Supervisor, Utilization Management TriWest Healthcare AllianceSupervisor, Utilization ManagementMilwaukee, WIRemoteFull timeTechnical Skills: Thorough knowledge of policies and procedures, knowledge of managed care principles and methods; medical terminology; proficiency in the application of clinical criteria: InterQual, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, current Procedural Terminology, and Healthcare Common Procedural Coding System, and American Dental codes; working knowledge with medical management systems; proficient with Microsoft Office; knowledge of UM Process; reporting techniques. • Prepares work schedules and monitors staff caseloads to ensure adequate staffing levels at all times and accurate data entry and application of the medical management system.
Sr Info Security Engineer TriWest Healthcare AllianceSr Info Security EngineerMilwaukee, WIRemoteFull timePlans delivery of solutions; answers technical and procedural questions from less experienced team members; teaches improvement processes; mentors team members and provides security technical leadership to other Information Security and Information Technology team members. • Experience in a role that has lead security operations, security tools and solutions, secure applications and networking in the implementation of NIST and Security Best Practices to meet or exceed compliance with the FISMA Moderate/High requirements.
Data Engineer Sr. TriWest Healthcare AllianceData Engineer Sr.Milwaukee, WIRemoteFull timeTechnical Skills: Strong knowledge of data warehouse design; data modeling; proficiency with SQL; strong experience with data extraction, transformation, and loading (ETL); working knowledge of report and dashboard development; strong knowledge of SQL Server / Snowflake databases; working knowledge of Oracle databases. • Bachelor's Degree in Business Administration, Computer Science, Mathematics, Engineering, or related field with programming and database systems coursework or equivalent database development experience.
Senior Buyer TriWest Healthcare AllianceSenior BuyerMilwaukee, WIRemoteFull timeAssists departments in obtaining pricing and other information from vendors as well as reviews contracts and assists business units in the management of contractual obligations of the vendor to ensure that all terms and conditions are met. Act as SME in support of Procurement, Contract Management, DHA/ VA Contract Modification, Finance and business teams in support of pricing efforts including ROMs, RFIs/ RFPs, contracts, and licensing agreements.
Senior Clinical Coding Analyst TriWest Healthcare AllianceSenior Clinical Coding AnalystMilwaukee, WIRemoteFull timeIndependent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources. Conducts retrospective medical claims review for coding and pricing determinations and/or coding review for inpatient (facility) claims to include diagnosis and procedural coding with DRG assignment.
Property Adjuster (Greater Milwaukee Area) Erie InsuranceProperty Adjuster (Greater Milwaukee Area)Milwaukee, WIRemoteFull timeAdditional benefits that include company-paid basic life insurance; short-and long-term disability insurance; orthodontic coverage for children and adults; adoption assistance; fertility and infertility coverage; well-being programs; paid volunteer hours for service to your community; and dollar-for-dollar matching of your charitable gifts each year. *This range represents a national range and the actual salary will depend on several factors including the scope and complexity of the role and the skills, education, training, credentials, location (State) based on ERIE's geographical differences, and experience of an applicant, as well as level of role for which the successful candidate is hired.
Property Adjuster (Central Wisconsin) Erie InsuranceProperty Adjuster (Central Wisconsin)Brookfield, WIRemoteFull timeAdditional benefits that include company-paid basic life insurance; short-and long-term disability insurance; orthodontic coverage for children and adults; adoption assistance; fertility and infertility coverage; well-being programs; paid volunteer hours for service to your community; and dollar-for-dollar matching of your charitable gifts each year. *This range represents a national range and the actual salary will depend on several factors including the scope and complexity of the role and the skills, education, training, credentials, location (State) based on ERIE's geographical differences, and experience of an applicant, as well as level of role for which the successful candidate is hired.
Customer Service Rep - Spanish Fluency Required TriWest Healthcare AllianceCustomer Service Rep - Spanish Fluency RequiredMilwaukee, WIRemoteFull timeAccurately assesses caller requests, answers caller inquires and processes requests while focusing on first call resolution and/or appropriate call escalation protocols. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.
Manager, Government Accounting TriWest Healthcare AllianceManager, Government AccountingMilwaukee, WIRemoteFull timeThe Government Accounting Manager leads program financial management activities across multiple federal contracts, contract line items, and contract modifications, ensuring compliant general ledger operations aligned with company policy, company disclosed accounting practices, FAR, DFARS, and CAS. As a key business partner to Budget, Contract Management, Procurement, and Human Capital teams, the manager ensures accurate financial reporting and supports program execution by ensuring general ledger reporting is relevant and reliable.
NewCustomer Service Representative (AR, IL, IA, KS, LA, MO, MN, NE, ND, OK, SD & WI) only TriWest Healthcare AllianceCustomer Service Representative (AR, IL, IA, KS, LA, MO, MN, NE, ND, OK, SD & WI) onlyMilwaukee, WIRemoteFull timeAccurately assesses caller requests, answers caller inquires and processes requests while focusing on first call resolution and/or appropriate call escalation protocols. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.
