Nulixir Inc Reviews Jobs in Usa
9,295 positions found
Looking for a career with a great company? We have opportunities available in Liverpool, NY for Truck Drivers and Warehouse Associates.
Attend our hiring event where well provide you with information about our team and the open positions below.
Our leadership team looks forward to meeting you!
When: October 12th, 10am - 5pm
Where: 4560 Morgan Place
Liverpool, New York 60;13090
What we offer:
Competitive pay
Comprehensive benefit plan (medical, dental, vision, short/long term disability, life insurance and more)
Retirement benefits
Paid time off (vacation, holidays, PTO and sick)
Employee Discount Programs
Paid training
Opportunities for growth and career advancement
We have the following positions available:
Class A or B CDL Truck Driver (Home Nightly) - $21.00/hr with a $5,000 Sign-on Bonus ($3,000 payable at 90 days and $2,000 at 1 year).
- Responsible for safely and efficiently operating a vehicle to deliver hardgoods, compressed cylinders, and associated products.
Cylinder Processor (Warehouse Associate) - $20.00/hr
- Responsible for performing duties associated with filling, labeling & preparing low pressure packaged gas cylinders and maintaining the cryogenic liquid filling system.
Praxair Distribution, Inc., a Linde Company, Praxair Distribution, Inc. is the worlds largest industrial gas company. We take pride in making our plant more productive with products, services and technologies that include high-performance surface coatings as well as specialty, medical, and process gases. For more information, please visit us at the job fair or at 60; qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, protected veteran status, pregnancy, sexual orientation, gender identity or expression, or any other reason prohibited by applicable law.
Immediate need for a talented Hospital RN – Care Coordination & Utilization Review . This is a 06+months contract opportunity with long-term potential and is located in San Jose, CA (Onsite). Please review the job description below and contact me ASAP if you are interested.
Job ID: 25-80861
Pay Range: $80 - $95/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
Key Responsibilities:
- Conduct utilization reviews using InterQual® / MCG®
- Support discharge planning and post-acute coordination
- Communicate with physicians, social work, and external providers
- Manage authorizations and payer-related workflows
- Maintain compliance with regulatory standards
Key Requirements and Technology Experience:
- Key Skills; CA RN License (Active)
- Acute inpatient hospital experience
- UM / Case Management / Discharge Planning background
Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here.
- Sunday 8 – 5 pm PST Pay Range: $43
- $44/hr.
on W2 Description: · The Care Review Clinician is responsible for performing utilization management (UM) reviews, including prior authorization of outpatient services, to ensure medical necessity, appropriate level of care, and compliance with regulatory and organizational guidelines.
· The clinician will review clinical documentation, apply evidence-based criteria, and collaborate with providers to facilitate timely and appropriate care for members.
· This role supports Client’s commitment to quality, cost-effective care and regulatory compliance within the California health plan.
Must Have Skills: · Knowledge of California delegation requirements · Strong understanding of utilization management processes · Experience with prior authorization review (outpatient preferred) · Ability to apply clinical guidelines (e.g.
MEDICAID, MCG) Day to Day Responsibilities: · Process outpatient prior authorization referrals · Review clinical documentation for medical necessity · Apply established UM criteria and guidelines · Communicate with providers for additional clinical information · Ensure compliance with state, federal, and Client policies · Document determinations accurately and timely Required Years of Experience: · Active, unrestricted California RN or LVN license required · Minimum of 3 years of clinical experience in utilization management
Medical Reviewer
As a Medical Reviewer in the Healthcare sector, you play a crucial role in ensuring the accuracy, compliance, and quality of medical content and documentation. Your work directly impacts patient safety, regulatory adherence, and the overall success of the company.
Importance of the Role:
Medical Reviewers are the gatekeepers of medical information, ensuring that all materials meet high standards of accuracy and integrity.
Impact on Team Collaboration: By collaborating with medical writers, researchers, and regulatory affairs teams, Medical Reviewers contribute to seamless teamwork and project success.
