You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective
Appeals Pharmacist Ensure Fair Medication Access for Patients A confidential managed care organization is seeking an experienced Appeals Pharmacist to review, evaluate, and process medication coverage appeals. This role is ideal for pharmacists who want to leverage their clinical
Actalent is Hiring a Team of UM/Appeals LPNs // Fully Remote! The Appeals Clinical Reviewer serves as an Appeals Utilization Review Nurse responsible for reviewing and evaluating member and provider appeals related to medical necessity determinations, authorization decisions, and claims
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective
Scheduled Hours40 Position SummaryAdvanced level specialization in complex pre-certifications as indicated on therapy and treatment plans to prevent controllable losses/write offs for the Department. May perform rechecks of insurance eligibility and verify authorization information for each
By joining Sedgwick, youll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with
Pharmacy Technician The Pharmacy Technician supports pharmacy operations including prior authorizations, formulary management, claims processing, audit/recovery, and Medicare Part D/Part B programs. This role partners with pharmacists, providers, and members to ensure accurate, compliant, and timely
Product Director 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
Remote Field Reimbursement Manager Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris revolutionizes the path
Essential Duties and Responsibilities: - Maintain updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position - Function as a Subject Matter Expert in