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Insight Global is seeking Technical Evaluation Review Board/CCB Coordinator to join our team for an exciting opportunity to work on a unique government contract. The contract assists in acquisition and technical sustainment engineering and will augment government resources. The coordinator manages government technical review board submissions, ensuring all programs meet required deliverables and are fully prepared for review before board meetings. They control document accuracy, track changes, and maintain compliant review packages across all stakeholders. The role requires confidently driving engineers and IPTs to meet requirements and deadlines, including pushing back when inputs are incomplete. This is a highly organized, assertive position focused on accountability, readiness, and execution.
Must Haves:
- BS/MS in engineering/specialty area
- 7 yrs directly related experience (5 yrs with MS degree)
- Active secret level security clearance or higher
- Strong planning, coordination, and organizational skills with the ability to manage multiple priorities
- Demonstrated experience developing, maintaining, and assessing technical baselines within controlled programs
- Familiarity with engineering standards, manufacturing methods, and configuration management practices, including military and ASME-guided environments
- Working knowledge of technical drawing conventions and engineering documentation controls
- Proficiency with Microsoft Office tools to prepare data-driven reports, metrics, and formal documentation
- High attention to detail, strong writing and verbal communication skills, and the ability to manage time effectively
- Ability to sit on-site at Hill AFB in Clearfield, UT Monday-Wednesday
Plusses:
- Experience supporting configuration and data management activities within a defense or government program environment
- Working knowledge of Air Force or DoD engineering release processes, configuration control standards, and technical documentation lifecycle management
- Familiarity with Engineering Change Proposals (ECPs), Interface Control Documents (ICDs), and associated revision and audit activities
- Prior involvement with functional and physical configuration audits, including coordination with suppliers or government facilities
- Training or certification in configuration or data management disciplines (e.g., CMPIC or similar)
- Demonstrated ability to maintain and protect complex engineering baselines for hardware and software systems
- Strong judgment and decision-making skills aligned with regulatory, contractual, and policy requirements
- Commitment to continuous learning and maintaining up-to-date technical proficiency
Position Title: Clinical Review Clinician - Appeals
Work Location: Remote - Nationally sourced (Preference for 2 candidates in AZ)
Assignment Duration: 6 months
Work Schedule: 8:00 AM - 5:00 PM EST or CST
Work Arrangement: Remote
Position Summary
Schedule is 8-5 EST or CST hours. Staff will work when there are members of the supervisor/leadership on.
Cases are assigned in round robin fashion for staff to review and work.
Background & Context
The Organization's clinical team handles various types of authorization and claim review requests from various markets nationwide, processing clinical reviews to ensure members have the best outcomes and access to care needed.
Key Responsibilities
Nurses review case files, add, update or edit authorizations.
Work closely with the MD team to make final decisions on cases.
Process clinical reviews to ensure members have access to care needed.
Help reduce provider abrasion by processing retrospective claim reviews.
Work closely with supervisors, senior clinicians, and the coordinator team on end-to-end case processes.
Participate in team collaboration via Teams group chats for routine questions.
Qualification & Experience
Education/Certification (Required): Associate in nursing, Bachelor's in nursing or higher.
Licensure (Required): RN, LPN
Licensure (Preferred): LVN
Must haves:
Medicare knowledge
InterQual or Milliman Experience
Clinical reviews for Utilization Management or Appeals
Nice to haves:
Medicare Appeals Experience
Disqualifiers:
Not having a valid/active RN/LPN license
Performance indicators:
Productivity expectations vary based on platform.
Prime: 7 CPD
iCP: 9 CPD
CenPas: 20 CPD cases per day
95% quality on all cases
Candidate Requirements
Education/Certification
Required: Associate in nursing, Bachelor's in nursing or higher.
