clinical appeals - r11356

clinical nurse

clinical pharmacist

financial analyst, global brand finance - ugg & hoka Jobs in Indiana

DataAnnotation

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 We are looking for medical experts to join our team to train AI models. You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of each model.
 
 
 
 Role
 
 
 
 In this role you will need to be an expert in healthcare. We are interested in a wide range of expertise, so relevant backgrounds include:
 
 
 Physicians &amp; Advanced Practice Clinicians: Physicians of all specialties (e.g., Internists, Cardiologists, Oncologists), Physician Assistants, Nurse Practitioners, Certified Nurse-Midwives, Certified Registered Nurse Anesthetists, Clinical Nurse Specialists, Registered Nurses.
 
 
 Therapists: Physical Therapists, Occupational Therapists, Speech-Language Pathologists, Respiratory Therapists, Athletic Trainers, Massage/Recreational Therapists.
 
 
 Diagnostic &amp; Laboratory Professionals: Radiologic Technologists, Sonographers, MRI &amp; Nuclear Medicine Technologists, Medical Laboratory Scientists, Phlebotomists, Histology &amp; Genetics Technicians.
 
 
 Public Health &amp; Specialized Roles: Dietitians/Nutritionists, Genetic Counselors, Epidemiologists, Public Health Nurses.
 
 
 
 Benefits
 
 
 
 This is a full-time or part-time REMOTE position
 
 
 You&rsquo;ll be able to choose which projects you want to work on
 
 
 You can work on your own schedule
 
 
 Projects are paid hourly starting at $40+ per hour, with bonuses on high-quality and high-volume work
 
 
 
 Responsibilities
 
 
 
 Give AI chatbots diverse and complex healthcare related problems and evaluate their outputs
 
 
 Evaluate the quality produced by AI models for correctness and performance
 
 
 Ensure the medical accuracy of model performance
 
 
 
 Qualifications
 
 
 
 Fluency in English (native or bilingual level)
 
 
 A current or in progress medical degree
 
 
 
 Notes
 
 
 
 Payment is made via PayPal
 
 
 We will never ask for any money from you
 
 
 PayPal will handle any currency conversions from USD
 
 
 Only applicants in the United States will be considered for this role
 
 
 This is an independent contract position.
 
 
 #MEDICINE
</div>

Clinical Nurse

CareSource

<div>
 
 Job Summary
 
 
 
 The Clinical Appeals Nurse is responsible for processing clinical appeals and attending state hearings within compliance and regulatory standards, clinical guidelines, and contractual obligations.
 
 
 
 Essential Functions
 
 
 
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 Responsible for the completion of clinical appeals and state hearings from all states
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 Perform clinical reviews of member and provider appeals for medical, dental, behavioral health, pharmacy, and waiver services
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 Analyze medical records, supporting documentation, and applicable guidelines to make informed decisions
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 Document clinical rationale clearly and accurately in alignment with organizational and regulatory standards
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 Work closely with medical directors, and pharmacists to resolve complex cases.
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 Communicate outcomes effectively to members, and providers.
 </li>
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 Review and complete all provider clinical appeals within required timeframes
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 Review and complete member clinical appeals within required timeframes
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 Communicate with state agencies and internal departments to prepare for State Hearings
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 Apply CareSource Medical Policy and Milliman guidelines when processing clinical appeals
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 Issue administrative denials appropriately
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 Refer denials based on medical necessity to medical director
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 Collaborate with the Quality Improvement and Clinical Operations teams to prepare all requests for Independent External Review
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 Participate in training programs to maintain clinical and regulatory expertise.
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 Perform any other job duties as requested
 
 
 </li>
 </ul>
 
 Education And Experience
 
 
 
 <ul>
 <li>
 Associate&rsquo;s Degree required
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 Managed care, appeals, Medicare, and Medicaid experience preferred
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 Prior clinical appeals, and/or Utilization review experience is strongly preferred
 
 
 </li>
 </ul>
 
 Competencies, Knowledge And Skills
 
 
 
