Qureos Mentor

Telligen

<div><div>This position will be responsible for conducting utilization review/medical management for all services including training/mentoring other team members and performing preliminary research on requested topics. In addition, the incumbent may provide technical assistance, medical record review and support to provider staff and physician reviewers.<br>
</div><div></div><br>
<div><b>This position is fully remote, but candidates must reside in a state where Telligen has a business or office presence.
</b></div><h3 class="jobSectionHeader"><b>What you'll do:</b></h3><ul><li>
Perform prospective, concurrent or retrospective utilization review/medical management for all services including appropriateness of quality of care based on contract, state, or URAC requirements.
</li><li>Screen individual situations according to specific criteria to determine if care is appropriate.
</li><li>Refer cases that fail to meet screening criteria to peer reviewer.
</li><li>Coordinate and participate in peer-to-peer review as warranted. With prior management approval, may deviate from criteria with proper justification to authorize the service.
</li><li>Serve as liaison between peer reviewer, provider, facility and/or subscriber. Coordinate and participates in appeal process as directed by management.</li><li>
Train or serves as a mentor to team members and physician reviewers to ensure reviews and appeals are conducted thoroughly and within specified time frames.
</li><li>Perform preliminary research on topics such as experimental or cosmetic services, coverage determinations, coding or standards of care.</li><li>
Document review and special project results in workflow documentation system, ensuring data is accurate and timely.
</li><li>Assist in compliance reporting.</li><li>
Perform miscellaneous duties as assigned.</li></ul><h3 class="jobSectionHeader"><b>
Required Skills and Experience</b></h3><ul><li>
Current RN license that is recognized in the relevant jurisdiction(s)or other certification directly relevant to the type of review performed</li><li>
Current RN license must be unrestricted and if there is a restriction that is allowed by a relevant jurisdiction, according to the Medical Director, it is of the type that does not affect the health professional&rsquo;s ability to fulfill the roles and responsibilities of a reviewer</li><li>
Four-year degree in healthcare or two- or three-year degree in nursing or related field and/or equivalent training and/or experience</li><li>
3 &ndash; 5 years recent experience working in a clinical environment</li><li>
5% local and/or overnight travel</li></ul><h3 class="jobSectionHeader"><b>
Preferred Skills and Experience
</b></h3><ul><li>Knowledge of URAC standards</li></ul><div><b>
Who We Are:</b></div><div>
</div><div>
Telligen is one of the most respected population health management organizations in the country. We work with state and federal government programs, as well as employers and health plans offering clinical, analytical, and technical expertise.</div><div></div><div><br>
Over our 50-year history, health care has evolved - and so have we. What hasn't changed is our deep commitment to those we serve. Our success is built on our ability to adapt, respond to client needs and deliver innovative, mission-driven solutions.</div><div></div><div><br>
Our business is our people and we&rsquo;re seeking talented individuals who share our passion and are ready to take ownership, make an impact and help shape the future of health.</div><div></div><div><b><br>
Are you Ready?</b></div><div>
</div><div>
We&rsquo;re on a mission to transform lives and economies by improving health.</div><div>
</div><div><b>
Ownership: </b>As a 100% employee-owned company, our employee-owners drive our business and share in our success.</div><div><b>
Community:</b> We show up - for our clients, our communities and each other. Being a responsible corporate partner is part of who we are.</div><div><b>
Ingenuity:</b> We value bold ideas and calculated risks. Innovation thrives when we challenge the status quo and listen to diverse perspectives.</div><div><b>
Integrity:</b> We foster a respectful, inclusive, and collaborative environment built on trust and excellence.</div><div>
</div><div><b>Thank you for your interest in Telligen!</b></div><div>
Follow us on Twitter, Facebook, and LinkedIn to learn more about our mission-driven culture and stay up to speed.</div><div></div><div><i><br>
While we use artificial intelligence tools to enhance our initial screening process, all applications are thoroughly reviewed by our human recruitment team to ensure a fair and comprehensive evaluation of each candidate.</i></div><div><i>
Telligen and our affiliates are Equal Opportunity Employers and E-Verify Participants.
</i></div><div><i>Telligen will not provide sponsorship for this position. If you will require sponsorship for work authorization now or in the future, we cannot consider your application at this time. We will not accept 3rd party solicitations from outside staffing firms.</i></div><div></div><div><i><br>
Telligen is an equal opportunity employer. Qualified applicants will be considered without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, protected veteran status, disability or any other protected class.</i></div><div></div><div><i><br>
Telligen is committed to ensuring that our employment process is open to all individuals, and provides reasonable accommodations to individuals who need assistance during any part of the employment process due to a disability, medical condition, or physical or mental impairment. Reasonable accommodations are considered on a case-by-base basis.</i></div><div></div><div><i><br>
If you need assistance to navigate Telligen&rsquo;s careers website or to apply for a position, please send an email to </i><i>careers@telligen.com</i></div>
<p>
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.</p></div>