Industry Trends: Medical Reviewers must stay abreast of evolving regulations, digital health innovations, and data privacy laws to uphold best practices in medical content creation.
Key Stakeholders: This role interacts closely with medical writers, regulatory bodies, compliance officers, and project managers, playing a vital role in the company’s content development pipeline.
Success Measurement: Performance is gauged based on adherence to regulatory guidelines, accuracy of medical content, timely completion of reviews, and feedback from stakeholders.
Key Responsibilities
As a Medical Reviewer, your responsibilities encompass a range of critical tasks:
Project Planning and Execution: You will be involved in planning, scheduling, and executing medical content reviews to ensure timely delivery and accuracy.
Problem-Solving and Decision-Making: Medical Reviewers analyze complex medical data, resolve discrepancies, and make informed decisions to maintain content integrity.
Collaboration with Cross-Functional Teams: You will collaborate with medical writers, researchers, and regulatory teams to align content with medical and regulatory standards.
Leadership and Mentorship: Mentoring junior team members, providing guidance on medical writing best practices, and leading by example in quality assurance processes.
Process Improvement and Innovation: Constantly seeking ways to enhance efficiency, streamline review processes, and innovate in medical content creation and review.
Technical or Customer-Facing Responsibilities: Engaging with clients, healthcare professionals, or regulatory bodies to address queries, clarify medical information, and ensure compliance.
Required Skills and Qualifications
To excel as a Medical Reviewer, candidates must possess the following skills and qualifications:
Technical Skills:
Proficiency in medical terminology, knowledge of medical writing software, familiarity with regulatory guidelines, understanding of clinical trial protocols.
Educational Requirements:
A degree in Pharmacy, Medicine, Life Sciences, or a related field. Certification in Medical Writing or Regulatory Affairs is a plus.
Experience Level:
Minimum 3-5 years of experience in medical reviewing, pharmaceutical industry experience, familiarity with FDA and EMA regulations.
Soft Skills:
Excellent communication skills, attention to detail, critical thinking, ability to work under pressure, and a collaborative mindset.
Industry Knowledge:
In-depth knowledge of medical content regulations, pharmacovigilance processes, adverse event reporting, and medical device documentation requirements.
The challenges of affordable healthcare continue to create new opportunities.
Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs.
These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
Supervises the assessment of all acute and sub-acute inpatient care for appropriateness of setting and services, according to pre-established criteria and guidelines and ensure a 95% compliance or greater.
Supervises the assessment and coordination of the members physical, psychosocial and discharge planning needs through communication with appropriate hospital staff including treating physician, PCP, utilization managers, social workers, discharge planners.
Assures appropriate staffing to support departmental/agency services.
Ensures all employees are oriented to their department/agency and job and provided with appropriate training, development and continuing education.
Correctly interprets and applies all Human Resources policies and procedures relative to discipline, recruitment and selection, performance appraisals, salary reviews and staffing.
Bachelor's Degree in Nursing.
Minimum one to three years previous management experience preferred.
Previous managed care experience in the areas of utilization management and/or case management required.
Working knowledge of Windows, Word, Excel.
Knowledge of Federal and State regulations, managed care regulations and concepts, and CQI methodologies.
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
Care Management Supervisor of Quality Review & Staff Education is responsible for quality assurance, accuracy, and overall integrity of the care management records completed by Care Management staff. This role is to ensure compliance with NYS DOH and CMS regulations through development of auditing tools and data validation. This Supervisor will analyze collected audit data, identify trends for staff re-training, and implement corrective action plans in collaboration with Clinical Management and Staff Education. They will oversee and conduct orientation, training, and education to all members of the Care Management team. Provides support to Director and Managers of Coordinated Care to ensure that all reporting requirements are prepared, submitted, and maintained in a professional and well-coordinated manner.
