Jobs in the United States

25+ jobs

Group jobs by employerEmail me new jobs Save this search

Added just now
TS
Billing Team Leader
Transitional Services For New York Inc
Queens, NY
- $75,000 USD / year
have an understanding of medical coding systems affecting the adjudication of patient accounts in EDI, UB04 or 1500 forms.
Added just now
TS
Maintenance Tech/ Utility Porter
Transitional Services For New York Inc
Queens, NY
- $30.21 USD / hour
Driver’s license required · A High School diploma or the equivalent and completion of a technical school and more than up to two years training certification required
Added just now
PM
Licensed Clinical Social Worker
Playground Management MSO LLC
Cookeville, TN
- $83,000 USD / year
Deliver therapy using evidence-based modalities (e.g., CBT, DBT-informed skills, play therapy techniques, family systems approach) tailored to developmental stage and clinical presentation.
Added just now
T
Sr. Enterprise Systems Engineer
TEKsystems
Mason, MI
- $57 to $70 USD / hour
The Enterprise Systems group is responsible for the physical and virtual server environment, storage, and 3rd-tier OS support for systems deployed at company locations world-wide.
Added just now
T
Customer Service Representative
TEKsystems
Tempe, AZ
- $21.42 USD / hour
…program, where you will receive extensive training on our clients, systems, and products. Throughout this entire period, you will receive hands-on coaching and support as well as guided…
Added just now
Securitized Products Trading Floor Support Lead
Barclays Services Corpor
United States
…supporting both front-office trading applications and backend systems, with the ability to demonstrate by example during high-severity incidents and business-critical…
Added just now
T
Customer Service Specialist
TEKsystems
Charlotte, NC
- $21.42 USD / hour
…program, where you will receive extensive training on our clients, systems, and products. Throughout this entire period, you will receive hands-on coaching and support as well as guided…
Added just now
Maintenance Technician
Mitsubishi Heavy Industries, Ltd.
Pooler, GA
…carpentry, mechanical, plumbing, and electrical work; HVAC systems, compressors, and other building systems; windows, doors, door locks, and cabinet…
Added just now
Solution Architect ServiceNow Service Portal, Moveworks
NewRocket
Remote, United States
Designing and building secure, performant integrations between the Moveworks Platform and customer enterprise systems including ServiceNow, Workday, Okta, Jira, and others.
Added just now
CN
Restaurant Manager
Chick-fil-A North Haven
North Haven, CT
- $23 to $30 USD / hour
Establish clear priorities, systems, and expectations while partnering with the leadership team to drive operational excellence and long-term success.
Added just now
Senior Staff Engineer - AI Cloud Platform
Exelixis Inc
Alameda, CA
Document infrastructure and work instructions for systems and applications, including architecture diagrams, runbooks and code-level commits / READMEs.
Added 1 min ago
Base Engine Calibration Engineer
Stellantis
Auburn Hills, MI
…engineer is also responsible for conducting engine hardware and systems testing and supporting all other teams with their standardized and specialized engine test requests. The…
Added 1 min ago
Torque Management Controls Engineer
Stellantis
Auburn Hills, MI
…and integration engineers to develop electrified powertrain systems for current and next-generation electrified powertrains for Stellantis Vehicles. The overall goal for the team is to…
Added 1 min ago
SF
Executive Director of Business Applications (0994)
San Francisco Unified School District
San Francisco, CA
- $164,038 to $213,383 USD / year
…Francisco. As a CORE district, SFUSD is also a leader in critical systems change for more comprehensive school accountability and innovations that help strengthen the instructional core,…
Added 1 min ago
Regional Optical Manager Key-Whitman Eye
Surgery Partners
Dallas, TX
Added 1 min ago
CG
Hospital Sales Specialist - Little Rock, AR
Chiesi Group
Little Rock, AR, AR
- $135,540 to $155,000 USD / year
Must live in the area of assigned territory of Little Rock, AR
Added 1 min ago
SL
Access Control Officer PT: Day
SITEMETRIC LLC
Chester, VA
- From $18 USD / hour
…including digital onboarding, smart badging, real-time location systems, messaging and mass texting, integrated turnstiles, real-time reporting, emergency mustering, and…
Added 1 min ago
C
Adoption Specialist - Infrastructure & Agentic
Cohere
Remote, United States
- $200,000 to $300,000 CAD / year
We’re training and deploying frontier models for enterprises who are building AI systems. We believe that our work is instrumental to the widespread adoption of AI and we are looking for…
Added 1 min ago
S
Business Intelligence & Systems Analyst Intern 2027
Stratolaunch
Mojave, CA
- $25 to $28 USD / hour
We are seeking a motivated Business Intelligence & Systems Analyst Intern to support the development of analytics capabilities across Stratolaunch’s enterprise systems. This role will work…
Added 1 min ago
Operations Coordinator
Silvus Technologies
Los Angeles, CA
Silvus Technologies, a leading provider of advanced MANET and MIMO communications systems, is reshaping mesh network technology for mission-critical applications – on the ground, in the air…
Added 1 min ago
Construction Superintendent
KHP Management LLC
Little Rock, AR
Use KH's established construction processes, reporting systems, and technology.
Added 1 min ago
CH
Juvenile Justice Family Advocate
Cocoon House
Everett, WA
- $28 to $31 USD / hour
Must have ability to run up and down indoor and outdoor stairwells in case of youth emergency
Added 1 min ago
EC
Electrical Estimator Intern (Electrical Construction) - Summer 2027
Egan Company
Champlin, MN
- $23 USD / hour
…energy projects, specializing in power distribution, lighting systems, generators, solar installations, and other essential electrical infrastructure. From powering large facilities and…
Added 1 min ago
Senior Software Engineer
E-Infosol LLC
Washington, DC
E-INFOSOL is seeking a Senior Software Engineer (.Net Developer) to design, build, test and maintain applications and services for a team using .NET. You will work across the full software…
Added 1 min ago
System Administrator
Sentar
Fort Meade, MD
…convergence of cybersecurity, intelligence, analytics, and systems engineering. We invite you to join the team where you can build, innovate, and secure your…

PacificSource

Utilization Management Clinician - PART TIME

Boise, ID, United States

$70,950.00 - $106,424.99 Our Values We live and breathe our values. · Part-time

Apply on pacificsource.wd5.myworkdayjobs.com About employer

Applications open in a new tab.

