Utilization Management Review Manager

UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members' well-being. With our commitment to simplicity, honesty, and leadership, we navigate challenges with our customers to achieve affordable health care...

Position SummaryDrive, lead and support the team for control assurance activities. Provide expertise in crafting and delivering assurance on Non financial key controls. This role will need to co-ordinate with a set of Control owners/risk managers/champions in respective business verticals where the controls are owned. The team will be part of central Control...

Key ResponsibilitiesReview patient records and provider notes to validate clinical necessityComplete prior authorization forms and submit to payers via online portals or faxFollow up on status of submitted requests and escalate delays appropriatelyMaintain documentation accuracy and compliance with turnaround time requirementsBalance quality of care with...

JOB DESCRIPTION:Manage and oversee the daily operations of the accounting department including: month and end-year processaccounts payable/receivablecash receiptsgeneral ledgerpayroll and utilitiestreasury, budgetingcash forecastingrevenue and expenditure variance analysiscapital assets reconciliationstrust account statement reconciliations,check runsfixed...

Drive, lead and support the team for control assurance activities. Provide expertise in designing and delivering assurance on Non financial key controls. This role will need to co-ordinate with a set of Control owners/risk managers/champions in respective business verticals where the controls are owned. The team will be part of central Control utility...

Key ResponsibilitiesReview patient records and provider notes to validate clinical necessityComplete prior authorization forms and submit to payers via online portals or faxFollow up on status of submitted requests and escalate delays appropriatelyMaintain documentation accuracy and compliance with turnaround time requirementsRequirementsActive USRN...

JOB DESCRIPTIONBAR MANAGER● A. Staff Management○ Hire, train and oversee bar employees○ Plot work schedule and ensure adequate manpower coverage in all shifts○ Facilitate training and development opportunities for staff○ Foster a positive culture and work environment and address any issues or conflicts●● B. Inventory Control○ Manage inventory...

The Messenger or Liaison / Utility Staff will be responsible for delivering documents and packages while also providing general support to the office and its operations. This role requires reliability, flexibility, and strong organizational skills to ensure smooth and efficient daily activities.Key Responsibilities:Delivery and Collection: Transport...

Non Negotiable: Project Management Tools7 years of Project Management, Supply Chain, Warehouse Maintenance, Transportation and Logistics, and Industrial Engineering,Excellent Communication SkillsJob Qualifications:-In-depth understanding of Project Management and Industrial Engineering principles.-Proficiency in Project Management / Industrial Engineering...

The Resource Manager is responsible for optimizing workforce deployment and ensuring a positive employee experience. This role is also responsible for the seamless coordination of resource allocation, onboarding, performance management, and employee relations within assigned accounts. The Resource Manager acts as a key liaison between employees, clients, and...