20 Best project specialist jobs (Hiring Now!)

Referral Specialist, RN, Health Plan
Sanford Health —South Dakota
Currently holds an unencumbered registered nurse (RN) license with the State Board of Nursing. Ensure services comply with professional standards, national and…
$27.50 - $44.00 an hour
Quick Apply
3h
Closing Specialist
Veterans United Home Loans —Columbia, MO
Quality Control: Perform quality control analysis to maintain high standards. Effectively Communicating: Coordinate with loan teams and third-party vendors,…
$19.23 an hour
Outreach Professional Sr/Farm Viability Specialist
University of Vermont —Burlington, VT
This position is also an integral outreach educator with primary responsibilities of working directly with farm business owners on financial statement…
$58,000 - $65,000 a year
Healthcare Process Improvement Specialist
Star Valley Health —Afton, WY
The Process Improvement Specialist will work closely with healthcare professionals, administrators, and other stakeholders to identify areas for improvement,…
$34.52 - $51.80 an hour
Quick Apply
Content Specialist
Steffes, LLC —Dickinson, ND
Experience in content and layout design, including proficiency in Adobe InDesign or similar tools. The primary focus will be on creating and implementing a…
From $50,000 a year
Quick Apply
Proofreader
Implico Communications Inc. —Dallas, TX
Ability to manage multiple projects simultaneously, demonstrating flexibility and problem-solving. This specialized training includes learning to write benefits…
$22 an hour
Quick Apply
13h
Email Marketing Specialist
LUVU BRANDS —Atlanta, GA
You should have a strong grasp of current marketing tools and strategies and be able to lead integrated digital marketing campaigns from concept to execution.
$58,004 a year
Quick Apply
Communication Specialist
FocusKPI Inc. —San Francisco, CA
Build and manage social media strategy for executives, maintaining a calendar of social posts. Pitch in with writing and content needs across the communications…
$35 - $42 an hour
Quick Apply
1d
Painter
Completely Custom Finishes —Belgrade, MT
Maintain equipment from hand tools, power tools, and saftey equipment. Completely Custom Finishes is a painting company specializing in high-end projects and…
$18 - $30 an hour
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11d
Construction Specialist
Palo Alto Alvarado Concepts —Greenwood Village, CO
Operate and maintain various hand tools and power tools necessary for drywall installation and finishing, such as tape measures, saws, drills, and sanders.
Estimated: $48.2K - $61.1K a year
Quick Apply
4d
Project Control Specialist
NetImpact Strategies —Falls Church, VA
Support the development and implementation of risk mitigation plans. Support the management and execution of IA projects, contributing to the development and…
Estimated: $47.6K - $60.3K a year
1d
Creative Project Management Specialist - Remote
Hilton Grand Vacations —Orlando, FL
Proactively and consistently conceive of, define, and develop process improvements to increase efficiency and productivity across the Branding & Creative…
Estimated: $55K - $69.6K a year
1d
Associate Transit Planner - Community Development
Spokane Transit Authority —Spokane, WA
A Bachelor’s degree from an accredited college or university in transportation or urban planning, geography, mapping, business or public administration,…
$70,059 - $93,886 a year
Substitute JAG Specialist
JobWorks, Inc. —Valparaiso, IN
Provides appropriate curriculum and ensures students achieve specific JAG competencies through classroom instruction; teaches through a variety of methods…
From $30 an hour
Quick Apply
Project Specialist - Church HR
HR Ministry Solutions —Remote
The HR Project Specialist is a detail oriented and driven person with an innate ability to see God’s fingerprints in HR for churches and has a passion to…
$20 - $22 an hour
Quick Apply
1d
Certification Specialist
American Osteopathic Association —Remote
Deals with the administrative and clerical duties of the position as needed to support the Vice President, Associate Vice President, and Certification Manager’s…
$58,000 - $63,500 a year
Quick Apply
3d
FEMA Public Assistance Specialist
Thompson Consulting Services —United States
Valid driver's license and safe driving history. May be required to work outside when conducting project site inspections or other field work.
$35 - $45 an hour
Quick Apply
2d
LIHTC Re-Certification & Project Based Section 8 Compliance Specialist
Confidential —Bronx, NY
Initial, Annual, and interim recertifications in compliance with management guidelines, local, state, and federal regulations. High School Diploma or GED.
$50,000 - $65,000 a year
Quick Apply
Senior Marketing Specialist
Gastineau Log Homes, Inc. —Kingdom City, MO
Proficiency in multimedia production tools and platforms, such as Adobe Creative Suite, Final Cut Pro, and social media management tools.
$50,000 - $60,000 a year
Quick Apply
9d
Risk Management Support Specialist
Confidential —Lago Vista, TX
Opportunity to obtain national Human Resource and Risk Management certifications plus other required state licenses.
Estimated: $63.6K - $80.5K a year
Quick Apply

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Referral Specialist, RN, Health Plan

