The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring that medical services are used efficiently and appropriately. They review medical records, treatment plans, and patient information to determine the necessity and appropriateness of medical procedures, tests, and treatments. Utilization Management Nurse Reviewers collaborate with healthcare providers, insurance companies, and patients to optimize healthcare delivery, control costs, and maintain quality care. Their responsibilities include assessing medical necessity, coordinating care, conducting utilization reviews, providing recommendations for care plans, and ensuring adherence to regulations and guidelines. This role requires strong clinical knowledge, critical thinking skills, communication abilities, and the ability to make informed decisions regarding patient care pathways. MAJOR DUTIES & RESPONSIBILITIES - Conduct assessments of medical services to validate their appropriateness using established criteria and guidelines, ensuring the medical necessity of treatments (e.g., CMS, Milliman Care Guidelines, InterQual, or health plan specific guidelines/criteria). - Examine and evaluate patient records to verify the quality of patient care and the necessity of provided services. - Offer clinical expertise and serve as a clinical reference for non-clinical staff members. - Input and manage essential clinical details within various medical management platforms. - Keep up-to-date with regulatory prerequisites (such as URAC) and state standards for utilization review. - Apply clinical reasoning to determine the suitable evidence-based guidelines. - Foster efficient and high-quality patient care by effectively communicating with management teams, physicians, and the Medical Director. Requirements - Proficient in both written and spoken communication. - Capable of maintaining professional communication with physicians and clients. - Skilled at handling multiple tasks and adjusting swiftly in a dynamic office setting. - Possesses a keen organizational sense and pays close attention to details. - Adept at resolving intricate and multifaceted problems. - Experienced with Microsoft tools such as Word, Excel, PowerPoint, and Outlook. - Background in medical or clinical practice through education, training, or professional engagement. - Holds an unrestricted LVN/RN license from an accredited vocational nursing program (for LVNs) or a nursing degree from an accredited college (for RNs). Additional Duties - May provide oversight to the work of the team members. - Continuously improves processes that help to facilitate better turnaround time, peer to peer success rates and lessens returned reports by clients for clarification purposes, ultimately resulting in higher client satisfaction. - Responsible for the final approval on cases for release to the client. - Will act as a liaison and coordinate quality issue reports along with all new reviewer reports with the VP of Clinical Operations. - EDUCATION/CREDENTIALS: Licensed Practical/Vocational Nurse with an active and unrestricted license to practice. JOB RELEVANT EXPERIENCE: 2 yrs minimum clinical nursing experience is required. One year of previous experience in Utilization Management is required. JOB RELATED SKILLS/COMPETENCIES: Demonstrate strong abilities in both spoken and written communication, along with effective interpersonal skills. Possess a proficient understanding of computer operations, particularly the Internet, Microsoft Word, Microsoft Access, Microsoft Excel, and Windows. Show the capability to acquire new skills and competencies to address the evolving requirements of systems, software, and hardware. WORKING CONDITIONS/PHYSICAL DEMANDS: Any lifting, bending, traveling, etc. required to do the job duties listed above. Long periods of sitting and computer work. WORK FROM HOME TECHNICAL REQUIREMENTS: Supply and support their own internet services. Maintaining an uninterrupted internet connection is a requirement of all work from home position.

Who We Are Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach to kidney care. We believe patients living with kidney disease deserve the best care. We are committed to improving patient outcomes and improving quality of life by delaying disease progression, shifting care to the home, and accelerating kidney transplants. We help nephrologists focus on the right patients at the right time across the full care spectrum. We do this by providing them with the best-in-class interdisciplinary clinical resources, analytical insight and tools, and services to patients. We listen to the needs of our patients, our employees, and our client partners, continually working to push beyond the status quo in which the care system manages patients today. Who You Are You are devoted, compassionate, and enjoy being on the front lines of healthcare, changing the lives of patients by supporting them and the team by focusing on customers. You’re excited about being part of a team that is building a healthcare delivery model that ensures the highest possible quality of life and best outcomes for those in our care. You believe people living with kidney disease deserve the best person-centered, holistic, comprehensive care and want to influence the healthcare system to drive towards that. You thrive in innovative and evolving environments with high rates of change. Your Role As a Sr. Analyst, Reporting & Analytics with Evergreen Nephrology, you will report to the Manager of Reporting & Analytics and collaborate with the broader analytics, technology, and operations teams to develop data-based solutions and tools that drive company performance and patient outcomes. Your reporting (e.g., Power BI) and analytical skills (SQL) will help develop new reports and tools, and your communication skills and business acumen will drive collaborative efforts in gathering requirements and feedback, providing analytic insight to our stakeholders, and drive improvements to our operating and clinical models. This role is an individual contributor role. Role Responsibilities - Collaborate with business partners to gather business reporting and analytics requirements to drive operational and clinical efficiency - Understand and validate the accuracy and quality of the data represented within analytics and reporting outputs - Collaborate with Data Engineering and Advanced Analytics to transform raw data into desired metrics and insights - Utilize