Licensed Vocational Nurse-LPN Apidel TechnologiesLicensed Vocational Nurse-LPNRemote, RIRemoteContractorThe Licensed Practical Nurse is a graduate of a school of Practical or Vocational Nursing, approved by the State Agency and/or accredited by the National League for Nursing (Accrediting Commission (NLNAC)) at the time the program was completed by the applicant. 1. Do you currently hold an active, unrestricted LPN/LVN license Yes No. 2. Do you have 2%2B years of RECENT hands-on prior authorization experience (not scheduling, DME, surgery or procedure referrals, or intake) Yes No.
Sr. Manager, AI Lead - Semantic Layer - Remote CSAA Insurance GroupSr. Manager, AI Lead - Semantic Layer - RemoteRIRemote$168,300–$187,000 / yearAlabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, Colorado - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker, Montana - Home Teleworkers {+ 21 more}. As the product owner, this leader will drive vision, strategy, roadmap, and adoption, translating complex business and technical needs into a scalable, governed, and business-aligned product that powers search, analytics, automation, interoperability, and generative AI use cases.
Specialist, Profee Follow Up Ovation HealthcareSpecialist, Profee Follow UpA-Stat Medical Billing - Pawtucket, RIRemoteGENERAL SUMMARY: Follow Up Specialists will work on electronic denial, paper denials and unpaid claims reports to resolve any claims that are denied or unpaid by all insurance carriers. Ovation Healthcare's vision is to be a dynamic, integrated professional services company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer focused behavior.
ADMINISTRATOR II (BHDDH) State of Rhode IslandADMINISTRATOR II (BHDDH)RI$103,293–$117,155 / yearREQUIRED QUALIFICATIONS FOR APPOINTMENT: KNOWLEDGE, SKILLS AND CAPACITIES: A thorough knowledge of the operations of the program or services area and the ability to utilize this knowledge in promoting effective and efficient programs and services; a thorough knowledge of trends and best practices in the program or services area and the ability to apply this knowledge to planning, coordinating, administering and evaluating the program; a working knowledge of the principles and practices employed in the administration of public health care programs and services; a working knowledge of relevant laws, regulations, policies and procedures; the ability to lead, supervise, direct, assign and evaluate the work of subordinates the ability to provide leadership and coordination; the ability to serve as and effective member of an administrative team; the ability to communicate effectively; the ability to meet and conform to the requirements of an operational set of performance specifications; and related capacities and abilities. GENERAL STATEMENT OF DUTIES: Within a Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH) area designated as a medium-sized organizational component, to have the assigned responsibility for assisting in the overall administration of the planning, development and implementation of operational functions; or to have the assigned responsibility for assisting in the overall administration of a BHDDH program of substantially comparable complexity; and to do related work as required.
Pharmacy Operations Manager Walgreen CoPharmacy Operations ManagerWarwick, RI$22.50–$31 / hourAssists Pharmacy Manager in monitoring that all pharmacy and team member licensures, registrations and certifications are active and in good standing/ compliant with all regulatory and legal requirements. Where state and federal laws/regulations allow, accountable for performing day-to-day non-clinical pharmacy operations, administrative activities; Ensures efficient pharmacy workflow and a positive patient experience.
Pharmacy Intern Grad Walgreen CoPharmacy Intern GradWarwick, RI$60.90–$82.30 / hourCounsels patients and answers their questions regarding usage of medicine, side effects, interactions, contraindications, patient information privacy, generics, less expensive medicines, over-the-counter products, and refers to medical provider as needed to ensure medication is taken correctly, health needs addressed, and satisfaction with service. Models and shares customer service best practices with all team members to deliver a distinctive and delightful customer experience, including interpersonal habits (e.g., greeting, eye contact, courtesy, etc.) and Walgreens service traits (e.g., offering help proactively, identifying needs, servicing until satisfied, etc.).
Highline Warranty Administrator Murgado Automotive GroupHighline Warranty AdministratorBarrington, Rhode IslandProblem Resolution : Addressing and resolving any issues or discrepancies related to warranty claims Coordination : Working closely with service advisors and technicians to verify warranty coverage and ensure timely claim submission Communication: Communicate effectively with customers, dealers, and manufacturers regarding warranty claims. We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information.
Absence Management Specialist Unit Leader MetLife IncAbsence Management Specialist Unit LeaderWarwick, RI$55,600–$99,300 / yearRecognized on Fortune magazine\''s list of the "World\''s Most Admired Companies", Fortune World's 25 Best Workplaces, as well as the Fortune 100 Best Companies to Work For, MetLife, through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics").
