• Manage complex multi-workstream projects and oversee junior team members • Analyze data to implement performance improvement and organizational change • Collaborate with team members and clients to align with business objectives • Communicate effectively with project teams and stakeholders • Lead and develop team members through training, supervision, and feedback

Title: Utilization Review Specialist Location: Dallas, TX, United States Requisition ID: 5230 Job Description: This is a PRN position About Company: We're officially a Great Place To Work! We've always believed that supporting our team is just as important as supporting our patients. Now, we're proud to share that we've earned Great Place To Work Certification - based entirely on feedback from our own employees. This certification reflects the culture we've worked hard to build - one rooted in trust, inclusion, and purpose-driven leadership. At Bradford Health Services, we are committed to providing exceptional care to our patients while fostering a supportive and rewarding workplace for our employees. We believe that taking care of our team allows them to take better care of others, which is why we offer a comprehensive benefits package designed to support their well-being. Our benefits include: - Medical Coverage - Three new BCBSAL medical plans with better rates, improved co-pays, and enhanced prescription benefits. - Expanded Coverage - Options for domestic partners and a wider network of in-network providers. - Mental Health Support - Improved access to services and a new Employee Assistance Program (EAP) featuring digital wellness tools like Cognitive Behavioral Therapy (CBT) modules and wellness coaching. - Voluntary Coverages - Pet insurance, home and auto insurance, family legal services, and more. - Student Loan Repayment - Available for nurses and therapists. - Retirement Benefits - 401(k) plan through Voya to help employees plan for the future. - Generous PTO - A robust paid time off policy to support work-life balance. - Voluntary Benefits for Part-Time Employees - Dental, vision, life, accident insurance, and telehealth options for those working 20 hours or more per week. At Bradford Health Services, we don't just invest in our patients-we invest in our people. About the Role: The Utilization Review Coordinator plays a critical role in ensuring that patients at our facility receive the appropriate level of care while managing treatment costs. This position involves coordinating, assessing, and authorizing treatment plans, collaborating with medical staff, and maintaining compliance with healthcare regulations. The Utilization Review Coordinator works closely with insurance companies, clinicians, and support staff to ensure that treatment plans are clinically appropriate and reimbursable, advocating for the best interests of the patients and the hospital. Key Responsibilities: - Case Review and Assessment - Conduct daily reviews of patient charts, treatment plans, and progress notes to determine if the level of care provided aligns with clinical guidelines and insurance requirements. - Monitor patient progress, reassess treatment needs, and recommend adjustments in care levels as needed. - Collaborate with clinical teams to understand patient needs, assess treatment efficacy, and make informed recommendations. - Insurance Coordination - Act as the primary point of contact with insurance providers for treatment authorization, concurrent review, and appeal processes. - Submit required documentation to insurance companies in a timely manner, including clinical updates, to secure and maintain treatment authorization. - Resolve reimbursement issues, advocating for patient treatment needs and securing necessary approvals. - Documentation and Compliance - Ensure all documentation is complete, accurate, and in line with state, federal, and hospital policies to facilitate compliance and quality audits. - Maintain a working knowledge of current insurance guidelines, DSM-5 criteria, and ASAM (American Society of Addiction Medicine) criteria. - Participate in internal and external audits, preparing records and reports as necessary. - Collaboration and Communication - Work closely with medical and support staff to ensure continuity of care and that utilization review processes are aligned with patient needs. - Provide guidance to clinical staff regarding documentation best practices and criteria required for continued care authorizations. - Participate in multidisciplinary team meetings to discuss patient care plans, discharge planning, and treatment adjustments. - Quality Improvement - Identify trends in denied claims or treatment authorizations, providing recommendations for process improvements. - Assist in training hospital staff on utilization review processes, criteria for different levels of care, and effective documentation practices. - Collaborate in developing policies to improve efficiency, patient care outcomes, and financial performance. Qualifications: - Education: Bachelor's degree in Nursing, Social Work, or a related field required. Master's degree in a health-related field preferred. - Experience: Minimum of 2 years in utilization review, case management, or related field, preferably within a behavioral health or chemical dependency setting. - Licensure: Current RN, LCSW, or LPC license preferred. - Skills and Competencies: - In-depth understanding of mental health, substance abuse treatment and ASAM criteria. - Strong analytical and critical thinking skills with the ability to make clinical judgments based on patient data. - Excellent communication and interpersonal skills to facilitate interactions with insurers, staff, and patients. - Proficiency with electronic medical records (EMR) and utilization review software. - Knowledge of state, federal, and industry regulations related to chemical dependency and mental health care. Working Conditions: - Full-time, primarily daytime hours, with occasional on-call duties or weekends as needed. - Must be able to work in a high-paced environment and handle sensitive information with discretion. - Physical demands may include sitting for extended periods, light lifting, and using a computer for most of the workday.

