• E-HealthJobs (Charles Town, WV)
    Job Title: Remote National Behavioral Health Medical Director Managed Care Category Temporary: Physicians Industry: Healthcare City: Charles Town State: WV Remote ... Behavioral Health Medical Director Will cover 6 states 180k total Medicare and Medicaid members Must have experience managing Medical Directors in multiple states at… more
    E-HealthJobs (10/08/19)
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  • Humana (Las Vegas, NV)
    …maintaining optimum health. We provide telephonic outreach to assess and support their health, offering education, identifying resources, and helping remove barriers ... the life\" preview of the Care Manager position Telephonically assess Medicare, Medicaid , Commercial, and/or and Group Account members in seven domains of… more
    Jobs2Careers (10/15/19)
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  • Humana (Las Vegas, NV)
    …maintaining optimum health. We provide telephonic outreach to assess and support their health, offering education, identifying resources, and helping remove barriers ... the life" preview of the Care Manager position Telephonically assess Medicare, Medicaid , Commercial, and/or and Group Account members in seven domains of… more
    PandaLogic (10/11/19)
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  • Fallon Community Health Plan (Worcester, MA)
    …In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and ... Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org. About NaviCare : Fallon… more
    Neuvoo (10/15/19)
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  • CHRISTUS Health (Irving, TX)
    Description The CHRISTUS Health Coding Integrity Specialist is a system support position that provides acute care coding subject matter expertise, leadership, ... support , and direction, for the CHRISTUS Health System. The...and other regulatory requirements including Centers for Medicare and Medicaid Services (CMS), the Joint Commission, and HIPAA standards… more
    PandaLogic (09/06/19)
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  • Wellcare Health Plans, Inc. (Tampa, FL)
    …children, seniors and individuals with complex medical needs primarily through Medicaid , Medicare Advantage and Medicare Prescription Drug Plans, as well as ... identity or expression, national origin, ancestry, disability, genetic Corporate Medical Director - Remote Share by Email Share on LinkedIn Share on Twitter Share on… more
    Wellcare Health Plans, Inc. (09/30/19)
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  • Trinity Health (Dale County, AL)
    …on LinkedIn Share on Twitter Share on Facebook Apply * Job Number: 00151621 * Location: Remote * Facility: Remote * Employment Type: Full time * Hours: 40 JOB ... Directs and supervises the medical duties and activities of professional and support personnel. 5. Assists in the development, implementation and review of quality… more
    Trinity Health (10/02/19)
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  • RN Utilization Management Nurse - Medicaid

    Humana (Simpsonville, KY)
    …The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit ... administration determinations for Humana's Kentucky Medicaid Plan. The Utilization Management Nurse 2 work assignments...This role is a part of Humana's Driver Safety program and therefore requires an individual to have a… more
    Humana (09/04/19)
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  • Manager, Utilization Management Nursing/Concurrent…

    Humana (Metairie, LA)
    …The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or ... rotating on-call/oversight during weekends and holidays. + Considered primarily remote /work at home (WAH) position, but will require travel...This role is a part of Humana's Driver Safety program and therefore requires an individual to have a… more
    Humana (09/04/19)
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  • Supervisor, UM Administration/ Clinical Claims…

    Humana (Baton Rouge, LA)
    …Responsibilities The Supervisor, UM Administration/Clinical Claims Review provides non-clinical support for the policies and procedures ensuring best and most ... work of a similar nature, and supervises a group of typically support and technical associates; coordinates and provides day-to-day oversight to associates. Ensures… more
    Humana (09/04/19)
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  • Remote RN Case Manager - Telephonic Nurse 2…

    Humana (Bethesda, MD)
    …maintaining optimum health. We provide telephonic outreach to assess and support their health, offering education, identifying resources, and helping remove barriers ... life" preview of the Care Manager position + Telephonically assess Medicare, Medicaid , Commercial, and/or and Group Account members in seven domains of functioning… more
    Humana (09/28/19)
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  • Remote RN Care Manager, Telephonic Nurse 2…

