative
-super organized, the team is very high volume
Screening questions:
Do you now or in the future require sponsorship (e.g. H-1B)? Y/N
EEO and ADA Statement:
Consulting Solutions and its family of companies is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.
If you are a person with a disability needing assistance with the application or at any point in the hiring process, please contact us at:
Join MD Newsline
Empowering Healthcare Professionals & Patient Advocates Through Engaging Content and Technological Innovation
Are you passionate about healthcare, technology, and sales? Join us in shaping the future of medical media as a Senior Account Executive. We create cutting-edge, engaging content for healthcare professionals and patient advocates, blending expertise in media with next-generation technology to drive better outcomes in healthcare communication.
This role requires being in office twice a week. We are looking for account executives in the New York City Area.
We’re looking for dynamic sales professionals to build strong client relationships, become trusted advisors to the pharmaceutical industry, and play a key role in advancing how healthcare content is delivered and consumed.
About MD Newsline
MD Newsline is a health communications and technology company. We are dedicated to providing essential medical resources to healthcare professionals and health advocates. Our platform offers a wide range of content focused on disease education, clinical trial updates, medical research insights, patient adherence strategies, and industry best practices. Our mission is to elevate patient outcomes and empower healthcare providers with vital medical knowledge.
What You’ll Do
As a Sales Executive, you will:
- Cultivate Relationships: Develop and maintain strong, long-term partnerships with clients, understanding their needs and delivering tailored solutions.
- Drive Business Growth: Identify and pursue new business opportunities within the pharmaceutical and healthcare sectors, becoming a trusted advisor and resource.
- Achieve Sales Excellence: Meet and exceed sales targets through strategic planning, negotiation, and collaboration.
- Collaborate for Success: Work closely with internal teams—including content creators, marketers, and tech specialists—to ensure client satisfaction and seamless delivery of solutions.
- Lead Industry Conversations: Establish yourself as a thought leader in the pharmaceutical and healthcare industry, contributing insights that shape its future.
What You’ll Bring
We’re seeking candidates with:
- Experience in Sales: Proven track record in sales, preferably within healthcare, media, technology, or pharmaceuticals.
- Exceptional Communication Skills: Ability to engage clients effectively, negotiate deals, and present solutions with confidence.
- Strategic Thinking: Skilled at identifying opportunities, setting goals, and achieving results through innovative strategies.
- Collaborative Spirit: A team player who thrives in cross-functional environments.
- Passion for Healthcare: Genuine interest in improving healthcare communication and outcomes through innovative solutions.
Preferred Qualifications:
- 3+ years of sales experience in a related industry.
- Familiarity with healthcare media or marketing solutions.
- Bachelor's degree in business, marketing, or a related field.
What We Offer
We believe in rewarding talent with a competitive and comprehensive compensation package:
- Base ($75,000 to $150,000/year) + Bonus + Profit Sharing + Long-Term Incentive Plan + Benefits
- Performance Bonuses: Annual bonuses tied to your success, with significant earning potential.
- Long-Term Incentive Plan (LTIP): Be a part of the company’s long-term growth and success.
- Profit Sharing: Share in the success of the company through our profit-sharing plan.
- Benefits: Comprehensive health, dental, and vision coverage.
- Flexible Time Off: Policies designed to let you take time off to be at your best, both at work and in life.
Why Join Us?
At our company, you’ll be at the forefront of healthcare media innovation, working with some of the brightest minds in the industry. We foster a collaborative and inclusive culture where creativity thrives and careers flourish.
We are proud to be an Equal Opportunity Employer, committed to diversity and inclusion in all its forms. We do not discriminate on the basis of race, color, religion, gender, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status.
Ready to Transform Healthcare Communication?
If you’re ready to make an impact, grow your career, and be part of a forward-thinking team, we’d love to hear from you. Apply now to start your journey with us!
Associate Director - Quantitative Research - Brand & Comms Focus
New York (Hybrid)
To$130,000 + Bens
Our client is a market research and advisory company with growing teams across the world. They work with a stellar list of global brand owners and inform & inspire them. They allow them to make better decisions using powerful data and key insights by using empowering technology and high-impact consulting. They have a tech-first mind set and are an evolving business in a time of change.
We are seeking an agency-trained quant researcher to join their brand and comms team working across tracking and ad hoc research projects. This is a hands-on, client-facing role, ideal for someone passionate about delivering high-quality insights, managing client relationships, and driving business growth through technology and innovation.
