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Health Plan Remote Jobs

73 fresh jobs found

Member Advocate II
Remote-NY, United States

Centene Corporation

Claims billing Grievance Member advocacy Member education Grievances Contract Compliance Health Plan Customer Care Performance Improvement +21

USD 77K+

Intermediate Configuration Analyst - Remote
Virginia Premier Health Plan Glen Allen, United States

Networx pricer Contract configuration Networx Qnxt Technical experience Functional analysis System Configuration Health Plan Acute care +15

USD 52K+

Utilization Review Nurse-Weekends-Remote
Sentara Park 1330, United States

Concurrent review Inpatient review RN license Retrospective review Milliman InterQual NCQA Discharge planning Health Plan +16

USD 60K+

Contract Associate/Juris Doctorate - Remote
Virginia Remote, United States

Healthcare law Document Drafting Healthcare operations Health Plan Legal Compliance Acute care Healthcare systems Policy Development Supply chain management +18

USD 88K+

Credentials Associate - REMOTE
Sentara Norfolk General Hospital, United States

Echo database Credentialstream Echo Data gathering Health Plan Credentialing Verification Database Management Nursing +13

USD 30K+

Manager, Community Relations – Medicare Sales
Remote-TX, United States

Centene Corporation

Community Development Community relations Community outreach Health Plan Public Relations Branding Coordination Reports Outreach +15

USD 86K+

Pharmacy Coordinator
Remote-IN, United States

Centene Corporation

Formulary process Prior authorizations Grievances Employee Training Pharmacy Technician Provider Relations Utilization Health Plan Utilization Review +21

USD 64K+

Contract Implementation Analyst
Remote-LA, United States

Centene Corporation

Contract implementation Provider information system Provider contracts Amisys UAT Government programs Claims payment Claims analysis UAT testing +24

Entry Mid Full Time

USD 44K+

Care Coordinator II
Remote-NJ, United States

Centene Corporation

Service assessments Education on Benefits Service plan Member Outreach Service coordination Home visits Guidelines Regulatory Guidelines Health Plan +17

Entry Mid Full Time

USD 55K+

Contract Negotiator II
Remote-NC, United States

Centene Corporation

Provider experience Contract Analysis Contract Compliance Guidelines Claims Adjudication Adjudication Provider Relations Health Plan Healthcare administration +22

USD 55K+

Manager, Community Relations – Medicare Sales
Remote-NY, United States

Centene Corporation

Community relations Community Development Community education Community outreach Health Plan Public Relations Branding Coordination Outreach +15

USD 86K+

Finance Analyst II
Remote-NY, United States

Centene Corporation

Financial Forecasting Health Plan Reconciliation Financial SAS Health Insurance Outlook Forecasting Accounting +11

Entry Mid Full Time

USD 55K+

Supervisor, Appeals Grievance
Remote-MO, United States

Centene Corporation

Appeals management Grievance Grievance resolution Grievances Performance Evaluation Appeals Health Plan Counseling Trend Analysis +26

USD 55K+

Public Programs Specialist
Remote-CA, United States

Centene Corporation

Member access Provider network management Clinical Management Grievances Healthcare Collaboration Health care services Service coordination Pharmacy Technician Medical Review +25

Entry Mid Full Time

USD 77K+

Community Relations Coordinator
Remote-DE, United States

Centene Corporation

Healthcare Programs Community relations Guidelines Community outreach Event Coordination Regulatory Guidelines Health education Health Plan Relationship Development +15

USD 77K+

Provider Account Manager
Remote-TX, United States

Centene Corporation

Claims billing practices Claims billing Billing practices Provider Relations Commercial Insurance Health Plan Tracking Client Services Claims +24

USD 55K+

Behavioral Health Care Manager
Remote-FL, United States

Centene Corporation

Service plan Treatment options Substance Use Disorders Home visits Substance use Personalized care plans Complex Care Management Telephonic Outreach Substance Use Disorder +30