Professional Biller II Care New England Health SystemProfessional Biller IIWarwick, Rhode IslandFull timeAbout Us: Care New England Health System (CNE) and its member institutions, Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, is a trusted, integrated health care organization that fuels the latest advances in medical research, attracts the nation’s top specialty-trained doctors, hones renowned services and innovative programs, and engages in the important discussions people need to have about their health and end-of-life wishes. Listens to patients issues, accesses the patient’s account and either explains transactions as documented, or works with the patient to identify incorrect items that prevent the billing from being paid appropriately.
NewThird Party Analyst Care New England Health SystemThird Party AnalystWarwick, RICare New England Health System (CNE) and its member institutions, Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, is a trusted, integrated health care organization that fuels the latest advances in medical research, attracts the nation's top specialty-trained doctors, hones renowned services and innovative programs, and engages in the important discussions people need to have about their health and end-of-life wishes. Care New England is helping to transform the future of health care, providing a leading voice in the ongoing effort to ensure the health of the individuals and communities we serve.
Director Payment Integrity Blue Cross & Blue Shield of Rhode IslandDirector Payment IntegrityProvidence, Rhode IslandTo further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia.
Mgr, Business Consultant CVS Health CorpMgr, Business ConsultantRI$60,300–$132,600 / yearThe Manager will be responsible for ensuring the accuracy, completeness, and timeliness of encounter data submissions while partnering closely with internal business and technical teams, as well as external vendors, to meet regulatory and operational requirements across multiple states. As the Dual Special Needs Plan (DSNP) business continues to expand, we are seeking an experienced Manager, Encounter Data & State Submission Operations to lead the end-to-end management of encounter and claims data submissions to state agencies.
Supervisor of TPC and CCBHC Revenue Cycle Care New England Health SystemSupervisor of TPC and CCBHC Revenue CycleWarwick, Rhode IslandFull timeJob Summary: The Supervisor of TPC and CCBHC Revenue Cycle is an operational leader responsible for supporting the day-to-day revenue cycle functions for The Providence Center (TPC) and Certified Community Behavioral Health Clinic (CCBHC) services. This role focuses on ensuring timely billing, accurate follow-up, and resolution of accounts receivable, while supporting a high-touch, service-oriented model that requires significant manual intervention.
Senior Director, Customer Business Development CVS Revlon IncSenior Director, Customer Business Development CVSProvidence, RIRemote$170,000–$210,000 / yearDirector is expected to challenge the status quo, identify new go-to-market opportunities, influence across merchandising, marketing, supply chain, store operations, finance, and digital/omnichannel teams, and mobilize internal cross-functional partners to deliver business results with excellence. Director, Sales is responsible for developing, executing, and fostering a collaborative business partnership between Revlon brands and CVS with accountability for delivering volume, share, profitability, and customer category growth objectives.
Deputy Personnel Administrator State of Rhode IslandDeputy Personnel AdministratorProvidence, RI$133,541–$152,065 / yearThe Deputy Personnel Administrator provides leadership and direction to professional Benefits Unit staff and works collaboratively with executive leadership, agency human resources teams, labor relations, union representatives, finance, procurement, legal counsel, actuaries, brokers/consultants, and external vendors to ensure compliant, equitable, fiscally responsible, and customer-focused delivery of benefits services statewide. REQUIRED QUALIFICATIONS FOR APPOINTMENT: KNOWLEDGES, SKILLS AND CAPACITIES: A thorough knowledge of the principles, practices and techniques of modern public personnel administration; a thorough knowledge of state government, and of the organizational structure and functions of its departments and agencies; a thorough knowledge of the principles, practices and techniques of personnel psychology, including position classification, employee selection and evaluation, organizational behavior, test development and construction; a thorough knowledge of any directly assigned program area, e.g.
Compliance and Risk Officer PROVIDENCE COMMUNITY HEALTH CENTERS, INC., THECompliance and Risk OfficerProvidence, RIThe Compliance and Risk Officer is responsible for the development, implementation, oversight, and continuous improvement of Providence Community Health Centers' Corporate Compliance Program, Enterprise Risk Management Program, Patient Safety Program, and Health Insurance Portability and Accountability Act (HIPAA) Privacy Program. The Compliance and Risk Officer serves as the organization's designated Compliance Officer and HIPAA Privacy Officer and provides support in identifying, assessing, mitigating, and monitoring organizational risk while ensuring compliance with applicable federal and state laws, regulations, contractual requirements, and organizational policies.