Preferred:
Licensure
Required: RN, LPN
Preferred: LVN- Years of experience required
- Disqualifiers
- Best vs. average
- Performance indicators
Must haves: Medicare knowledge, InterQual or Milliman Experience, Clinical reviews for Utilization Management or Appeals
Nice to haves: Medicare Appeals Experience
Disqualifiers: Not having a valid/active RN/LPN license
Performance indicators: Productivity expectations vary based on platform. Prime 7 CPD, iCP 9 CPD and CenPas is 20 CPD cases per day with 95% quality on all cases
Best vs. average: Productivity expectations are set based on platform.- Top 3 must-have hard skills
- Level of experience with each
- Stack-ranked by importance
- Candidate Review & Selection
1
Utilization Management or Appeals review background (1 plus year)
2
Medicare NCD/LCD and InterQual/Milliman Software (1 plus year)
3
Retrospective claims clinical reviews (1 plus year)
Certification Details
- BLS
- California RN License
Job Details
- Utilization Review Nurse II represents the fully experienced level in utilization review and discharge planning activities.
- Obtains and evaluates medical records for in-patient admissions to determine if required documentation is present.
- Obtains appropriate records as required by payor agencies and initiates Physician Advisories as necessary for unwarranted admissions.
- Conducts on-going reviews and discusses care changes with attending physicians and others.
- Formulates and documents discharge plans.
- Provides on-going consultation and coordination with multiple services within the hospital to ensure efficient use of hospital resources.
- Identifies pay source problems and provides intervention for appropriate referrals.
- Coordinates with admitting office to avoid inappropriate admissions.
- Coordinates with clinic areas in scheduling specialized tests with other health care providers, assessing pay source and authorizing payment under Medically Indigent Adult program as necessary.
- Reviews and approves surgery schedule to ensure elective procedures are authorized.
- Coordinates with correctional facilities to determine appropriate use of elective procedures, durable medical goods and other services.
- Answers questions from providers regarding reimbursement, prior authorization and other documentation requirements.
- Learns the documentation requirements of payor sources to maximize reimbursement to the hospital.
- Keeps informed of patient disease processes and treatment modalities.
- Level II teaches providers the documentation requirements of payor sources to maximize reimbursement to the hospital.
- Level II may assist in training Utilization Review Nurse I's.
- Knowledge of payor source documentation requirements and governmental regulations affecting reimbursement; knowledge of acute care nursing principles, methods and commonly used procedures; knowledge of common patient disease processes and the usual methods for treating them; knowledge of medical terminology, hospital routine and commonly used equipment; knowledge of acute hospital organization and the interrelationships of various clinical and diagnostic services.
- Ability to effectively evaluate the medical records of hospital admissions regarding continuing stay necessity, appropriateness of setting, delivered care, use of ancillary services and discharge plans.
- Ability to assess and judge the clinical performance of physicians and other health professionals.
- Ability to communicate documentation needs in an effective and tactful manner that promotes cooperation.
- Ability to teach co-workers what is needed and required in the medical record for reimbursement and audit purposes.
- Ability to gather and analyze data and prepare reports and recommendations based thereon.
- Ability to get along with physicians, other health providers, outside payor sources and the general public.
- Performs other job related duties as assigned.
Job Requirements
- Possession of a valid license as a Registered Nurse in the State of California.
- Level I: two (2) years of experience or its equivalent as a registered nurse in an acute care hospital, at least one (1) of which was on a medical/surgical ward or unit.
- Level II: one (1) year of utilization review/discharge planning experience in an acute care hospital or as a Case Manager in an alternate medical setting such as a clinic or physician’s office performing utilization review or discharge planning.
- Alternatively, possession of a valid license as a Registered Nurse in the State of California and five (5) years of experience as a Case Manager in an alternate medical setting such as a clinic or physician’s office performing utilization or discharge planning.
- Incumbents may be required to possess and maintain specific certificates competency based on unit specific requirements as a condition of employment.
Additional Details
- Case management experience in California (excluding Kaiser), preferably more than 1 assignment.
- Able to do both Utilization review and Care Coordination/Discharge planning.
- Experience in acute care/ICU/ED units.
- Extra: Trauma facilities experience.
- Experience with teaching facilities.
Ready to Rock Your Document Review Skills?
Hey legal eagles! Are you a newly licensed attorney looking for an exciting, long-term project that lets you flex your document review muscles? A fantastic firm in the Charleston, SC area is on the hunt for sharp onsite Document Review Attorneys to jump into an immediate, 6+ month gig. This isn't just another project; it's a chance to supercharge your resume and gain invaluable experience with a team that truly values you. Please note, if you have done extensive document review for Defense firms, you are likely conflicted out.