- Baccalaureate Nursing Degree from an NLN-Accredited School of Nursing
- Experience and knowledge of Managed Care: A minimum of two years nursing experience in Community Health or related field and/or minimum of two years of progressive job-related experience, including care management and coordination, education and supervision
- Demonstrates strong critical-thinking, problem-solving skills, and knowledge of Medicare and Medicaid
- Effective communication skills both written and oral
- Possesses strong critical thinking skills and knowledge of Medicare and Medicaid regulations
- Excellent analytical skills, interpretation of data
- Ability to set priorities and to handle multiple assignments
- Working knowledge of audit techniques and methodologies
- Secures relevant information to identify potential problems and makes recommendations for appropriate solutions
- Work effectively within interdisciplinary team environment
- Computer literate, Windows, Excel, Word, Visio and data base programs required. PowerPoint preferred
- Working knowledge of State and Federal regulations
Conducts comprehensive clinical reviews of adverse determinations related to medical necessity. Initiates outreach to providers to obtain clarification or additional documentation in alignment with established clinical criteria and organizational policies, to support Medical Director decision making. Provides support for claim appeals in relation to medical necessity. Ensures the timely and accurate resolution of appeal cases and supports organizational adherence to all state, federal, and accreditation standards. Facilitates member second level appeal process.
EDUCATION/EXPERIENCE
Graduate from an accredited school of professional nursing is required. BSN preferred. Minimum 2 years acute care experience or managed care experience is required. Basic knowledge of Medicaid, Medicare preferred. Knowledge of InterQual screening criteria, ICD-10, CPT coding preferred.
LICENSURE
Current Registered Nurse (RN) 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) is preferred.
Conducts comprehensive clinical reviews of adverse determinations related to medical necessity. Initiates outreach to providers to obtain clarification or additional documentation in alignment with established clinical criteria and organizational policies, to support Medical Director decision making. Provides support for claim appeals in relation to medical necessity. Ensures the timely and accurate resolution of appeal cases and supports organizational adherence to all state, federal, and accreditation standards. Facilitates member second level appeal process.
EDUCATION/EXPERIENCE
Graduate from an accredited school of professional nursing is required. BSN preferred. Minimum 2 years acute care experience or managed care experience is required. Basic knowledge of Medicaid, Medicare preferred. Knowledge of InterQual screening criteria, ICD-10, CPT coding preferred.
LICENSURE
Current Registered Nurse (RN) 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) is preferred.
Conducts comprehensive clinical reviews of adverse determinations related to medical necessity. Initiates outreach to providers to obtain clarification or additional documentation in alignment with established clinical criteria and organizational policies, to support Medical Director decision making. Provides support for claim appeals in relation to medical necessity. Ensures the timely and accurate resolution of appeal cases and supports organizational adherence to all state, federal, and accreditation standards. Facilitates member second level appeal process.
EDUCATION/EXPERIENCE
Graduate from an accredited school of professional nursing is required. BSN preferred. Minimum 2 years acute care experience or managed care experience is required. Basic knowledge of Medicaid, Medicare preferred. Knowledge of InterQual screening criteria, ICD-10, CPT coding preferred.
LICENSURE
Current Registered Nurse (RN) 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) is preferred.
Conducts comprehensive clinical reviews of adverse determinations related to medical necessity. Initiates outreach to providers to obtain clarification or additional documentation in alignment with established clinical criteria and organizational policies, to support Medical Director decision making. Provides support for claim appeals in relation to medical necessity. Ensures the timely and accurate resolution of appeal cases and supports organizational adherence to all state, federal, and accreditation standards. Facilitates member second level appeal process.
EDUCATION/EXPERIENCE
Graduate from an accredited school of professional nursing is required. BSN preferred. Minimum 2 years acute care experience or managed care experience is required. Basic knowledge of Medicaid, Medicare preferred. Knowledge of InterQual screening criteria, ICD-10, CPT coding preferred.
LICENSURE
Current Registered Nurse (RN) 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) is preferred.