This is a tech enabled forward thinking business who embrace the advances that technology is bringing to market research in both analysis and delivery. They have invested in the best-in-class insights platform and delivery tools and are well supported and organised by a strong back office and ops function.
Offices are in midtown Manhattan where key members of the global leadership team also work.
We are unable to offer sponsorship for this role.
Hearing Representative - Special Education Claims
Background on the Project:
A prestigious government agency is addressing the backlog of special education claims in New York City to ensure timely and fair resolution of disputes between parents and the city regarding educational plans for children with special needs. Recent rulings have emphasized the need for faster resolution of these claims and improvements in special education services and payment processes. This initiative requires dedicated attorneys to join the team and play a critical role in managing a high volume of cases and driving claims through the administrative process.
Role Overview:
Our client is seeking contract attorneys barred and in good standing in any state with 1+ years of litigation experience to Work Remotely on a 1 plus year assignment. As a Hearing Representative, you will represent our client throughout the entire special education claims process—from intake to resolution or settlement.
Pay Rates:
- 1 to 7 years of experience: $41.75/hour
- 7+ years of experience: $43.75/hour
Key Responsibilities:
- Case Management: Manage a high-volume caseload of 100–200 special education claims, ensuring timely and effective handling.
- Representation: Prepare for and/or litigate complex cases involving significant legal precedents, policy implications, or financial impact. Represent the agency in administrative hearings, pre-hearing conferences, and settlement negotiations.
- Administrative Process: Navigate procedural requirements and ensure compliance with federal and state education laws and regulations.
- Documentation: Prepare and review all necessary filings, agreements, and reports with accuracy and thoroughness.
- Settlement Negotiation: Work with parents, public advocacy groups, and opposing counsel to reach fair resolutions while negotiating claims for attorney's fees.
- Training and Collaboration: Collaborate with special education specialists, technical experts, and attorneys; provide training to field staff and clinical staff on compliance with education laws.
- Research and Compliance: Analyze case law, gather evidence, and evaluate settlement demands. Provide guidance on compliance obligations to parents and students under hearing orders.
Required Qualifications:
- Bar Admission: Active bar license in good standing in any U.S. state.
- Litigation Experience: Minimum of 1+ years of recent litigation experience (more preferred).
- Tech Savvy: Strong proficiency in Microsoft Office Suite and ability to troubleshoot basic technical issues.
- Caseload Management: Proven ability to manage 100–200 cases concurrently.
- Timekeeping: Ability to log activities in 15-minute increments throughout the workday.
- Remote Work Skills: Dedicated workspace, reliable Wi-Fi, and comfort with virtual tools like Microsoft Teams and Outlook.
- Schedule Flexibility: Willingness to accommodate early morning hearings and work within Eastern Time Zone hours (7 AM–7 PM).
- Preferred Experience: Administrative Law, IEP/Special Education, Experience working for a government agency, Public Interest work, Settlement experience.
We are an equal opportunity employer and comply with all applicable federal, state, and local fair employment practices laws. We strictly prohibit and do not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex, sexual orientation, gender (including gender identity and expression), marital or familial status, age, physical or mental disability, perceived disability, citizenship status, service in the uniformed services, genetic information, height, weight, or any other characteristic protected under applicable federal, state, or local law. Applications from members of minority groups and women are encouraged.
Remote working/work at home options are available for this role.
Hearing Representative - Special Education Claims
Background on the Project:
A prestigious government agency is addressing the backlog of special education claims in New York City to ensure timely and fair resolution of disputes between parents and the city regarding educational plans for children with special needs. Recent rulings have emphasized the need for faster resolution of these claims and improvements in special education services and payment processes. This initiative requires dedicated attorneys to join the team and play a critical role in managing a high volume of cases and driving claims through the administrative process.
Role Overview:
Our client is seeking contract attorneys barred and in good standing in any state with 1+ years of litigation experience to Work Remotely on a 1 plus year assignment. As a Hearing Representative, you will represent our client throughout the entire special education claims process—from intake to resolution or settlement.
Pay Rates:
- 1 to 7 years of experience: $41.75/hour
- 7+ years of experience: $43.75/hour
Key Responsibilities:
- Case Management: Manage a high-volume caseload of 100–200 special education claims, ensuring timely and effective handling.
- Representation: Prepare for and/or litigate complex cases involving significant legal precedents, policy implications, or financial impact. Represent the agency in administrative hearings, pre-hearing conferences, and settlement negotiations.