What You'll Be Doing as a Document Review Attorney (Your Superpower Moves!):
- Sleuthing through documents with precision and speed, using Relativity or other cool e-discovery software.
- Uncovering crucial information and sharing those "aha!" moments with your team leaders.
- Crafting top-notch litigation documents, like those all-important Deposition Dossiers.
- Tackling other fascinating tasks as your project leaders need a hand.
Who We're Searching For (Are You Our Next Superstar?):
- You've got that shiny JD from an ABA-accredited law school.
- You're either a licensed member of the SC Bar, or have a UBE score ready to transfer to SC, or are licensed in another state.
- You're a detail-oriented dynamo – thorough, organized, and nothing gets past your eagle eyes.
- You're a master of managing your time and can work independently like a pro.
- Your communication skills, both written and verbal, are top-notch.
- Bonus points if you're already a Relativity guru or have document review attorney experience, but no worries if not – we're ready to help you learn!
- You've got that natural knack for problem-solving.
The Sweet Deal (What's In It For You!):
- Competitive hourly rates ranging from $27 to $30.
- Subsidized health insurance for our awesome full-time reviewers!
Be ready to pass a comprehensive conflicts check! And rest assured, your resume is held in the strictest confidence.
Think you're a fit? We can't wait to hear from you! Apply at : This job description is not intended to be all-inclusive. The employee may perform other related duties as negotiated to meet the ongoing needs of the organization.
The WeCARE Physician is the role of Review Physician supports the Medical Director in the implementation of standard operation policies and procedures to ensure that UBA WeCARE complies with all New York City's HRA contractual requirements.
Key Responsibilities are:-To conduct medical reviews of Clinical Assessments/Clinical Reassessments for finalization, complete Wellness Plans dispositions for UBA WeCARE clients, and act as a clinical support for UBA WeCARE staff in the fulfillment of funder, (NYC HRA), contracted goals.
-Conduct medical reviews of Clinical Assessments completed by Qualified Health Professionals -Displays knowledge of medical conditions and SSA disability criteria.-Review prior WeCARE documentation, documentation provided by the client, prior and current Clinical Assessment/Clinical Reassessments, previous Medical Evaluation and Substance Use Assessment (when indicated).-Review, address, and correct any inconsistencies in the history obtained by the QHP-Order and review additional specialty assessments as indicated -Review and update Reasonable Accommodations and work limitations.-Determine appropriate medical diagnoses.
Assess the stability of client's medical issues.-Obtain medical documentation from EPIC, PSYCKES, and Bronx RHIO.-Enter information/complete appropriate forms in HRA (funder) database (SEAMS).
-Complete off-line/paper when medical record system SEAMS, is not functioning completely or is partially working.
-Ensure all off-line paper documents and medical records obtained from outside sources are scanned into SEAMS within 24 hours.
-Review the SSA sequential evaluation process conducted by the QHP to ensure accuracy.-Review provided wellness documentation from treatment providers -Check for medical documentation in EPIC, PSYCKES, and Bronx RHIO-Update and review reasonable accommodations and limitations-Ensure the FCO is correct and that the FCO justification contains relevant information -Review Wellness extensions with Medical Director and provide summary justifications for same-Able to assist and motivate clients to comply with WeCARE process.
Able to assist clients to access services to reduce barriers to compliance with WeCARE appointments.
-Knowledge of medical and behavioral health diagnoses.-Knowledge of various software systems including SEAMS, EPIC, PSYCKES, Bronx RHIO, etc.
-Possess strong computer skills with knowledge of Microsoft Office applications.
-Knowledge of SSA disability application process is preferred.Experience with NYC HRA preferred.Two years of professional experience in medical or clinical practice.Complete Wellness Enhancement Forms as indicated for Wellness track clients Medical and computer software (SEAMS, EPIC) and medical depository information databases (example PSYCKES, Bronx RHIO)In addition to a competitive salary of $180,000-220,000, we offer LTD, STD, paid malpractice, health, dental, vision and a 403(b).
Interested candidates should have a current unrestricted NYS Doctor of Medicine license to practice and American Board of Medical Specialties or American Osteopathic Association Board Certification and send an updated CV to Senior Recruiter, Desiree Aulet at Montefiore is an equal employment opportunity employer.
Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.