USD 55K+

Senior Compliance Analyst - ICHRA
Remote-MO, United States

Centene Corporation

Health plan compliance Regulatory Interpretation Regulatory filings Compliance monitoring Health Plan Training Programs Risk assessments Regulatory Affairs Policy Development +23

Senior Mid Full Time

USD 68K+

Dir, Ent Vendor Mgmt - Shp Vmo
Sentara Park 1330, United States

Managed care contracting Health Plan Problem Resolution Care management Managed Care Vendor Management Reimbursement IT Healthcare +5

USD 132K+

Quality Program Strategist II
Remote-FL, United States

Centene Corporation

Health plan compliance Performance goals HOS Quality performance CAHPS Cphq HEDIS Health Plan Clinical Experience +31

USD 68K+

Supervisor, Provider Network
Remote-TX, United States

Centene Corporation

Network account management Quality Initiatives Provider Contracting Claims payment Guidelines Health Plan Procedures Claims Supervisory +19

USD 55K+

Quality Program Strategist
Remote-FL, United States

Centene Corporation

Health program design Quality Initiatives Cphq Researching Data Systems Quality Metrics Program Design HEDIS Lean Six Sigma +23

USD 55K+

Contract Negotiator II
Remote-CA, United States

Centene Corporation

Guidelines Provider experience Contract Analysis Claims Adjudication Contract Compliance Adjudication Provider Relations Healthcare administration Health Plan +21

USD 52K+

Care Management Support Coordinator II
Remote-FL, United States

Centene Corporation

Guidelines Social determinants Social Determinants of Health Health Plan Customer Care Referrals Community Resources Procedures Care management +18

Entry Mid Full Time

USD 55K+

Manager, Network Strategy and Market Analysis
Remote-FL, United States

Centene Corporation

Performance Insights Network strategy Analytical support Health administration Strategic consulting Health Plan Strategic initiatives Risk mitigation Data-driven decision making +33

USD 86K+

Community Resource Coordinator II
Remote-FL, United States

Centene Corporation

Non-clinical assessments In-person outreach Member support Community education Health Assessments Social determinants Community outreach Health education Social Determinants of Health +16

USD 55K+

Contract Negotiator III
Remote-CA, United States

Centene Corporation

Guidelines Provider experience Contract Analysis Claims Adjudication Contract Compliance Adjudication Provider Relations Healthcare administration Health Plan +20

Senior Mid Full Time

USD 68K+

Care Management Support Coordinator II
Remote-OK, United States

Centene Corporation

Guidelines Social determinants Social Determinants of Health Health Plan Customer Care Referrals Community Resources Procedures Care management +17

Entry Mid Full Time

USD 34K+

Payer Contract Manager Sr
Working Virtually, United States

MultiCare Health System

RUG RVU Pricing terminology Payer mix analysis Conversion factors Payer contracting Medical data analysis Apc DRG +22

Senior Mid Full Time

USD 99K+

Senior Vice President, Network Development & Contracting
Remote-IL, United States

Centene Corporation

Contracting management Provider contracts Network strategy Contract Analysis Provider Contracting Network development Network Operations Contract negotiations Provider Relations +29

Exec Senior Full Time

USD 221K+

Claims Research Specialist
Remote-MO, United States

Centene Corporation

Medicaid benefits Claims billing Claims research Government programs Claims payment Provider Relations Payment Processing Health Plan Referrals +15

USD 77K+

Contract Negotiator I
Remote-MO, United States

Centene Corporation

Guidelines Provider experience Contract Analysis Contract Compliance Claims Adjudication Adjudication Provider Relations Healthcare administration Health Plan +20

Entry Mid Full Time

USD 55K+

Contract Negotiator I
Remote-IA, United States

Centene Corporation

Healthcare Programs Guidelines Provider experience Contract Analysis Contract Compliance Claims Adjudication Adjudication Provider Relations Healthcare administration +20