Senior Review Coordinator

<div>
 This position will be responsible for conducting utilization review/medical management for all services including training/mentoring other team members and performing preliminary research on requested topics. In addition, the incumbent may provide technical assistance, medical record review and support to provider staff and physician reviewers.
 <br/>
 <br/>
 This position is fully remote, but candidates must reside in a state where Telligen has a business or office presence.
 <br/>
 <br/>
 <strong>
  What you'll do:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Perform prospective, concurrent or retrospective utilization review/medical management for all services including appropriateness of quality of care based on contract, state, or URAC requirements.
  </li>
  <li>
   Screen individual situations according to specific criteria to determine if care is appropriate.
  </li>
  <li>
   Refer cases that fail to meet screening criteria to peer reviewer.
  </li>
  <li>
   Coordinate and participate in peer-to-peer review as warranted. With prior management approval, may deviate from criteria with proper justification to authorize the service.
  </li>
  <li>
   Serve as liaison between peer reviewer, provider, facility and/or subscriber. Coordinate and participates in appeal process as directed by management
  </li>
  <li>
   Train or serves as a mentor to team members and physician reviewers to ensure reviews and appeals are conducted thoroughly and within specified time frames.
  </li>
  <li>
   Perform preliminary research on topics such as experimental or cosmetic services, coverage determinations, coding or standards of care
  </li>
  <li>
   Document review and special project results in workflow documentation system, ensuring data is accurate and timely.
  </li>
  <li>
   Assist in compliance reporting
  </li>
  <li>
   Perform miscellaneous duties as assigned
   <br/>
   <br/>
   <br/>
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Required Skills And Experience
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Current RN license that is recognized in the relevant jurisdiction(s)or other certification directly relevant to the type of review performed
  </li>
  <li>
   Current RN license must be unrestricted and if there is a restriction that is allowed by a relevant jurisdiction, according to the Medical Director, it is of the type that does not affect the health professional&rsquo;s ability to fulfill the roles and responsibilities of a reviewer
  </li>
  <li>
   Four-year degree in healthcare or two- or three-year degree in nursing or related field and/or equivalent training and/or experience
  </li>
  <li>
   3 &ndash; 5 years recent experience working in a clinical environment
  </li>
  <li>
   5% local and/or overnight travel
   <br/>
   <br/>
   <br/>
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Preferred Skills And Experience
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Knowledge of URAC standards
   <br/>
   <br/>
   <br/>
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Who We Are:
  <br/>
 </strong>
 Telligen is one of the most respected population health management organizations in the country. We work with state and federal government programs, as well as employers and health plans offering clinical, analytical, and technical expertise.
 <br/>
 <br/>
 Over our 50-year history, health care has evolved - and so have we. What hasn't changed is our deep commitment to those we serve. Our success is built on our ability to adapt, respond to client needs and deliver innovative, mission-driven solutions.
 <br/>
 <br/>
 Our business is our people and we&rsquo;re seeking talented individuals who share our passion and are ready to take ownership, make an impact and help shape the future of health.
 <br/>
 <br/>
 <strong>
  Are you Ready?
  <br/>
 </strong>
 We&rsquo;re on a mission to transform lives and economies by improving health.
 <br/>
 <br/>
 <strong>
  Ownership:
 </strong>
 As a 100% employee-owned company, our employee-owners drive our business and share in our success.
 <br/>
 <br/>
 <strong>
  Community:
 </strong>
 We show up - for our clients, our communities and each other. Being a responsible corporate partner is part of who we are.
 <br/>
 <br/>
 <strong>
  Ingenuity:
 </strong>
 We value bold ideas and calculated risks. Innovation thrives when we challenge the status quo and listen to diverse perspectives.
 <br/>
 <br/>
 <strong>
  Integrity:
 </strong>
 We foster a respectful, inclusive, and collaborative environment built on trust and excellence.
 <br/>
 <br/>
 <strong>
  Thank you for your interest in Telligen!
  <br/>
 </strong>
 Follow us on Twitter, Facebook, and LinkedIn to learn more about our mission-driven culture and stay up to speed.
 <br/>
 <br/>
 <em>
  While we use artificial intelligence tools to enhance our initial screening process, all applications are thoroughly reviewed by our human recruitment team to ensure a fair and comprehensive evaluation of each candidate.
  <br/>
  <br/>
 </em>
 <em>
  Telligen and our affiliates are Equal Opportunity Employers and E-Verify Participants.
  <br/>
  <br/>
 </em>
 <em>
  Telligen will not provide sponsorship for this position. If you will require sponsorship for work authorization now or in the future, we cannot consider your application at this time. We will not accept 3rd party solicitations from outside staffing firms.
  <br/>
  <br/>
 </em>
 <em>
  Telligen is an equal opportunity employer. Qualified applicants will be considered without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, protected veteran status, disability or any other protected class.
  <br/>
  <br/>
 </em>
 <em>
  Telligen is committed to ensuring that our employment process is open to all individuals, and provides reasonable accommodations to individuals who need assistance during any part of the employment process due to a disability, medical condition, or physical or mental impairment. Reasonable accommodations are considered on a case-by-base basis.
  <br/>
  <br/>
 </em>
 <em>
  If you need assistance to navigate Telligen&rsquo;s careers website or to apply for a position, please send an email to
 </em>
 <em>
  careers@telligen.com
  <br/>
  <br/>
 </em>
 We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
</div>