Title: Utilization Review Specialist Location: Tuscaloosa United States Job Description: About Company: We're officially a Great Place To Work! We've always believed that supporting our team is just as important as supporting our patients. Now, we're proud to share that we've earned Great Place To Work Certification - based entirely on feedback from our own employees. This certification reflects the culture we've worked hard to build - one rooted in trust, inclusion, and purpose-driven leadership. At Bradford Health Services, we are committed to providing exceptional care to our patients while fostering a supportive and rewarding workplace for our employees. We believe that taking care of our team allows them to take better care of others, which is why we offer a comprehensive benefits package designed to support their well-being. Our benefits include: - Medical Coverage - Three new BCBSAL medical plans with better rates, improved co-pays, and enhanced prescription benefits. - Expanded Coverage - Options for domestic partners and a wider network of in-network providers. - Mental Health Support - Improved access to services and a new Employee Assistance Program (EAP) featuring digital wellness tools like Cognitive Behavioral Therapy (CBT) modules and wellness coaching. - Voluntary Coverages - Pet insurance, home and auto insurance, family legal services, and more. - Student Loan Repayment - Available for nurses and therapists. - Retirement Benefits - 401(k) plan through Voya to help employees plan for the future. - Generous PTO - A robust paid time off policy to support work-life balance. - Voluntary Benefits for Part-Time Employees - Dental, vision, life, accident insurance, and telehealth options for those working 20 hours or more per week. At Bradford Health Services, we don't just invest in our patients-we invest in our people. About the Role: The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient, and compliant with regulatory standards. This position involves thorough evaluation of patient records, treatment plans, and clinical data to determine the appropriateness of care and resource utilization. The specialist collaborates closely with healthcare providers, insurance companies, and case managers to facilitate timely approvals and optimize patient outcomes. By applying clinical knowledge and regulatory guidelines, the role helps control healthcare costs while maintaining high-quality patient care. Ultimately, the Utilization Review Specialist contributes to the integrity and sustainability of healthcare delivery systems across the United States. Minimum Qualifications: - Bachelor's degree in a healthcare or related field. - At least 2 years of experience in utilization review, case management, or clinical healthcare roles. - Strong knowledge of medical terminology, clinical procedures, and healthcare regulations. - Familiarity with insurance authorization processes and healthcare reimbursement models. - Excellent analytical, communication, and organizational skills. Preferred Qualifications: - Experience with electronic health records (EHR) systems and utilization management software. - Certification in Utilization Review (e.g., Certified Professional in Utilization Review or Certified Case Manager). - Prior experience working with managed care organizations or insurance companies. - Advanced knowledge of Medicare, Medicaid, and other payer-specific guidelines. Responsibilities: - Review and analyze medical records, treatment plans, and clinical documentation to assess the necessity and appropriateness of healthcare services. - Coordinate with healthcare providers, insurance representatives, and case managers to obtain additional information and clarify treatment details. - Make informed decisions regarding authorization, continuation, modification, or denial of services based on clinical guidelines and regulatory requirements. - Maintain accurate and detailed records of utilization review activities, decisions, and communications in compliance with organizational policies and legal standards. - Stay current with evolving healthcare regulations, payer policies, and clinical best practices to ensure consistent and compliant review processes. Skills: The Utilization Review Specialist applies clinical expertise and analytical skills daily to evaluate patient care plans against established medical criteria and payer policies. Effective communication skills are essential for collaborating with multidisciplinary teams, including physicians, nurses, and insurance representatives, to gather necessary information and explain review decisions. Organizational skills enable the specialist to manage multiple cases simultaneously while maintaining detailed documentation and meeting deadlines. Proficiency with healthcare IT systems supports efficient data retrieval and documentation of utilization review activities. Continuous learning and adaptability are important to stay updated on regulatory changes and evolving clinical standards, ensuring compliance and optimal patient care.