visualization tools (e.g., PowerBI) to design and create analytics dashboards and operational reports - Train end users on newly deployed dashboards/deliverables - Support ongoing enhancements and maintenance of deployed dashboards/deliverables - Manage internal and external timelines for data reporting - Identify and track issues with reports, including defects in logic, data quality problems, and process errors - Maintain documentation of existing reports and dashboards (KPI definitions, data sources, etc.) - Other duties consistent with this role, as assigned. Required Qualifications - A bachelor’s degree in engineering, data science, statistics, public health, economics, or a related field. Master’s degree preferred. - 3+ years of experience in a reporting or health economics environment in the health care industry - 1+ years developing dashboards and reports utilizing BI tools (e.g., Power BI, or Tableau) - Strong SQL skills required; expertise in SQL and Python programming preferred - Experience developing data models, or partnering with data engineering teams to translate business needs into scalable, analytics-ready datasets - Health care industry experience, value-based care preferred - Proven hands-on knowledge of turning data into relevant reports and visualizations - Strong organizational, analytical, multi-tasking, documentation, presentation, and problem-solving skills - Ability to communicate effectively in both oral and written form to a widely diverse audience - Strong business acumen and interpersonal skills - Working understanding of healthcare privacy and security practices - Experience with healthcare data (EMR and/or claims) preferred - High curiosity and a growth mindset - Intermediate skills with MS Office Suite of products including Outlook and Teams - Able to work effectively in a primarily remote environment: - Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended - Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role - Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Compensation The pay range for this role is $75,000 to $95,000 annually. Exact pay is determined based on experience, education, demand for the role, and other role-specific factors. This role is also eligible for an annual bonus. Benefits Evergreen Nephrology’s total rewards program is designed to support you in and outside of work. You can expect: - Paid time off starting at 4 weeks for full-time employees - 12 paid holidays per year - Medical, dental, vision and life insurance, including an HSA with employer match - Reimbursement for continuing medical education for eligible roles - A 401(k) program where Evergreen matches up to 4% of contributions - Paid parental leave - A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology Evergreen Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other protected category under local, state or federal laws. If you are an applicant with a disability who requires reasonable accommodation for any part of the hiring process, please contact us for assistance at recruiting@evergreennephrology.com.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This role involves utilizing data analytics to drive strategic initiatives, significantly impacting decision-making processes across the organization. - Lead complex, cross‑functional analytic projects from concept to delivery, ensuring alignment with organizational strategy. - Design, develop, and implement advanced analytic models, predictive tools, and data‑driven methodologies. - Build and maintain enterprise dashboards, reporting systems, and decision‑support applications for operational and executive users. - Act as a trusted advisor to senior leadership, offering expert‑level interpretation of data and strategic recommendations. - Present insights clearly and persuasively to executive audiences, ensuring complex analysis is accessible and actionable. - Develop automated workflows, reusable analytic tools, and standardized processes that enhance efficiency and reliability. - Mentor Analysts and Senior Analysts, helping strengthen technical skills, analytical thinking, and best‑practice methodologies. - Evaluate and introduce new analytics tools, technologies, and platforms that expand data capabilities. - Ensure analytic output complies with internal standards, HIPAA, and enterprise data governance requirements. - Maintain expertise in healthcare analytics, including claims, enrollment, and clinical data sources. Qualifications - Bachelor’s degree in Data Science, Statistics, Mathematics, Healthcare, Business, or a related field (or equivalent experience). - Master’s degree in a related analytic field preferred. - 8+ years of experience in healthcare analytics, dental analytics, actuarial analytics, or a related quantitative domain. - Advanced proficiency in SQL, with the ability to build complex queries and optimize data pipelines. - Expertise in Python, R, and/or other advanced analytics programming languages. - Strong data visualization skills using Power BI, Tableau, or similar platforms — able to design intuitive, executive‑ready dashboards. - Demonstrated ability to build predictive models, forecasting tools, and advanced analytic frameworks. - Strong understanding of healthcare claims, enrollment, and clinical datasets; dental industry experience is a plus. - Familiarity with HIPAA, data governance, and healthcare regulatory requirements. - Exceptional analytical and problem‑solving skills; able to synthesize complex data into meaningful insights. Benefits - Fully remote (U.S.) with extensive computer and virtual collaboration. - Occasional travel may be required for team meetings or leadership sessions. - Opportunity to develop your accounting expertise. - Collaborative and supportive work environment. - Exposure to multiple financial functions and process improvement activities. Company Description