JOB TITLE: Clinical Review RN (Medicaid Cost Outlier)
Nurse Background: 2+ years of acute care/medical surgical experience required. Interqual/MCG experience a plus.
GENERAL RESPONSIBILITIES: This individual will complete the full spectrum of activities related to Utilization or Quality reviews as assigned. They will utilize their knowledge and expertise of the review program to conduct clinical level review, supporting Medical Review Analysts, and Physician Consultants to ensure an appropriate and accurate process.
DUTIES:
1. Conduct utilization reviews up to and including the appeal level. This includes chart screen, complete electronic worksheets, enter required information and make level one denial decisions when necessary.
2. Conduct quality and clinical study data collection reviews. This includes chart review, complete detailed electronic data worksheets.
3. Act as a resource for the administrative staff in training, problem solving, and clarifying procedures. Will provide technical assistance and conduct/participate in staff huddles.
4. Participate in collaborative training specific to clinical study objectives.
5. Other activities as may be deemed necessary.
QUALIFICATIONS:
1. Licensed as a Registered Professional Nurse in New York State.
2. Knowledge and experience with electronic medical records including utilization, quality, and clinical charting.
3. Ability to oversee, problem solve and work collaboratively with peers, medical, analytical, and administrative support staff.
4. Excellent written and verbal skills.
5. Ability to work independently with little supervision.
6. Ability and desire to be flexible, innovative, and creative.
EDUCATION & EXPERIENCE:
1. Baccalaureate degree in Nursing or graduate of an approved Registered Professional Nurses training program and licensed to practice in the State of New York.
2. A minimum of 2 years experience in an acute care facility preferably in medical surgical and utilization review experience highly preferable.
LOCATION: Jericho, NY (onsite)
***there is a free shuttle from the Jericho LIRR station + parking onsite
SHIFTS: M-F, 40 hours or 4x10s (no weekends)
PAY: $50-55/hr
DURATION: long term open ended contract includes benefits, sick time, 401k, weekly pay
- Ensure scientific accuracy and clinical appropriateness and validity of promotional materials from a medical/scientific standpoint
- Serve as a member of the Promotional Review Board or PRB
Relationships:
- Reports to a Director level employee in Medical Information and works with stakeholders throughout and at external agencies.
- Key relationships include Marketing, Legal, Regulatory Affairs and Medical Affairs.
Essential Functions:
- Provide critical review of promotional pieces to ensure medical accuracy, validity and appropriateness of content in accordance with approved labeling, scientific data and relevant laws, regulations to support the safe and effective use of products by patients and the medical community.
- Determine appropriateness of data and references used to support promotional claims and marketing messages and provide proactive recommendations and/or guidance for alternative da-ta/references/language where needed
- Align and collaborate with key cross-functional stakeholders including other Promotional Review Board or Promotional Review Board or PRB reviewers and commercial team members on issues or concerns related to promotional materials or claims
- Engage with commercial business partners early in the development of promotional materials to enhance efficiency, when applicable
- Review, provide comments and document verdicts for all assigned promotional materials within PRB workflow system based on assigned deadlines
- Participating in Promotional Review Board or PRB meetings as assigned
- Remain current with medical literature and data in assigned therapeutic area
Education Qualifications:
- PharmD (Doctor of Pharmacy) or MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine) or NP (Nurse Practitioner) with a minimum of two years of relevant professional experience (e.g. academic or clinical or industry experience)
Additional Qualifications:
- Thorough understanding of the US pharmaceutical industry or healthcare landscape, promotional review process and relevant guidance and compliance requirements
- Detail-oriented with demonstrated editorial skills
Medical Promotional Review Specialist
6-month contract
Must be able to work on a W2
Hybrid in Plainsboro, NJ
TOP 3 “MUST HAVES”:
1. Demonstrated expertise in reviewing medical literature and independently evaluating scientific validity and clinical appropriateness of promotional content.
2. Proven ability to clearly and concisely communicate scientific information
3. Demonstrated ability to build and maintain collaborative relationships across multiple disciplines
PURPOSE:
Ensure scientific accuracy and clinical appropriateness and validity of promotional materials from a medical/scientific standpoint
Serve as a member of the Promotional Review Board (PRB)
ESSENTIAL FUNCTIONS:
• Provide critical review of promotional pieces to ensure medical accuracy, validity and appropriateness of content in accordance with approved labeling, scientific data and relevant laws, regulations and NNI policies to support the safe and effective use of products by patients and the medical community.
