20 Best jobs in Brandon, SD (Hiring Now!)

Referral Specialist, RN, Health Plan
Sanford Health —Sioux Falls, SD
Currently holds an unencumbered registered nurse (RN) license with the State Board of Nursing. Ensure services comply with professional standards, national and…
$27.50 - $44.00 an hour
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Shipping & Receiving Coordinator
Bierschbach Equipment —Sioux Falls, SD
Validate inbound shipments and process receipt transactions in ERP system. Leads all outbound shipping & inbound processes within the Branch.
Estimated: $36K - $45.5K a year
11d
Early Childhood Teacher Assistant
Blue Dragon Academy —Garretson, SD
Develop and implement engaging lesson plans that promote the intellectual and social development of children. Familiarity with tools and strategies.
From $13 an hour
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Wash Bay Attendant
Blachowske Truck Line Inc. —Brandon, SD
Experience operating a truck with air brakes and manual transmission considered an asset. Light maintenance work (assisting technician’s).
$15 - $20 an hour
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Warehouse Worker (11:30 PM - 5:00 AM)
UPS —Sioux Falls, SD
The ability to lift up to 70 lbs. Reliability, responsibility, and a really good pair of work shoes. Excellent weekly pay, every Friday.
$21 an hour
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Asphalt Plant Manager/Operator
Confidential —Sioux Falls, SD
Communicate current job information with contractors and drivers. Ensure the asphalt plant's safe operation and asphalt plant employees' safety.
Estimated: $94.4K - $120K a year
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Field Service Calibration Technician-Sioux Falls SD Area
J&J Calibration Service Inc —Sioux Falls, SD
Valid drivers license and the ability to obtain a Commercial Drivers License (CDL) through training. Experience as a calibration technician, machinist, service…
$18 - $23 an hour
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Account Executive
It Outlet, Inc —Brandon, SD
New business development and lead generation through phone calls, email and social media. This is a permanent full-time position with growth potential.
$25,000 - $50,000 a year
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Motor Coach Bus Driver
Windstar Lines, Inc. —Sioux Falls, SD
Motorcoach drivers arrive at the shop and perform DOT required pre-trip inspection, travel in the motorcoach to pick up your group, and then the adventure…
Up to $85,000 a year
Corporate Controller
Building Products Inc —Sioux Falls, SD
This position is poised for internal growth and must have knowledge of multi-state tax configuration and auditing processes for week, month and year end.
$100,000 - $120,000 a year
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Laboratory Technician - Part-time (Benefit Eligible)
Avera Dells Area Hospital —Dell Rapids, SD
Certification from a National Credentialing Agency (NCA) or American Society of Clinical Pathology (ASCP) certification preferred.
$22.00 - $31.75 an hour
Concrete Ready Mix Driver
Buffalo Ridge Concrete Inc —Sioux Falls, SD
Valid CDL license or CDL learners permit. Perform daily truck inspections, responsible for routine and preventative maintenance, keeping truck clean, inside and…
Estimated: $44K - $55.7K a year
Quick Apply
Part-Time Ramp and Customer Service Agent
Envoy Air Inc. —Sioux Falls, SD
Valid driver’s license (some license restrictions may prohibit a candidate from being considered for this role). Authorized to work in U.S. without sponsorship.
$15.97 an hour
5h
RV Lead Technician/Shop Foreman
Noteboom RV —Harrisburg, SD
Maintain records of job progress, equipment usage, and employee performance. Perform quality control checks, verifying all finished products meet quality…
Estimated: $50.7K - $64.2K a year
Quick Apply
11d
Remote Customer Care Representative
CAPITAL Services —Sioux Falls, SD
Plus, we offer WORK FROM HOME (if you are located within a 60-mile radius of Sioux Falls, SD). Remote Customer Care Representative - Competitive pay starting at…
From $16.50 an hour
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Morning Warehouse Worker Package Handler
UPS of South Dakota —Sioux Falls, SD
The ability to lift up to 70 lbs. Excellent weekly pay, every Friday. Up to $25,000 in tuition assistance. Medical, dental and vision after waiting period.
$21 an hour
LPN [CL]
Avera Health —Sioux Falls, SD
Must have current Licensed Practical Nurse (LPN) license in the State of South Dakota and/or meeting the requirements of Multi-state licensure required.
$20.75 - $29.25 an hour
IT Managed Services Sales Professional
It Outlet, Inc —Brandon, SD
Establish, develop and maintain business relationships with prospective customers in the assigned territory continually surpassing their needs and consistently…
$47,518 - $59,906 a year
Quick Apply
Site Inspector
CES, LLC —Sioux Falls, SD
(Students, retirees, independent contractors, anyone looking for part time income). This is PART TIME independent contractor work (1099).
$41 - $60 an hour
Quick Apply
19h
Warehouse Order Selector (Full Time)
SpartanNash —Sioux Falls, SD
Must frequently sit, walk and stand; use hands to handle, grasp, and twist objects, tools, or controls; and use both feet for repetitive movements as in…
$19 an hour
Quick Apply

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Referral Specialist, RN, Health Plan

Sanford Health - Sioux Falls, SD

Quick Apply

Job Details

Full-time $27.50 - $44.00 an hour

Benefits

Health insurance
Dental insurance
401(k)
Vision insurance
Opportunities for advancement
Life insurance

Qualifications

Nursing
RN License
ICD coding
3 years
Medical administrative support
Bachelor's degree
Case management
Utilization management
CPT coding
Medical terminology
Communication skills

Full Job Description

Careers With Purpose

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.