Job Description Summary Product Quality Engineer for RRSP, Gearboxes, and Bearings Manufacturing Process will drive product qualifications and quality improvements for key performance indicators (KPIs) of suppliers within the supply chain including quality plan implementation. Individual will own supplier First Article Inspection results and drive supplier compliance to Source Substantiation Plans or design intent verification. Provide supplier product release direction when part approval cycles are not complete while also being the internal quality focal for those parts. Collaborate with Supplier Quality, Supplier Quality Operations and New Product Introduction/Management of Change teams as required- this collaboration may include supplier onsite visitation. Lastly, they will understand how the team integrates with other teams outside of Quality to meet short term and long term the business objectives. Demonstrate an in-depth understanding of key business drivers; uses this understanding to accomplish own work. In-depth understanding of how work of own team integrates with other teams and contributes to the area. Job Description Roles and Responsibilities - Product Quality Engineer will have a technical understanding of engineering drawings and will have the ability to manage suppliers and/or quality projects. - Communication with direct colleagues and the business concerning the status of First Article Inspection and Source Substantiation Plans - Role is responsible for supplier processes, from initial qualification, maintenance, and necessary improvement driven by business quality needs. - Provide onsite support at suppliers, as needed (approximately 15% travel) - Collaboration with other Engineering, Quality, and Sourcing functions to ensure joint success - Impacts projects, processes, and procedures in own field. The role operates with some autonomy but is focused on execution of activities/provision of advice within an enabling discipline covered by standard functional practices and procedures. Activities require professional judgment but may require more senior levels of guidance. - Utilizes technical expertise and judgement to solve problems. Leverages technical skills and analytic thinking required to solve problems. May use multiple internal sources outside of own team to arrive at decisions. - Uses high level of judgment to make decisions and handle complex tasks or problems in areas of operational, product management, manufacturing, technology, or engineering. Has ability to assess quality of information given and ask pertinent questions to stakeholders. Able to offer new solutions to problems outside of set parameters and can construct and provide recommendations. Uses multiple internal and some external sources outside of own function to help arrive at a decision. - May lead functional teams or projects with minimal resource requirements, risk, and/or complexity. Communicates difficult concepts and may influence others' options on specific topics. May guide others to consider a different point of view. Required Qualifications - Bachelor’s Degree from an accredited college or university (or a high school diploma/GED with a minimum of 4 years (quality) experience + minimum of 3 years (quality) experience Desired Characteristic - Demonstrated experience in manufacturing or supplier quality. - Strong oral and written communication skills. Demonstrated ability to analyze and resolve problems. - Ability to document, plan, market, and execute programs. Established project management skills. - Demonstrated history of problem solving, root cause and corrective action methodology, data analysis, statistical analysis and quality experience. - Humble: respectful, receptive, agile, eager to learn​ - Transparent: shares critical information, speaks with candor, contributes constructively​ - Focused: quick learner, strategically prioritizes work, committed ​ - Leadership ability: strong communicator, decision-maker, collaborative​ - Problem solver: analytical-minded, challenges existing processes, critical thinker. - Demonstrated gearbox manufacturing knowledge and experience is advantageous to the role. - Demonstrated bearings manufacturing knowledge and experience is advantageous to the role. - Demonstrated casting or forging process knowledge and experience is advantageous to the role. The base pay range for this position is 86,000k-114000k. The specific pay offered may be influenced by a variety of factors, including the candidate’s experience, education, and skill set. This position is also eligible for an annual discretionary bonus based on a percentage of your base salary/ commission based on the plan. This posting is expected to close on Monday, March 5, 2026. GE Aerospace offers comprehensive benefits and programs to support your health and, along with programs like HealthAhead, your physical, emotional, financial and social wellbeing. Healthcare benefits include medical, dental, vision, and prescription drug coverage; access to a Health Coach from GE Aerospace; and the Employee Assistance Program, which provides 24/7 confidential assessment, counseling and referral services. Retirement benefits include the GE Aerospace Retirement Savings Plan, a 401(k) savings plan with company matching contributions and company retirement contributions, as well as access to Fidelity resources and planning consultants. Other benefits include tuition assistance, adoption assistance, paid parental leave, disability insurance, life insurance, and paid time-off for vacation or illness. ​ GE Aerospace (General Electric Company or the Company) and its affiliates each sponsor certain employee benefit plans or programs (i.e., is a “Sponsor”). Each Sponsor reserves the right to terminate, amend, suspend, replace or modify its benefit plans and programs at any time and for any reason, in its sole discretion. No individual has a vested right to any benefit under a Sponsor’s welfare benefit plan or program. This document does not create a contract of employment with any individual. This role requires access to U.S. export-controlled information. Therefore, employment will be contingent upon the ability to prove that you meet the status of a U.S. Person as one of the following: U.S. lawful permanent resident, U.S. Citizen, have been granted asylee or refugee status (i.e., a protected individual under the Immigration and Naturalization Act, 8 U.S.C. 1324b(a)(3)). Additional Information GE Aerospace offers a great work environment, professional development, challenging careers, and competitive compensation. GE Aerospace is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age, disability, protected veteran status or other characteristics protected by law. GE Aerospace will only employ those who are legally authorized to work in the United States for this opening. Any offer of employment is conditioned upon the successful completion of a drug screen (as applicable). Relocation Assistance Provided: No #LI-Remote - This is a remote position