 <ul>
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 Intermediate proficiency with Microsoft Office products and Facets
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 Knowledge of NCQA, URAC, OAC, and MDCH regulations
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 Strong clinical judgment
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 Attention to detail
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 Ability to navigate complex regulations while maintaining a commitment to high-quality care
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 Strong written and oral communication skills
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 Ability to work independently and within a team environment
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 Critical listening and thinking skills
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 Proper grammar usage
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 Time management skills
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 Proper phone etiquette
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 Customer Service oriented
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 Decision making/problem solving skills
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 Knowledge of Medicaid, and Medicare,
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 Flexibility
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 Change resiliency
 
 
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 </ul>
 
 Licensure And Certification
 
 
 
 <ul>
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 Current, unrestricted license as a Registered Nurse (RN) is required
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 Multi-state RN license is preferred
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 MCG Certification is required or must be obtained within six (6) months of hire
 
 
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 </ul>
 
 Working Conditions
 
 
 
 <ul>
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 General office environment; may be required to sit or stand for extended periods of time
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 Position requires the flexibility to work weekends, evenings, and/or holidays, as needed
 
 
 </li>
 </ul>
 
 Compensation Range
 
 
 
 $62,700.00 - $100,400.00 CareSource takes into consideration a combination of a candidate&rsquo;s education, training, and experience as well as the position&rsquo;s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee&rsquo;s total well-being and offer a substantial and comprehensive total rewards package.
 
 
 
 Compensation Type
 
 
 
 Hourly
 
 
 
 Competencies
 
 
 
 <ul>
 <li>
 Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business
 
 
 </li>
 </ul>
 This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
 
 
</div>

Clinical Appeals - R11356

<div>
 We are looking for a
 
 Clinical Pharmacist
 
 to join our team to train AI models. You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of each model.
 
 
 In this role, you will need to be an expert in healthcare. We are interested in a wide range of expertise, so relevant backgrounds include Clinical Documentation &amp; HIM, Medication Management (PharmD), Laboratory Medicine and Pathology Services (MLS, MD), Quality Improvement &amp; Patient Safety, Regulatory Compliance, Accreditation &amp; Medical Staff, Care Coordination &amp; Case Management, Population Health &amp; Value-Based Care, and Managed Care &amp; Utilization Management.
 
 
 
 Benefits
 
 
 
 <ul>
 <li>
 Full-time or part-time remote position
 </li>
 <li>
 Choose which projects you want to work on
 </li>
 <li>
 Flexible schedule
 </li>
 <li>
 Projects are paid hourly starting at $50+ per hour
 </li>
 <li>
 Bonuses available for high-quality and high-volume work
 
 
 </li>
 </ul>
 
 Responsibilities
 
 
 
 <ul>
 <li>
 Provide AI chatbots with diverse and complex healthcare-related problems
 </li>
 <li>
 Evaluate AI outputs for logic, accuracy, and performance
 </li>
 <li>
 Ensure the medical accuracy and overall quality of model responses
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 <ul>
 <li>
 Fluency in English (native or bilingual level)
 </li>
 <li>
 A current or in-progress medical or healthcare-related degree
 
 
 </li>
 </ul>
 
 Notes:
 
 Payment is made via PayPal. We will never ask you for any money. PayPal will handle any currency conversions from USD. Only applicants in the United States will be considered for this role. This is an independent contractor position.
 
 
 
 #medicine
 
</div>

Clinical Pharmacist

<div>
 At Deckers Brands, Together, Every Step is a promise kept that every employee can bring their authentic self, is valued and supported, as a whole person, at work and beyond. Together, Every Step is how we continue to deliver exceptional business results, experience an amazing place to work, and have a positive impact on the communities and world around us.
 
 
 
 Job Title:
 
 Financial Analyst, Global Brand Finance - UGG &amp; HOKA
 
 
 
 Reports to:
 
 Global Brand Finance Director - HOKA &amp; UGG
 
 
 
 Location:
 
 United States (Remote)
 
 
 Interested applicants must reside in one of the following approved states: Arizona, California, Colorado, Indiana, Massachusetts, Minnesota, New York, Oregon, Pennsylvania, Texas, Utah, Washington.
 
 
 
 The Role
 
 
 
 As a Financial Analyst supporting UGG and HOKA at the global level, you&rsquo;ll be at the intersection of brand strategy, product decisions, and financial discipline. You&rsquo;ll help leaders understand how investments drive demand, category growth, and long-range brand performance. This developmental, high-impact role partners closely with Global Brand Marketing, Global Merchandising and Planning, Accounting, and cross-functional operations teams to improve planning quality, strengthen reporting clarity, and enable better, faster decision-making. You&rsquo;ll be supported by senior finance leaders while taking meaningful ownership of core workstreams and deliverables.
 