- Administrative Process: Navigate procedural requirements and ensure compliance with federal and state education laws and regulations.
- Documentation: Prepare and review all necessary filings, agreements, and reports with accuracy and thoroughness.
- Settlement Negotiation: Work with parents, public advocacy groups, and opposing counsel to reach fair resolutions while negotiating claims for attorney's fees.
- Training and Collaboration: Collaborate with special education specialists, technical experts, and attorneys; provide training to field staff and clinical staff on compliance with education laws.
- Research and Compliance: Analyze case law, gather evidence, and evaluate settlement demands. Provide guidance on compliance obligations to parents and students under hearing orders.
Required Qualifications:
- Bar Admission: Active bar license in good standing in any U.S. state.
- Litigation Experience: Minimum of 1+ years of recent litigation experience (more preferred).
- Tech Savvy: Strong proficiency in Microsoft Office Suite and ability to troubleshoot basic technical issues.
- Caseload Management: Proven ability to manage 100–200 cases concurrently.
- Timekeeping: Ability to log activities in 15-minute increments throughout the workday.
- Remote Work Skills: Dedicated workspace, reliable Wi-Fi, and comfort with virtual tools like Microsoft Teams and Outlook.
- Schedule Flexibility: Willingness to accommodate early morning hearings and work within Eastern Time Zone hours (7 AM–7 PM).
- Preferred Experience: Administrative Law, IEP/Special Education, Experience working for a government agency, Public Interest work, Settlement experience.
We are an equal opportunity employer and comply with all applicable federal, state, and local fair employment practices laws. We strictly prohibit and do not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex, sexual orientation, gender (including gender identity and expression), marital or familial status, age, physical or mental disability, perceived disability, citizenship status, service in the uniformed services, genetic information, height, weight, or any other characteristic protected under applicable federal, state, or local law. Applications from members of minority groups and women are encouraged.
Remote working/work at home options are available for this role.
Salary: $150,000
- $225,000 per year A bit about us: Law firm based in Los Angeles operating in complex litigation, representing individuals and corporations in high-stakes matters such as antitrust and business litigation, mass torts, class actions, insurance bad faith litigation, consumer claims, data breach, and commercial disputes.
Why join us? Competitive salary commensurate with experience.
Bonus opportunities tied to performance.
Health, dental, vision, and retirement benefits.
Professional development support and clear growth path.
Collegial, supportive environment with a strong litigation team.
Job Details We are seeking an experienced Insurance Bad Faith Attorney to join our team and handle complex first- and third-party coverage and bad faith litigation matters.
This role is ideal for an attorney who thrives in high-stakes disputes, enjoys courtroom advocacy, and has a strong background in insurance law.
Responsibilities Represent policyholders or insurers in bad faith litigation and related insurance coverage disputes.
Manage all phases of litigation, including pleadings, discovery, law and motion practice, depositions, mediations, and trial.
Conduct thorough analysis of insurance policies, claims files, and case law to develop strategies for defense or recovery.
Draft high-quality briefs, motions, coverage opinions, and settlement evaluations.
Advise clients on risk, coverage obligations, and litigation strategy.
Handle negotiations, settlement conferences, and mediations with insurers, insureds, and opposing counsel.
Qualifications Juris Doctor (JD) degree from an accredited law school.
Active membership in good standing with the California State Bar.
3+ years of experience in insurance coverage and/or bad faith litigation (policyholder or defense side).
Strong knowledge of California insurance statutes, case law, and regulations.
Excellent legal research, writing, and oral advocacy skills.
Proven ability to independently manage a caseload and work collaboratively with a litigation team.
Trial experience preferred, but not required.
Interested in hearing more? Easy Apply now by clicking the "Apply Now" button.
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Remote working/work at home options are available for this role.
The Physician Advisor works closely with the Client’s medical staff leadership, the entire medical staff, including resident physician house staff, all areas of resource management, case management, social services, discharge planning, and utilization management to recommend methods to optimize use of hospital services for all patients.
This includes identifying opportunities to optimize length of hospital stay and efficient management of resources, ensuring patients are in the appropriate level of care, supporting documentation, coding improvements and compliance, and monitoring the appropriate use of diagnostic and therapeutic modalities.
