Job Title Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward
Job Title Provides senior level support for marketing and communications operations activities across the Molina enterprise. Job Description Supports the development and maintenance of marketing and communications workflows, campaign schedules, and projects, and ensures successful media
The Clinical QA Supervisor is responsible for the oversight of the review of Physician reports and accompanying medical records to ensure that the report is complete, accurate, and consistent with medical evidence. Oversight of QA staff
JOB SUMMARY We are seeking a highly organized and results-driven Project Manager to lead and manage cross-functional strategic initiatives that support organizational growth and operational excellence. This role will partner closely with executive leadership to drive
Our client, a Medical Center facility under the aegis of a California Public Ivy university and one of largest health delivery systems in California, seeks an accomplished EPIC Clarity BI Engineer NOTE- THIS IS 100% REMOTE
Job Title Leads and supervises multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or other special programs. Ensures members
Remote Prior Authorization Pharmacist Work From Home in Managed Care A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests, ensure medical necessity, and improve patient access to safe and effective therapies. This
Job Title Leads and manages team responsible for configuration activities including accurate and timely implementation and maintenance of critical information on claims databases, validation of data stored on databases, and adherence to health plan business and
Job Title Provides executive level strategy and leadership for teams responsible for optimization of clinical operations across the enterprise. Job Description Develops and implements processes to ensure healthcare services functions including utilization management/care management/etc. and clinical vendors
Sr. Director, Member Engagement Operations Homebase Medical is getting back to basics. Our mission is to optimize the quality of life for homebound older adults, allowing them to live independently and with dignity in their own
Job Title Provides support and subject matter expertise for member clinical dental review activities. Job Description Determines appropriateness and medical necessity of member dental care services - targeting opportunities for quality improvement and satisfaction for members and
Job Title Lead Healthcare Data Strategist Job Summary Leads the design, development, and standardization of healthcare data assets supporting Medical Economics, Finance, Actuarial, and operational business functions. This role is responsible for driving scalable data frameworks,
Job Title Provides senior level support for implementation of health plan provider engagement strategies and activities to drive necessary quality and risk adjustment outcomes Uses a consultative approach emphasizing physician engagement and behavior change through actionable
Job Title Investigative Support For Special Investigation Unit Job Description Provides investigative support for special investigation unit (SIU) activities specific to medical provider coding fraud, waste and abuse (FWA). Investigates and resolves instances of health care fraud
Job Title Certified Clinical Transplant Nurse specializing in Transplant/Gene Therapy for a pediatric population. Job Summary Provides senior level support for health education activities. Responsible for developing, implementing, and maintaining health plan health education programs. Assists
Clinical Wellbeing Specialist Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people
Future Opportunities Healthcare Provider Network Contractor EWINGS is seeking to build our talent network with Network Contractor professionals that have a minimum of 5+ years of experience developing healthcare provider networks. By submitting your resume now,
This is a remote position. About Us Atlantic Health Strategies partners with mission-driven behavioral health organizations to provide expert compliance, licensing, accreditation, operational, and administrative support. We work with providers across the continuum of care, including detox,
We appreciate you checking us out! Work At Home Data Entry Research Panelist Jobs - Part Time, Full Time This work-from-home position is ideal for anyone with a diverse professional background, including administrative assistants, data entry
Now Hiring: Remote Licensed Professional Clinical Counselor (LPCC) – California Location: Huntington Beach, California Employment Type: Full-Time Salary: $140,000.00 - $160,000 per year + benefits Are you a dedicated LPCC passionate about delivering quality mental health