Commence is positioned at the forefront of data-driven healthcare transformation, delivering data-centric solutions to improve health outcomes and efficiency. The team emphasizes clarity, compliance, and collaboration to build trusted, scalable systems for CMS programs. The Senior Business
Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists
Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists
Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists
Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists
Your Role The Delegation Oversight Utilization Management team is responsible for the organization, tracking and data entry of IPA Utilization Management audits, issues, complaints and monitoring. Identifies root cause of the problem and maintains monthly reporting
City/StateVirginia Beach, VA Work ShiftFirst (Days) Overview: Sentara Virginia Beach General Hospital is hiring a Stroke Program Coordinator for a Part Time, Day shift in Virginia Beach, VA! Shift: PT - (20hrs) Days The Stroke Program
City/StateVirginia Beach, VA Work ShiftFirst (Days) Overview: Overview The Director of Appeals and Grievance will plan, develop, and direct the department services and activities for all existing and new business opportunities. This includes setting strategic long-
Job Family:General Coding Travel Required:None Clearance Required:None What You Will Do: The Vascular Surgery Coder must be proficient in surgical coding for all Trauma Surgery type cases. E/M experience is also required for associated providers. The
AppleOne Employment Services is seeking a Seasonal Member Advocate to support members remotely from September through December. The role involves assisting with benefits, eligibility, claims, referrals, and plan options, while delivering high-quality customer service and resolving
Utilization Management Physician (UMP) Remote | Full-Time | Florida Compensation: $240,000 base + bonus Schedule: 40 hours/week Work Model: Remote (on-site meetings in Daytona Beach, FL) Overview Seeking an experienced Utilization Management Physician to perform medical
Commence, a data-centric healthcare transformation leader, invites a Senior Business Analyst to drive CMS case-management initiatives in a fully remote role. You will lead requirements management, ensure traceability, and collaborate with stakeholders across product, engineering, and CMS teams
Remote Prior Authorization Pharmacist Transition your clinical skills into a fully remote Prior Authorization Pharmacist role. Review medication requests from home, apply evidence-based criteria, and help patients get the therapies they need with predictable schedules and
Mount Sinai Medical Center of Florida, Inc. is seeking an experienced Certified Inpatient Coding Specialist (CCS) to code and abstract inpatient records using ICD-10-CM and ICD-10-PCS. The role supports a fully remote Florida-based position with a 95%
Licensed Medicare Sales Agent *Work Remotely in the comfort of your own home * *Must have active health insurance license in the state that you reside* *You will be a captive agent* HealthPlanOnes mission is to
Job Title Provides support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network.
Director, Data Management (EIM) The Director, Data Management is a senior leadership role within Molina Healthcare responsible for enterprise data management strategy, delivery, and modernization across core health plan domains. This role leads the design, integration,