Entry Mid Full Time

USD 55K+

Dosimetrist - REMOTE
Virginia Remote, United States

Dosimetry Medical dosimetry Radiation therapy Service orientation Health Plan Verification Patient care Critical thinking IT +3

Senior Mid Full Time

USD 103K+

Business Analyst I - Claims
Remote-MT, United States

Centene Corporation

Amisys Claims Configuration Teradata Business Process Analysis Microsoft Applications Health Plan Microsoft Access Business solutions User Acceptance Testing +24

Entry Mid Full Time

USD 95K+

Pharmacy FWA Investigator I
Remote-FL, United States

Centene Corporation

Pharmacy fraud Audit experience Retail Pharmacy Data Sources Pharmacy Technician Corrective action plans Government programs Claims analysis Health Plan +32

Entry Mid Full Time

USD 44K+

Contract Associate/Juris Doctorate - Remote
Virginia Remote, United States

Business risk assessment Document Drafting Healthcare law Healthcare operations Health Plan Acute care Verification Legal Compliance Healthcare systems +19

USD 91K+

Health Care Analyst - Claims
Remote-NY, United States

Centene Corporation

Healthcare Claims Quality review Regulatory reporting Health Plan Information systems Financial Claims Database Management Snowflake +26

Entry Mid Full Time

USD 55K+

Program Manager (Provider Engagement)
Remote-OH, United States

Centene Corporation

Clinical improvements Managed healthcare Value-based contracting Health care operations Provider engagement Risk Adjustment Provider Relations Utilization Health Plan +31

USD 86K+

Senior Market and Operations Manager
Remote-MO, United States

Centene Corporation

Provider experience Community relations Operational reporting Problem identification Operational performance Utilization Provider Relations Healthcare administration Financial Performance +38

Senior Full Time

USD 105K+

Intermediate Configuration Analyst - Remote
Virginia Premier Health Plan Glen Allen, United States

Networx pricer Contract configuration Networx Technical experience Functional analysis Qnxt System Configuration Health Plan Acute care +15

USD 52K+

Manager, Solutions Consulting
Remote US

Health plans RFP Responses Solutions Consulting Health Plan Healthcare Technology Clinical expertise Client Engagement Partnerships Content Creation +7

USD 150K+

Senior Director, Solutions Consulting
Remote US

Health plans RFP Responses Solutions Consulting Health Plan Healthcare Knowledge Sales presentations Healthcare Technology Clinical expertise Client Engagement +10

Senior Full Time

USD 200K+

Care Management Support Coordinator II
Remote-PA, United States

Centene Corporation

Health Plan Customer Care Social Determinants of Health Referrals Community Resources Procedures Problem Resolution Regulatory requirements Care management +17

Entry Mid Full Time

USD 55K+

Quality Program Strategist II
Remote-NY, United States

Centene Corporation

Performance goals HOS Quality performance CAHPS Cphq HEDIS Health Plan Clinical Experience Cross-functional Teams +29

USD 68K+

Regulatory Consultant- Remote!
Virginia Remote, United States

Clinical process improvement Speaking Health Plan Acute care Verification Healthcare systems Quality Management System Judgment Policy Development +17

USD 54K+

Credentials Associate -REMOTE
Sentara Norfolk General Hospital, United States

Credentialstream Speaking Echo Data gathering Health Plan Verification Credentialing Judgment Database Management +14

USD 30K+

Community Resource Coordinator II
Remote-WA, United States

Centene Corporation

Non-clinical assessments In-person outreach Member support Community education Health Assessments Health education Community outreach Telephonic Outreach Health Plan +16

Entry Mid Full Time

USD 55K+

Vice President, Population Health - Care Management
Remote-MO, United States

Centene Corporation

Consumer assessment URAC CAHPS Member engagement HEDIS NCQA Health Plan Population health Medical management +28

USD 182K+

Quality Practice Advisor
Remote-OK, United States

Centene Corporation

Risk Adjustment Coding Cphq Documentation standards Medical record documentation Provider education ICD-9 NCQA HEDIS Risk Adjustment +23

USD 52K+

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