NewDirector, Referral Management TriWest Healthcare AllianceDirector, Referral ManagementMilwaukee, WIRemoteFull timeCollaborates with Utilization Management Director, MVS Directors, network providers, Military Treatment Facilities and TRICARE Regional Office West regarding TriWest's RM program initiatives including submission, review, optimization and return of clinical documentation processes. In collaboration with our Military & Veteran Services (MVS) leadership team and the Clinical Operations Utilization Management team, the Director develops strategies for achieving annual Referral Management goals and objectives, including input on system configuration and process development.
Senior Human Capital Generalist TriWest Healthcare AllianceSenior Human Capital GeneralistMilwaukee, WIRemoteFull timeTechnical Skills: Advanced collaboration, listening, consulting, and conflict resolution skills; experience conducting investigations; in-depth knowledge of TriWest Human Capital policies and procedures; knowledge of Human Resources management concepts; Federal, state, and local employment law; ability to maintain the confidentiality of information and maintain safeguards; presentation skills. Coaches leaders on Triest Human Capital policies and procedures, including employee relations, leadership development, exit interviews, turnover analysis, performance appraisal system, leadership training, and investigations.
Business Analyst Sr TriWest Healthcare AllianceBusiness Analyst SrMilwaukee, WIRemoteFull timeIndependent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources. The position collaborates to ensure relevant analysis and complete, timely reporting is provided to meet TriWest business needs and Government's Healthcare requirements.
Direct Contracting Manager TriWest Healthcare AllianceDirect Contracting ManagerMilwaukee, WIRemoteFull timeMedicaid, Medicare, TRICARE, VAPC3), and the insurance industry; skill in diplomacy and negotiation; skill in financial analysis to analyze contractual reimbursement; skill in project management; skill in presentation; proficient with Excel. Develops hospital, physician and ancillary service agreements, ensures adherence with government operational manuals, monitors network shortfalls, and resolves access issues throughout the assigned region.
Dir, Bus Design & Prod Mgmt TriWest Healthcare AllianceDir, Bus Design & Prod MgmtMilwaukee, WIRemoteFull timeThis position requires in-depth knowledge and expertise in all aspects of TriWest's business contracts and provides cross-functional leadership and design as needed to adjust to a constantly changing environment. The Director of Business Design and Product Management oversees multiple operational support teams including Business Design and Integration (BDI) and Product Management.
Customer Service Rep (AZ, CO, ID, MT, NM, NV, OR, UT & WA only) TriWest Healthcare AllianceCustomer Service Rep (AZ, CO, ID, MT, NM, NV, OR, UT & WA only)Milwaukee, WIRemoteFull timeAccurately assesses caller requests, answers caller inquires and processes requests while focusing on first call resolution and/or appropriate call escalation protocols. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.
Salesforce Health Cloud Architect TriWest Healthcare AllianceSalesforce Health Cloud ArchitectMilwaukee, WIRemoteFull timeTechnical Skills: General knowledge of data communication architectures, design, and support; General knowledge of the technology impacts on business and how to integrate technical plans to support enterprise business function; Business problem-solving skills; Understanding of project management concepts and techniques, including metrics. Works directly with Salesforce Health Cloud development teams, administrators and 3rd party vendor partners to provide expert technical direction, instruction, and leadership around complex technical concepts.
Technical Services & Sustainability Operation (Tsso) Sales Executive JLLTechnical Services & Sustainability Operation (Tsso) Sales ExecutiveMilwaukee, WIRemoteThis role is responsible for driving fee revenue and contribution income growth for JLL's Technical Services & Sustainability Operations (TSSO) within assigned accounts and market segments, and reports to the Head of Functional Occupier Solutions. The TSSO Sales Executive works collaboratively with pursuits teams, account managers, and the Global TSSO operations team to deliver growth, enhance client relationships, and advance TSSO positioning in the market.
Engineering Director JLLEngineering DirectorMilwaukee, WIRemoteWhether you've got deep experience in commercial real estate, skilled trades or technology, or you're looking to apply your relevant experience to a new industry, join our team as we help shape a brighter way forward. The role involves overseeing engineering staff, supporting building operations, developing strategic plans, and ensuring consistent maintenance management practices across the portfolio.
Environmental Site Assessor JLLEnvironmental Site AssessorMilwaukee, WIRemote$45,000–$90,000 / yearWhat this job involves: As an Environmental Phase I Report Writer at JLL, you'll play a critical role in delivering comprehensive environmental site assessments that inform real estate transactions and support our clients' strategic objectives. Whether you've got deep experience in commercial real estate, skilled trades or technology, or you're looking to apply your relevant experience to a new industry, join our team as we help shape a brighter way forward.