At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day. We all have the power to help, heal and change lives — beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One. Job Title Utilization Review Nurse - Employee Health Plan (EHP) Location Independence Facility Independence West Creek Department Clinical Integration Health Plan Management-Finance Job Code T24041 Shift Days Schedule 8:00am-4:30pm Job Summary Job Details Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will receive endless support and appreciation and build a rewarding career with one of the most respected healthcare organizations in the world. As a Utilization Review Nurse, you will provide clinical information to insurance companies to obtain authorization for future and elective surgeries, coordinate peer-to-peer reviews between insurance Medical Directors and Cleveland Clinic physicians and manage all pre-determination cases. This position primarily supports utilization review, with a strong focus on outpatient prior authorization requests. By taking this opportunity, you will join a fun, supportive, motivated, and detail-oriented team that is looking for a nurse with these qualities to join the team. A caregiver in this role works remotely from 8:00 a.m. – 4:30 p.m. Position requires residency in northeast Ohio. A caregiver who excels in this role will: - Provide insurance companies with detailed clinical information when required to complete the authorization and pre-certification process. - Communicate and attempt to resolve level of service discrepancies between CCF and insurance companies. - Coordinate level of service justification directly with physician and communicate directly with third party payers to obtain approval. - Complete responses on behalf of physician for denials. - Review medical records and communicate with physicians to obtain authorization. - Coordinate peer to peer reviews with CCF physicians and the insurance company Medical Director. Reviews are completed for CCF physicians at Main Campus and the community hospitals. - Coordinate pre-determinations for specific procedures and maintain confidentiality of all patients' related information. - Adhere to all JCAHO and Medicare compliance regulations. Minimum qualifications for the ideal future caregiver include: - Graduate of an accredited practical/vocational or professional nursing program - Current state licensure as a Licensed Practical Nurse (LPN) or Registered Nurse (RN) - Two or more years of experience in coding or a patient care acute facility, preferably at a tertiary care medical center - Excellent communications skills required to communicate will all levels in a health care environment Preferred qualifications for the ideal future caregiver include: - Utilization Review experience - Epic experience Physical Requirements: - Requires extensive sitting and dexterity to perform work on a PC. - Requires walking for extended periods of time. - Good visual acuity through normal or corrected vision. - Sedentary Work - Exerting up to 10 pounds of force occasionally (Occasionally: activity or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body. - Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. - Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met. Personal Protective Equipment: - Follows standard precautions using personal protective equipment as required. The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our drug free environment. All offers of employment are followed by testing for controlled substances. Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption. Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility. If applying for a Florida position, please see the following website for more information on the background screening requirements required by the Agency of Health Care Administration: https://info.flclearinghouse.com/ Please review the Equal Employment Opportunity poster. Cleveland Clinic is pleased to be an equal employment opportunity employer.

The Role A BIM Coordinator at ENG oversees the overall coordination and monitoring of the modeling efforts. (Lead Coordination), managing one or more projects at the same time. The BIM Coordinator, like the Job Captain, manages internal efforts, but it has a more global vision and a more direct relationship with owners, clients and teams (being the liaison between all of those). This role also includes reviewing strategies, new or not, that will be used in each project, and things related to innovation/standardization (how to do things better, and how to handle that with other project leaders). The BIM Coordinator is involved in production (data, operation and similar), being someone who has experience coordinating several trades and can help the team out in one or many projects, providing consulting on standards and BIM practices, especially regarding the project's constructability. Depending on the project and client, the BIM Coordinator will work with more stable or variable schedules, different amounts of rules to be followed, etc. So, even if, in some ways, this role does lead and manage, it acts more as a facilitator, articulating internal and external stakeholders. Minimum Requirements and skills - Construction background/knowledge - +7 years of experience with REVIT & NAVISWORKS. - Client relationship management skills. - Team management experience. - Great communicational skills with advanced English level. Desirable requirements: - Experience in US-based projects. Company Culture and Values - Candor: We value honesty, openness, and sincerity in all interactions. - Accountability: We take ownership and are committed to delivering high-quality work on time. - Win-Win Mentality: We strive for mutual success in all business relationships. Growth Opportunities As part of our commitment to your career progression, we offer: - Career Development Programs. - Internal Mobility. - Performance-Based Promotions. - Leadership Opportunities. - Project Diversity. Why join us? Explore our amazing benefits! ✨ 🌍 Work from Anywhere: Flexibility to work remotely or from a coworking space. 🌴No Policy for PTO: Recharge with flexible paid time off when you need it. 🎉 Wellness & Culture: Freedom and responsibility culture, healthy snack allowances, fun challenges and team celebrations. 🎓Continuous Learning: Programs to develop your technical and soft skills. 💻Work Equipment to Keep You Productive: We provide everything you need to create the perfect workspace. 🎧Tech & Office Allowances: Upgrade your workspace with our one-time allowances. With "Pimp up your Devices," and “Home Office set up allowance” you can upgrade gadgets for a better experience. 📶 Monthly Internet Allowance: Stay connected with a monthly allowance for internet and expenses. 💵 Highly Competitive Compensation Package: Includes both fixed and variable payments, all processed in our local currency, USD. #LI-DNI

