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HJ Staffing
Join a leading Medicare Advantage Health Plan as a Medical Director of Utilization Management, focusing on clinical integrity and compliance.
Humana
Humana
Join Humana as a Consumer Service Operations Professional to support health initiatives through customer service and claims processing.
MDLive
MDLive
The Account Manager at Accredo will oversee operational performance strategies for specialty pharmacy clients, focusing on growth and client satisfaction.
Soleo Health
Soleo Health is looking for a Prior Authorization Pharmacist to manage prior authorization requests for specialty pharmacy, working remotely.
USAble Mutual Insurance Company
The Clinical Pharmacist will manage pharmacy care and collaborate with healthcare professionals to ensure effective drug utilization.
AbbVie
The Senior Regional Business Executive will drive sales initiatives for AbbVie's Chronic Migraine and Movement Disorders franchise across the United States.
Centene Management Company
Centene is seeking a Trainer I to develop and conduct training programs for its contact centers, primarily in a remote setting.
Guidehealth
Guidehealth is looking for a part-time Medical Director in Psychiatry to oversee utilization management activities for a commercial health plan.
National Committee for Quality Assurance
The Policy Manager leads the development and maintenance of healthcare product standards while collaborating across teams.
Facktor
Join Facktor as a Value-Based Care Director to lead innovative healthcare strategies focused on value-based reimbursement and optimizing patient outcomes.
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CRD Careers (Independent Recruiters)
Join a national managed care organization as a Senior Clinical Coding Auditor & Trainer, focusing on improving coding accuracy and compliance.
Wellpartner
The Adjudication Associate (Omnicare) is responsible for claims processing and ensuring timely reimbursements while working overnight hours.
A.R
Aetna Resources
Join CVS Health as a Utilization Management Nurse Consultant, working from home to assess and coordinate healthcare services.
A.R
Aetna Resources
CVS Health is seeking a remote Appeals Nurse Consultant to process Medicare appeals and ensure compliance with clinical guidelines.
WNR
WNR
The Supervisor of Utilization Management will lead and support the clinical staff in managing utilization reviews and ensuring compliance with regulations.