We’re here for one reason and one reason only – to cure cancer. Every moment is dedicated to developing treatments and every action moves us one step closer to our goal. We’ve made incredible scientific breakthroughs and our pioneering personalized CAR T-cell therapies have changed the paradigm. But we're not finished yet. Join Kite, as we make even bigger advances in cancer therapies, and help shape where our business and medical science goes next. We believe every employee deserves a great leader. People Leaders are the cornerstone to the employee experience at Gilead and Kite. As a people leader now or in the future, you are the key driver in evolving our culture and creating an environment where every employee feels included, developed and empowered to fulfil their aspirations. Join Kite and help create more tomorrows. Job Description The Senior Associate, Regulatory Writing will be responsible for writing and/or editing clinical documents for INDs, BLAs, MAAs, and associated regulatory submissions. This is an individual contributor role. Roles and Responsibilities (including, but not limited to): - Serve as medical writing contributor or lead for clinical trial-related regulatory documents - Write/edit/review content of clinical trial-associated documents for new and ongoing programs - Work with cross-functional teams to ensure production of high-quality written documents - Perform literature searches as needed and summarize data for incorporation into documents - Adhere to company Style Guide, templates, and SOPs for document development - Commit to company timelines for all assigned documents Requirements: - Bachelor’s degree required; advanced degree in life sciences preferred - BA/BS and 6+ years of relevant experience (less with advanced degree) - Strong scientific background in cellular immunology or related field, or oncology, is a plus - Experience with generating text from data or literature - Experience with clinical trial-related report documents is a plus - Demonstrated advanced writing skills with strong command of English language and grammar - Proficiency with MS Office Suite, EndNote, and MS Word templates - Strong oral and written communication skills - Efficient, organized, and able to handle short timelines in a fast-paced environment - Ability to work both independently and collaboratively - Ability to identify issues, ask questions, and propose solutions The salary range for this position is: $115,260.00 - $149,160.00. Kite considers a variety of factors when determining base compensation, including experience, qualifications, and geographic location. These considerations mean actual compensation will vary. This position may also be eligible for a discretionary annual bonus, discretionary stock-based long-term incentives (eligibility may vary based on role), paid time off, and a benefits package. Benefits include company-sponsored medical, dental, vision, and life insurance plans*. For additional benefits information, visit: https://www.gilead.com/careers/compensation-benefits-and-wellbeing * Eligible employees may participate in benefit plans, subject to the terms and conditions of the applicable plans. Kite is a biopharmaceutical company engaged in the development of innovative cancer immunotherapies with a goal of providing rapid, long-term durable response and eliminating the burden of chronic care. The company is focused on chimeric antigen receptor (CAR) and T cell receptor (TCR) engineered cell therapies designed to empower the immune system's ability to recognize and kill tumors. Kite is based in Santa Monica, CA. For more information on Kite, please visit www.kitepharma.com. Sign up to follow @KitePharma on Twitter at www.twitter.com/kitepharma. For jobs in the United States: Kite Pharma is committed to providing equal employment opportunities to all employees and applicants for employment, and is dedicated to fostering an inclusive work environment comprised of diverse perspectives, backgrounds, and experiences. Employment decisions regarding recruitment and selection will be made without discrimination based on race, color, religion, national origin, sex, age, sexual orientation, physical or mental disability, genetic information or characteristic, gender identity and expression, veteran status, or other non-job related characteristics or other prohibited grounds specified in applicable federal, state and local laws. In order to ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Era Veterans' Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact ApplicantAccommodations@gilead.com for assistance. For more information about equal employment opportunity protections, please view the 'Know Your Rights' poster. NOTICE: EMPLOYEE POLYGRAPH PROTECTION ACT YOUR RIGHTS UNDER THE FAMILY AND MEDICAL LEAVE ACT Kite Pharma will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, (c) consistent with the legal duty to furnish information; or (d) otherwise protected by law. Our environment respects individual differences and recognizes each employee as an integral member of our company. Our workforce reflects these values and celebrates the individuals who make up our growing team. Kite Pharma provides a work environment free of harassment and prohibited conduct. We promote and support individual differences and diversity of thoughts and opinion. For Current Kite Pharma Employees and Contractors: Please apply via the Internal Career Opportunities portal in Workday.