Duties and Responsibilities Responds to requests for assistance on clinical reviews for medical necessity or any other reason, by any member of the Case Management department in a timely fashion Provides consultation to attendings, nurses, and case management staff regarding complex clinical issues and advises on justification required for continued stay, medical necessity and utilization management Obtains familiarity and working knowledge of standard published criteria such as MCG/InterQual and applies professional judgment and patient specific variables as may be necessary or justifiable Maintains accountability for achieving case management outcomes and fulfills the obligations and responsibilities of the role to support the medical staff in the clinical progression of patient care Describes ways to provide improved health record documentation that specifically affect ICD code assignment capture of severity, acuity, risk of mortality, and DRG assignment Participates in ongoing training and education related to the Physician Advisor role and responsibilities including topics related to Utilization Management, Care Management and other related areas as requested Meets productivity and quality standards within established time requirements.
Work product and performance meets or exceeds quality standards.
Achieve performance goals as outlined in employment agreement Maintains confidentiality of patient care and business matters Demonstrates behavior that supports the organization’s mission.
Participates in required orientation and training related to the Physician Advisor role Demonstrates commitment to meeting/exceeding strategic initiatives of organization Upholds the organization’s values of teamwork and professionalism and applies Code of Conduct standards to all members of the healthcare team Facilitate, mentor, and educate other physicians regarding payer requirements Attends all meetings as requested by PAOC leadership Participate in the peer review process as may be necessary or requested Maintain medical licensure and board certification in good standing During scheduled work hours, commits full attention to Physician Advisory and execution of outlined tasks Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards Qualifications Board Certified and licensed to practice medicine in the US or 3+ years active clinical experience in the US 3+ years working as a Physician Advisor performing Level of care reviews as well as Peer to Peer Reviews Basic technical skills with Hospital EMRs, Microsoft Office and Teams a must Hold and maintain an unrestricted medical license and Board Certification Possess or acquires a solid foundation, knowledge, and/or experience in the areas of utilization management, quality improvement, and patient safety Possess a working knowledge of (Hospital) organization & case management operations and administrative standards and policies Familiarity with MCG/InterQual placement status criteria is preferred Member of the American College of Physician Advisors (ACPA) preferred Board Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc.
(ABQAURP) preferred Physician Advisor Sub-Specialty Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc.
(ABQAURP) preferred Excellent customer service and interpersonal skills and the utmost professionalism is required Able to effectively present information, both formal and informal Strong analytical skills Strong written and verbal communications skills with all levels of internal and external customers Strong organizational skills and ability to set priorities and multi-task, demonstrates flexibility, teamwork, and is accustomed to change in the healthcare environment Demonstrates ability to drive results and produce outcomes Demonstrates initiative as well as basic independent trouble-shooting skills Working Conditions This role requires availability to provide a minimum of 16 shifts per month.
Each shift is 6-8 hours in duration and includes 4 weekend shifts per month.
Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
Work Environment: The noise level in the work environment is usually minimal.
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
#CB
Remote working/work at home options are available for this role.
Duties & Responsibilities Maintain the integrity of information in each appeal produced Review a high volume of written appeals to ensure information is medically accurate Research payer denials related to referral, pre-authorization, notifications, medical necessity, non-covered services, and billing resulting in denials and delays in payment Make recommendations for workflow revisions to improve efficiency and reduce denials Present case studies and recommendations to clients and impacted stakeholders Review payor communications, identifying risk for loss reimbursement related to medical policies and prior authorization requirements; escalates potential issues to clinical stakeholders, managed care contracting, and Revenue Cycle leadership as appropriate Identify opportunities for process improvement and actively participate in process improvement initiatives, internally and externally Other duties as assigned Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards Understand and comply with Information Security and HIPAA policies and procedures at all times Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties Qualifications Bachelor’s degree in a health-related field; 2 years of experience may be considered in lieu of a degree in addition to the required experience.
LPN or RN preferred.
Two years of recent experience in hospital case management, hospital prior authorization, or utilization management Experienced in medical chart review Claim-related appeal writing experience preferred Experience with medical and insurance terminology, CPT, ICD coding structures, and billing forms Experience with MCG and/or InterQual guidelines preferred Proficiency in Microsoft Office Suite Strong interpersonal skills, ability to communicate well at all levels of the organization Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses High level of integrity and dependability with a strong sense of urgency and results oriented Excellent written and verbal communication skills required Gracious and welcoming personality for customer service interaction Working Conditions Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.
Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
Work Environment: The noise level in the work environment is usually minimal.
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
Remote working/work at home options are available for this role.