Sanford Health - South Dakota

Quick Apply

Job Details

Full-time $27.50 - $44.00 an hour 3 hours ago

Benefits

Health insurance
Dental insurance
401(k)
Vision insurance
Opportunities for advancement
Life insurance

Qualifications

Nursing
RN License
ICD coding
3 years
Medical administrative support
Bachelor's degree
Case management
Utilization management
CPT coding
Medical terminology
Communication skills

Full Job Description

Careers With Purpose

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

Facility: Remote SD (Central Time)

Location: City - Remote SD, SD

Address:
Shift: 8 Hours - Day Shifts

Job Schedule: Full time

Weekly Hours: 40. 00

Salary Range: $27.50 - $44.00

Department Details

Fun, fast paced work, remote work

Job Summary

Communicate with providers and/or members regarding management of out-of-network exception requests. Provide care coordination for designated Health Plan members that includes managing and directing members to appropriate resources, services and programs. Work directly with referring providers and participating provider specialty groups in coordinating care.

Responsible for managing the authorization process for participating plan members ensuring that all services are performed within assigned evidence-based guidelines and performed at the appropriate level of care in a timely, cost-effective and efficient manner. The collection and interpretation of clinical information is necessary to initiate and execute authorizations. Essential functions must occur simultaneously; therefore, the specialist must be able to appropriately handle and prioritize various daily tasks. Must be able to collaborate with other health plan departments as needed for medical coverage, case agreement negotiation and policy application. Obtain and maintain appropriate documentation concerning services in accordance to regulatory and accreditation guidelines and timelines. Provide information to providers and members in regards to authorization and/or denial of services. Ability to review, analyze and summarize reports and have effective oral and written communication skills. Understanding of medical terminology, international classification of diseases and current procedural terminology (CPT) codes. Understanding and administration of medical, administrative and management principles and policy necessary to operate within a managed care organization.

Ability to determine appropriate action for referring cases that do not meet departmental standards and require additional secondary review and/or escalation as needed.

May also be actively involved in collaborating with members of the healthcare team to promote medically necessary resource utilization and achievement of fiscal outcomes when appropriate. Collaborates with physicians and other clinical professionals as needed to assist in documentation improvement practices for effective and appropriate services. Dynamic and tactful interpersonal skills, particularly in relating to physicians and other health care professionals. Educates members of the healthcare team regarding trends, external regulations and internal policies that effect resource utilization and potentially, prior authorization.

Assists the department in monitoring the utilization of resources, risk management and quality of care for patients in accordance with guidelines and criteria. Assist in report preparation, correspondence, and maintenance of appropriate records. Ensure services comply with professional standards, national and local coverage determinations (NCD/LCD), centers for Medicare and Medicaid services (CMS), as well as state and federal regulatory requirements. Maintain working knowledge of payer standards for UM functions for authorization requirements.

May assist with additional special projects related to work, upcoming initiatives, new organizational goals and audits when delegated. Considered a resource to all team members and acts as a point of contact for guidance, training, and assisting with questions. Demonstrate flexibility and adaptability where scheduling may fluctuate due to communication needs within interdepartmental and clinical units are required.

Possesses strong clinical knowledge and skills. Collaborates with team members both internally and externally to ensure care is coordinated and appropriate based on evidence based medicine. Ability to work independently or as a member of a team. Ability to multitask and work with little direction. Works primarily day hours.

Administer and prioritize daily tasks, and apply Sanford Health Plan policies and regulatory requirements consistently and use good judgment as when to seek out guidance. Possess broad understanding of products and benefits and a demonstrated understanding of regulatory requirements and timeframes.

Assist with coordination of activities related to insurance pre-certification/authorization. Provide counseling to members or their representative regarding pre-service requirements and instructions.

Qualifications

Bachelor's degree in nursing preferred. Graduate from a nationally accredited nursing program required, including, but not limited to, Commission on Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN), and National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA).

Will consider applicant with significant background in case management and/or utilization management experience. Minimum of three years nursing experience is required.

Currently holds an unencumbered registered nurse (RN) license with the State Board of Nursing. Obtains and subsequently maintains required department specific competencies and certifications.

Benefits

Sanford Health offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits .

Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org .

Sanford Health has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.

Req Number: R-0189887

Job Function: Health Plan

Featured: No

Quick Apply

project specialist jobs

Referral Specialist, RN, Health Plan

Closing Specialist

Outreach Professional Sr/Farm Viability Specialist

Healthcare Process Improvement Specialist

Content Specialist

Proofreader

Email Marketing Specialist

Communication Specialist

Painter

Construction Specialist

Project Control Specialist

Creative Project Management Specialist - Remote

Associate Transit Planner - Community Development

Substitute JAG Specialist

Project Specialist - Church HR

Certification Specialist

FEMA Public Assistance Specialist

LIHTC Re-Certification & Project Based Section 8 Compliance Specialist

Senior Marketing Specialist

Risk Management Support Specialist

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