Job details

Pay: $70,950.00 - $106,424.99 Our Values We live and breathe our values.
Job type: Part-time
Posting language: English
Posted: Nov 12, 2026

Original job description

Looking for a way to make an impact and help people?

Join PacificSource and help our members access quality, affordable care!

PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.

Collaborate closely with physicians, nurses, social workers and a wide range of medical and non-medical professionals to coordinate delivery of healthcare services. Assess the member’s specific health plan benefits and the additional medical, community, or financial resources available. Provide utilization management (UM) services which promote quality, cost-effective outcomes by helping member populations achieve effective utilization of healthcare services. Facilitate outstanding member care using fiscally responsible strategies.

Essential Responsibilities:

Collect and assess member information pertinent to member’s history, condition, and functional abilities in order to promote wellness, appropriate utilization, and cost-effective care and services.
Coordinate necessary resources to achieve member outcome goals and objectives.
Accurately document case notes and letters of explanation which may become part of legal records.
Perform concurrent review of members admitted to inpatient facilities, residential treatment centers, and partial hospitalization programs.
Maintain contact with the inpatient facility utilization review personnel to assure appropriateness of continued stay and level of care.
Identify cases that require discharge planning, including transfer to skilled nursing facilities, rehabilitation centers, residential, and outpatient to include behavioral health, home health, and hospice services while considering member co-morbid conditions.
Review referral and preauthorization requests for appropriateness of care within established evidence-based criteria sets.
When applicable, identify and negotiate with appropriate vendors to provide services.
When appropriate, negotiate discounts with non-contracted providers and/or refer such providers to Provider Network Department for contract development.
Work with multidisciplinary teams utilizing an integrated team-based approach to best support members, which may include working together on network not available (NNA), out of network exceptions (OONE), and one-time agreements (OTA).
Serve as primary resource to member and family members for questions and concerns related to the health plan and in navigating through the health systems issues.
Interact with other PacificSource personnel to assure quality customer service is provided.
Act as an internal resource by answering questions requiring medical or contract interpretation that are referred from other departments, as well as physicians and providers of medical services and supplies.
Assist employers and agents with questions regarding healthcare resources and procedures for their employees and clients.
Identify high cost utilization and refer to Large Case Reinsurance RN and Care Management team as appropriate.
Assist Medical Director in developing guidelines and procedures for Health Services Department.

Supporting Responsibilities:

Act as backup and be a resource for other Health Services Department staff and functions as needed.
Serve on designated committees, teams, and task groups, as directed.
Represent the Heath Services Department, both internally and externally, as requested by Medical Director.
Meet department and company performance and attendance expectations.
Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
Perform other duties as assigned.

SUCCESS PROFILE

Work Experience: Minimum of three (3) years of nursing or behavioral health experience with varied medical and/or behavioral health exposure and capability required. Experience in acute care, case management, including cases that require rehabilitation, home health, behavioral health and hospice treatment strongly preferred. Insurance industry experience helpful, but not required.

Education, Certificates, Licenses: Active, unrestricted Registered Nurse (RN) license, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW), or Psychiatric Mental Health Nurse Practitioner, (PMHNP) credential required. Case Manager Certification as accredited by CCMC preferred.

Knowledge: Thorough knowledge and understanding of medical and behavioral health processes, diagnoses, care modalities, procedure codes including ICD and CPT Codes, health insurance and state-mandated benefits. Understanding of contractual benefits and options available outside contractual benefits. Working knowledge of community services, providers, vendors and facilities available to assist members. Understanding of appropriate case management plans. Ability to use computerized systems for data recording and retrieval. Assures patient confidentiality, privacy, and health records security. Establishes and maintains relationships with community services and providers. Maintains current clinical knowledge base and certification. Ability to work independently with minimal supervision. Must be able to function as part of a collaborative, cohesive community.

Competencies:

Adaptability Building Customer Loyalty Building Strategic Work Relationships Building Trust Continuous Improvement Contributing to Team Success Planning and Organizing Work Standards

Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.

Skills:

Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork Compensation Disclaimer The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range.

Base Range:

$70,950.00 - $106,424.99 Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:

We are committed to doing the right thing.
We are one team working toward a common goal.
We are each responsible for customer service.
We practice open communication at all levels of the company to foster individual, team and company growth.
We actively participate in efforts to improve our many communities-internally and externally.
We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
We encourage creativity, innovation, and the pursuit of excellence.

Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

Apply on pacificsource.wd5.myworkdayjobs.com About employer

More about this job

Skills

Customer service
Acute care
Case management
RN
Mental health
NP
CPT
Work independently
Adaptability
Process improvement
Collaboration
Communication skills
Organizational skills
Problem solving
Teamwork

Report this job

Work requirements

Jobs in the United States