 
 
 We celebrate diversity--of your background, your experiences and your unique identity. We are committed to ensuring an inclusive and equitable workplace where all of our employees can Come as They Are. We believe that when we bring our different perspectives to work, we are truly Better Together.
 
 
 
 
 Your Impact
 
 
 
 <ul>
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 Lead budgeting, forecasting, and performance management for Global Brand Marketing across UGG and HOKA, ensuring spend aligns with strategy and SG&amp;A targets
 </li>
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 Build ROI and campaign performance frameworks to drive disciplined investment decisions across agencies, sport marketing, and partnerships
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 Support 3 to 5-year revenue and margin planning by developing consistent, well-governed assumptions across brand, product, and finance partners
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 Translate product, pricing, and mix decisions into clear financial implications, risks, and tradeoffs throughout go-to-market milestones
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 Partner with Finance, Operations, and Demand Planning to improve inventory visibility, support composition analysis, and scenario planning
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 Deliver hindsight and forecast-accuracy analyses across planning horizons to strengthen decision-making and learning loops
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 Provide high-impact ad hoc analysis to support strategic initiatives and evolving business needs
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 Continuously streamline tools, reporting, and processes to improve decision speed, clarity, and quality
 
 
 </li>
 </ul>
 
 Who You Are
 
 
 
 <ul>
 <li>
 Bachelor&rsquo;s degree in a relevant field preferred, or equivalent experience demonstrating strong financial analysis, modeling, and business acumen
 </li>
 <li>
 Minimum 1+ years of experience in FP&amp;A, corporate finance, or a related analytical role
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 Strong Excel modeling skills (required)
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 Experience with Hyperion or similar planning systems (preferred)
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 Familiarity with Power BI or Tableau (nice to have)
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 Ability to manage multiple priorities and deadlines
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 Strong collaboration and communication skills
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 Interest in consumer brands, marketing analytics, and long-range planning
 
 
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 </ul>
 
 What We'll Give You
 
 
 
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 Competitive Pay and Bonuses - We&rsquo;ve created a variety of competitive compensation programs to foster career development, reward success and to show our employees just how much they&rsquo;re valued.
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 Financial Planning and wellbeing - No matter what financial goals our employees have set, we want to help them get there. Our plans provide powerful ways to protect income, pay for expenses and invest in the future.
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 Time away from work - Sometimes we need time away to be with family, focus on our health or just simply recharge. Our plans support our employees&rsquo; needs to get out, get healthy and come back stronger than ever.
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 Extras, discounts and perks - Being a valued member of the Deckers Brands team means more than just a paycheck. From generous discounts to community-based programs, we offer a variety of cool extras
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 Growth and Development - Deckers Brands was built on the idea of pursuing passion. That&rsquo;s why we offer extensive opportunities and support for personal and professional development.
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 <li>
 Health and Wellness - There&rsquo;s nothing basic about our comprehensive health and wellness programs and offerings. While at work and at play, we aim to support a healthy lifestyle.
 
 
 </li>
 </ul>
 $75,000 - $85,000/Annually
 
 
 The salary range posted reflects the minimum and maximum target for new hire salaries for this role in Goleta, CA. Individual pay will be determined by location and additional factors, including job related skills, experience, and relevant education or training. Your recruiter can share more about the specific salary for your preferred location during the hiring process.
 
 
 
 Equal Employment Opportunity
 
 
 
 
 Diversity and inclusion are key to our success. We are proud to be an equal opportunity employer, and our employees are people with different strengths, experiences and backgrounds who share a passion for our brands. We welcome qualified applicants regardless of their race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, age, military or veteran status, mental or physical disability, medical condition and all the other beautiful parts of your identity.
 
 
 
</div>

Financial Analyst, Global Brand Finance - UGG & HOKA

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4 jobs In Indiana

Clinical Nurse

Clinical Appeals - R11356

Clinical Pharmacist

Financial Analyst, Global Brand Finance - UGG & HOKA