<div><div>As a Proposal Writer Intern, you will gain hands-on experience writing content to support Telligen&rsquo;s proposal efforts. This content will include updating, refining and creating new Telligen documents such as:</div><div>
</div><ul><li>Corporate overview</li><li>Market-specific gold standards</li><li>Contract narratives</li><li>Basic writeups</li><li>Bios and resumes</li><li>Procedures</li></ul><div>
</div><div>
You may also be able to contribute to live proposal content development.</div><div></div><div><br>
Intern will be based in our West Des Moines office five days per week.</div>
<h3 class="jobSectionHeader"><b>What you'll do:</b></h3><ul><li>
Work within the bids and proposals (B&amp;P) team to review priority content needs.</li><li>
Interview operational subject matter experts as needed to flesh out pertinent details for assigned content.</li><li>
Usher documents through necessary reviews and update them at each review stage.</li><li>
Update existing content to reflect changes over the past year.</li><li>
Explore/use Telligen&rsquo;s home-grown AI tools to help with content creation and revisions.</li><li>
Present weekly progress reports to the senior proposal writer and B&amp;P manager.</li><li>
Escalate roadblocks to applicable leadership.</li></ul><h3 class="jobSectionHeader"><b>
Required Skills and Experience
</b></h3><ul><li>Currently enrolled in a college or university seeking a degree in Communications, Marketing, Journalism or a related field; must have completed a minimum of two years of coursework.</li><li>
Strong writing and editing skills, as well as familiarity with AP Style.</li><li>
Solid interviewing and organizational skills.</li><li>
Ability to manage multiple priorities, superior attention to detail.</li><li>
Experience with video communication platforms such as Zoom or Microsoft Teams.</li><li>
Experience using Microsoft Office or 365.</li><li>
Must be available to work 20-40 hours per week on-site over the summer.</li></ul><div><b>
Who We Are:</b></div><div>
</div><div>
Telligen is one of the most respected population health management organizations in the country. We work with state and federal government programs, as well as employers and health plans offering clinical, analytical, and technical expertise.</div><div></div><div><br>
Over our 50-year history, health care has evolved - and so have we. What hasn't changed is our deep commitment to those we serve. Our success is built on our ability to adapt, respond to client needs and deliver innovative, mission-driven solutions.</div><div></div><div><br>
Our business is our people and we&rsquo;re seeking talented individuals who share our passion and are ready to take ownership, make an impact and help shape the future of health.</div><div></div><div><b><br>
Are you Ready?</b></div><div>
</div><div>
We&rsquo;re on a mission to transform lives and economies by improving health.</div><div>
</div><div><b>
Ownership: </b>As a 100% employee-owned company, our employee-owners drive our business and share in our success.</div><div><b>
Community:</b> We show up - for our clients, our communities and each other. Being a responsible corporate partner is part of who we are.</div><div><b>
Ingenuity:</b> We value bold ideas and calculated risks. Innovation thrives when we challenge the status quo and listen to diverse perspectives.</div><div><b>
Integrity:</b> We foster a respectful, inclusive, and collaborative environment built on trust and excellence.</div><div>
</div><div><b>Thank you for your interest in Telligen!</b></div><div>
Follow us on Twitter, Facebook, and LinkedIn to learn more about our mission-driven culture and stay up to speed.</div><div></div><div><i><br>
While we use artificial intelligence tools to enhance our initial screening process, all applications are thoroughly reviewed by our human recruitment team to ensure a fair and comprehensive evaluation of each candidate.</i></div><div><i>
Telligen and our affiliates are Equal Opportunity Employers and E-Verify Participants.
</i></div><div><i>Telligen will not provide sponsorship for this position. If you will require sponsorship for work authorization now or in the future, we cannot consider your application at this time. We will not accept 3rd party solicitations from outside staffing firms.</i></div><div></div><div><i><br>
Telligen is an equal opportunity employer. Qualified applicants will be considered without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, protected veteran status, disability or any other protected class.</i></div><div></div><div><i><br>
Telligen is committed to ensuring that our employment process is open to all individuals, and provides reasonable accommodations to individuals who need assistance during any part of the employment process due to a disability, medical condition, or physical or mental impairment. Reasonable accommodations are considered on a case-by-base basis.</i></div><div></div><div><i><br>
If you need assistance to navigate Telligen&rsquo;s careers website or to apply for a position, please send an email to </i><i>careers@telligen.com</i></div>
<p>
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.</p></div>

Proposal Writer Internship

Join Telligen and explore 3   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Telligen

About Company

Senior Review Coordinator

Senior Review Coordinator

Proposal Writer Internship