    Humana (Las Vegas, NV)
    …maintaining optimum health. We provide telephonic outreach to assess and support their health, offering education, identifying resources, and helping remove barriers ... life" preview of the Care Manager position + Telephonically assess Medicare, Medicaid , Commercial, and/or and Group Account members in seven domains of functioning… more
    Humana (10/01/19)
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  • Sr. Project Manager Government Services…

    Health Management Systems, Inc. (TX)
    …Performs other functions as assigned **Knowledge, Skills and Abilities:** + Medicaid program knowledge required; strong foundational understanding and experience ... defined implementation processes including leading kick off meetings, managing program design and implementation, project planning, and ongoing operations. Solid… more
    Health Management Systems, Inc. (08/08/19)
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  • Revenue Integrity Coding and Billing Specialist-…

    Navigant Consulting Inc. (Vienna, VA)
    …and denials. This position contributes to the mission of the Revenue Integrity Program to help improve compliance with government, managed care and other third-party ... Integrity, the Revenue Integrity Coding Billing Specialist provides revenue cycle support services through efficient review and timely resolution of assigned… more
    Navigant Consulting Inc. (10/15/19)
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  • Regional Operations Manager - Remote

    DaVita (Sacramento, CA)
    …the country. **We are in search of a strong leader to manage and support the geographical areas of** **Oregon, Northern, Central California, and Reno, Nevada.** The ... to be all inclusive: I **mplement DaVita's Patient Pathways Program ** + Travel to new program hospital...EPO, Indemnity) as well as government insurance programs (Medicare, Medicaid ) preferred + Minimum of two (2) years' management… more
    DaVita (09/26/19)
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  • Pharmacist Clinical - IngenioRx - ( Remote

    Anthem (Reston, VA)
    Pharmacist Clinical - IngenioRx - ( Remote in Pacific, Mountain or Central time zones ONLY) #PS27003 **Location:** **United States** **New** **Requisition #:** ... companies and a Fortune Top 50 Company. **Pharmacist Clinical - IngenioRx - ( Remote in Pacific, Mountain or Central time zones ONLY) #PS27003** Summary: Responsible… more
    Anthem (10/16/19)
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  • Medical Management Specialist I ( Remote

    Anthem, Inc (Costa Mesa, CA)
    Medical Management Specialist I ( Remote CA) (PS26817) **Location:** **California, United States** **Requisition #:** PS26817 **Post Date:** Oct 07, 2019 _Your ... 50 Company. **Medical Management Specialist I:** Responsible for providing non-clinical support to the Medical Management and/or Operations areas. Primary duties may… more
    Anthem, Inc (10/08/19)
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  • Program Coordinator I

    Consumer Direct Care Network (Allen, TX)
    Program Coordinator I at Consumer Direct Care Network (View all jobs) Allen, TX Company: Consumer Direct Care Network Position: Program Coordinator I Schedule: ... Full-time Location: Allen, TX (Not remote ) *For consideration of employment, please include a resume.*...our team located in our Allen, TX office. The Program Coordinator I will be responsible for assisting in… more
    Consumer Direct Care Network (07/28/19)
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  • Program Consultant Senior (SNAP)

    Virginia State Government (Richmond, VA)
    …Such programs include Energy Assistance, Medical Assistance Programs which includes Medicaid and Family Access to Medical Insurance Security Plan (FAMIS), ... Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), and...required to work a schedule that is split between remote and onsite (shared workspace) locations. A motor vehicle… more
    Virginia State Government (10/16/19)
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  • Deputy Program Manager

    Cognosante (Columbia, MD)
    …cloud governance experience to join our team. This is a hands-on deputy position in support of the program management role to oversee and manage a cloud ... sector organizations do everything from strategic consulting and acquisition support to application development, data integration, data standards, and...governance and onboarding program . The ideal candidate will have knowledge in agile… more
    Cognosante (09/05/19)
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