This position is Remote in Massachusetts. You will have the flexibility to work remotely* as you take on some tough challenges. Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The Audit Team Lead will be responsible for playing a leadership role in performing compliance reviews of medical and administrative documentation to identify instances of healthcare fraud and/or wasteful and abusive conduct by health care providers who submit claims for payment. This position will utilize information from claims data analysis, plan members, the medical community, law enforcement, employee conduct, and confidential investigations in order to document relevant findings. The Audit Team Lead will lead site visits and desk audits of provider claims, and medical and administrative records, to gather and analyze all necessary information to determine whether subject adhered to state and federal compliance policies, reimbursement policies, and contract compliance. The Audit Team Lead will present and discuss audit findings with client and input information into Optum audit workflow tools and the client’s case tracking system. Where applicable, the Audit Team Lead will support appeal and fraud investigation activities. Finally, the Audit Team Lead will supervise and support the work of other Auditors in all of the responsibilities noted here. This position is full time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm EST. It may be necessary, given the business need, to work occasional overtime. We offer 8 weeks of paid training. The hours during training will be 8:00 am to 5:00 pm EST, Monday - Friday. Primary Responsibilities: - Supervise and support the work of other Auditors as detailed below. - Review medical and administrative records for audit/compliance review - Travel to provider sites up to 25%25/month to collect records and engage with providers - Present and participate in discussions with client regarding audit observations and findings - Collaborate with a team of 2-5 auditors to complete reviews - Enter audit findings data and notes in online/electronic platform using Excel-based templates - Attend and participate in dispute reviews and administrative hearings You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - High School Diploma or GED - Must be 18 years of age OR older - Nurse licensure (RN or LPN) or medical coder certification (CPC or CPMA) - Must be willing to travel up to 25%25 within the state of Massachusetts - 1+ years experience reviewing health care documentation in a clinical or administrative role - 1+ years basic experience with Excel, including familiarity with basic formulas and data analysis - Written and verbal communications skills - Customer service skills - Ability to work full time (40 hours/week), Monday - Friday, with flexibility for occasional overtime or weekend needs Preferred Qualifications: - Clinical or administrative experience in long term care, for example, nursing facility care delivery/administration and/or community-based LTC service programs like Home Health - Familiarity with Medicaid program and/or billing requirements - Working knowledge of medical terminology and claim coding - Experience in claim processing, healthcare provider information, and healthcare billing practices - Familiarity with CPT-4, HCPCs and ICD-10 code terminology - Experience working in a remote/telecommute workspace Telecommuting Requirements: - Reside within Massachusetts - Ability to keep all company sensitive documents secure (if applicable) - Required to have a dedicated work area established that is separated from other living areas and provides information privacy. - Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service *All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

• Research, develop, and implement AI models for video generation, editing, and enhancement • Experiment with state-of-the-art generative AI techniques (GANs, diffusion models, neural rendering) • Collaborate with leadership to define and execute the AI roadmap for video generation and editing • Optimize AI algorithms for performance, scalability, and real-time processing • Explore and apply computer vision techniques for scene understanding, object tracking, and video summarization • Stay updated with the latest advancements in AI, video generation, and editing technologies • Document and present research findings and technical developments to leadership