• Determine appropriateness of data and references used to support promotional claims and marketing messages and provide proactive recommendations and/or guidance for alternative da-ta/references/language where needed
• Align and collaborate with key cross-functional stakeholders including other PRB reviewers and commercial team members on issues or concerns related to promotional materials or claims
• Engage with commercial business partners early in the development of promotional materials to enhance efficiency, when applicable
• Work with the Medical Director for the assigned product(s)/therapeutic area(s) to increase efficiency, medical alignment, and mitigate risk of promotional claims
• Review, provide comments and document verdicts for all assigned promotional materials within PRB workflow system based on assigned deadlines
• Participate in PRB meetings as assigned
• Remain current with medical literature and data in assigned therapeutic area(s)
• Participate in relevant internal and external meetings and trainings on new guidance/regulations, new scientific information and marketing strategy
QUALIFICATIONS:
• PharmD / MD/ DO / NP with a minimum of two years of relevant professional experience (e.g. academic, clinical or industry experience); post-doctoral fellowship may be substituted for professional experience, as appropriate
• Thorough understanding of the US pharmaceutical industry and healthcare landscape, promotional review process and relevant guidance and compliance requirements
• Detail-oriented with demonstrated editorial skills
• Strong organization and prioritization skills
• Ability to work on cross-functional teams
• Ability to critically analyze and apply scientific data in a customer-focused manner
• Strong verbal and written communication skills
• Effective negotiation skills and ability to influence others
The Estimator is responsible for ensuring all flooring bids are technically accurate, competitively structured, and financially sound before submission to customers. This role serves as the final quality control checkpoint for bid accuracy, scope alignment, and margin protection across new construction and large project bids.
They will work closely with sales, estimating, purchasing, and operations to ensure bids are properly structured, risk is identified early, and projects are prepared for successful execution.
This position requires extensive experience in flooring estimating, construction bidding, and plan/spec review, with the ability to identify scope gaps, quantity errors, and pricing risks before bids are released. This role plays a critical part in protecting company margin, preventing costly project mistakes, and improving bid quality across the organization.
Primary Responsibilities:
Bid Strategy & Quality Control
- Review large and complex flooring bids prior to submission.
- Validate takeoffs, material quantities, labor assumptions, and pricing structures.
- Ensure bids align with project plans, specifications, and scope requirements.
- Identify risk areas such as:
- Scope gaps
- Quantity miscalculations
- Incorrect product specifications
- Margin erosion
- Installation complexity
- Provide feedback and corrections to estimators and sales teams before submission.
Preconstruction Review
- Review architectural plans and specifications for flooring scope.
- Confirm scope alignment between drawings, specifications, and proposals.
- Identify missing scope or potential change order risks prior to bid submission.
- Assist estimating team in improving bid structure and consistency.
Margin Protection
- Ensure bids meet company margin expectations.
- Identify pricing risks before customer submission.
- Flag bids that require leadership review.
Bid Process Improvement
- Identify recurring estimating errors and training opportunities.
- Develop internal bid review standards and checklists.
- Support ongoing estimator training and quality improvement.
Post-Award Project Validation
- Review awarded bids to confirm final scope and pricing accuracy.
- Ensure project setup in ERP reflects the approved bid structure.
- Confirm correct materials, quantities, and pricing before purchasing.
Cross-Department Coordination
- Work closely with sales, estimating, purchasing, operations, and finance to ensure projects are properly prepared for execution.
Required Experience
- 5–10+ years of construction estimating experience
- Extensive flooring estimating experience
- Experience reviewing construction plans and specifications
- Strong knowledge of flooring materials and installation methods
- Experience preparing or reviewing large project bids
- Strong understanding of construction scopes and subcontractor bidding
- Advanced Excel skills
- Experience with estimating software
Preferred
- Experience estimating large multifamily or production builder projects
- Experience with takeoff software such as:
- MeasureSquare
- PlanSwift
- Bluebeam
No Recruiters, please.
As a Digital Car Sales Specialist, your focus will be on closing deals, utilizing our online systems to guide customers through every stage of the sales process—from the initial lead inquiry to final sale.