Facility: GSS SD Sf Ctr

Location: Sioux Falls, SD

Address: 401 W 2nd St, Sioux Falls, SD 57104, USA

Shift: 8 Hours - Day Shifts

Job Schedule: Full time

Weekly Hours: 40. 00

Salary Range: $27.50 - $44.00

Department Details

Fun, fast paced work, remote work

Job Summary

Communicate with providers and/or members regarding management of out-of-network exception requests. Provide care coordination for designated Health Plan members that includes managing and directing members to appropriate resources, services and programs. Work directly with referring providers and participating provider specialty groups in coordinating care.

Responsible for managing the authorization process for participating plan members ensuring that all services are performed within assigned evidence-based guidelines and performed at the appropriate level of care in a timely, cost-effective and efficient manner. The collection and interpretation of clinical information is necessary to initiate and execute authorizations. Essential functions must occur simultaneously; therefore, the specialist must be able to appropriately handle and prioritize various daily tasks. Must be able to collaborate with other health plan departments as needed for medical coverage, case agreement negotiation and policy application. Obtain and maintain appropriate documentation concerning services in accordance to regulatory and accreditation guidelines and timelines. Provide information to providers and members in regards to authorization and/or denial of services. Ability to review, analyze and summarize reports and have effective oral and written communication skills. Understanding of medical terminology, international classification of diseases and current procedural terminology (CPT) codes. Understanding and administration of medical, administrative and management principles and policy necessary to operate within a managed care organization.

Ability to determine appropriate action for referring cases that do not meet departmental standards and require additional secondary review and/or escalation as needed.

May also be actively involved in collaborating with members of the healthcare team to promote medically necessary resource utilization and achievement of fiscal outcomes when appropriate. Collaborates with physicians and other clinical professionals as needed to assist in documentation improvement practices for effective and appropriate services. Dynamic and tactful interpersonal skills, particularly in relating to physicians and other health care professionals. Educates members of the healthcare team regarding trends, external regulations and internal policies that effect resource utilization and potentially, prior authorization.

Assists the department in monitoring the utilization of resources, risk management and quality of care for patients in accordance with guidelines and criteria. Assist in report preparation, correspondence, and maintenance of appropriate records. Ensure services comply with professional standards, national and local coverage determinations (NCD/LCD), centers for Medicare and Medicaid services (CMS), as well as state and federal regulatory requirements. Maintain working knowledge of payer standards for UM functions for authorization requirements.

May assist with additional special projects related to work, upcoming initiatives, new organizational goals and audits when delegated. Considered a resource to all team members and acts as a point of contact for guidance, training, and assisting with questions. Demonstrate flexibility and adaptability where scheduling may fluctuate due to communication needs within interdepartmental and clinical units are required.

Possesses strong clinical knowledge and skills. Collaborates with team members both internally and externally to ensure care is coordinated and appropriate based on evidence based medicine. Ability to work independently or as a member of a team. Ability to multitask and work with little direction. Works primarily day hours.

Administer and prioritize daily tasks, and apply Sanford Health Plan policies and regulatory requirements consistently and use good judgment as when to seek out guidance. Possess broad understanding of products and benefits and a demonstrated understanding of regulatory requirements and timeframes.

Assist with coordination of activities related to insurance pre-certification/authorization. Provide counseling to members or their representative regarding pre-service requirements and instructions.

Qualifications

Bachelor's degree in nursing preferred. Graduate from a nationally accredited nursing program required, including, but not limited to, Commission on Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN), and National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA).

Will consider applicant with significant background in case management and/or utilization management experience. Minimum of three years nursing experience is required.

Currently holds an unencumbered registered nurse (RN) license with the State Board of Nursing. Obtains and subsequently maintains required department specific competencies and certifications.

Benefits

Sanford Health offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits .

Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org .

Sanford Health has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.

Req Number: R-0189887

Job Function: Health Plan

Featured: No

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jobs in Brandon, SD

Referral Specialist, RN, Health Plan

Shipping & Receiving Coordinator

Early Childhood Teacher Assistant

Wash Bay Attendant

Warehouse Worker (11:30 PM - 5:00 AM)

Asphalt Plant Manager/Operator

Field Service Calibration Technician-Sioux Falls SD Area

Account Executive

Motor Coach Bus Driver

Corporate Controller

Laboratory Technician - Part-time (Benefit Eligible)

Concrete Ready Mix Driver

Part-Time Ramp and Customer Service Agent

RV Lead Technician/Shop Foreman

Remote Customer Care Representative

Morning Warehouse Worker Package Handler

LPN [CL]

IT Managed Services Sales Professional

Site Inspector

Warehouse Order Selector (Full Time)

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