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Health Services Remote Jobs

89 fresh jobs found

Behavioral Health Inpatient Care Manager - Initial Clinical Examiner Team- Evernorth Health Services- Remote
California Work at Home, United States

The Cigna Group

Technology navigation Technology systems Treatment plans Mental Health Counseling Medical necessity Behavioral healthcare Utilization Review Discharge planning Health Services +25

USD 65K+

Utilization Specialty OT Therapist Pediatric
Remote-TX, United States

Centene Corporation

Outpatient Therapy Services Clinical recommendations Evidenced Based Practice Pediatric care Authorization requests Operations support Documentation standards Network management +17

USD 118K+

Remote Behavioral Medical Director
Remote-IL, United States

Centene Corporation

Clinical practice improvement Health financing Provider network development Medical management programs Health care quality Health administration Personnel management Medical Review Clinical Quality +31

Exec Senior Full Time

USD 231K+

Senior Behaviorial Health Program Manager
Remote-MI, United States

Centene Corporation

Managed care experience Corrective action plans Health management Clinical Criteria Workflow Design Provider education Psychology Health education Clinical Training +29

Senior Full Time

USD 86K+

Medical Director - Post-Acute Care - Evernorth Home-based Care - Remote
Tennessee Work at Home, United States

The Cigna Group

Case conferences Medical care management Board certification Educational training Ncqa standards Peer-to-peer discussions Medical Review Quality of care Federal Laws +21

Exec Senior Full Time

USD 203K+

Behavioral Health Clinical Liaison
Remote-FL, United States

Centene Corporation

Outpatient Treatment plans Substance use Substance abuse Provider education Clinical assessment Procedures Treatment Planning Health Services +28

USD 68K+

Clinical Review Nurse - Prior Authorization
Getzville-105 Crosspoint Pkwy (11106), United States

Centene Corporation

Clinical reviews Authorization requests Health management Health management systems Medical appropriateness Medicaid regulations Clinical Review Medical necessity Acute care +18

USD 95K+

Infusion Care Coordinator
Remote-TX, United States

Centene Corporation

Client inquiries Hemophilia IVIG Pharmacy systems Care Plans Coverage determination Pharmacy Technician Triage Microsoft Suite +11

USD 64K+

Clinical Review Nurse - Concurrent Review
Remote-NY, United States

Centene Corporation

Health management Health management systems Medicaid regulations Clinical Review Medical necessity Acute care Discharge planning Health Services Medical Records +15

USD 52K+

Part-Time Weekend Medical Director
Remote-FL, United States

Centene Corporation

Health financing Government programs Medical management programs Provider network development Health administration Health care quality Personnel management Medical Review Clinical Quality +32

Exec Senior Part Time Full Time

USD 231K+

Director, Clinical Pharmacy
Remote US, United States

Drug Utilization Analysis Formulary Development Pharmacy benefit management Clinical pharmacy Development programs Home health services Medication Adherence PBM Corporate Communications +44

Exec Senior Full Time

USD 168K+

Clinical Programs Pharmacy Technician Representative 2
Remote US, United States

Call center processes Insurance processing Medication therapy Bilingual English and Spanish Development programs Home health services Medication Adherence Clinical programs Prescription +35

USD 40K+

Pharmacy FWA Investigator I
Remote-FL, United States

Centene Corporation

Government programs Pharmacy fraud Corrective action plans Audit experience Claims analysis Pharmacy Technician Health Services Medical management Fraud Investigation +25

Entry Mid Full Time

USD 44K+

Supervisor, Utilization Management
Remote-NC, United States

Centene Corporation

Regulations knowledge UM Accreditation Standards Accreditation Clinical Review Procedures Health Services Prior authorization Medical management +17

USD 73K+

Bilingual Retention Representative
Remote-NY, United States

Centene Corporation

Health Services Medical management Effective Communication Database Management Databases Health Insurance Business Analysis Bilingual Access +13

USD 30K+

Pharmacy Technician (Appeals)
Remote-FL, United States

Centene Corporation

Formulary research Grievances Pharmacy operations Pharmacy Technician Appeals Medicare part d Prior authorization Health Services Medical management +10

Entry Mid Full Time

USD 38K+

RN Clinical Review Nurse - Concurrent Review
Remote-CA, United States

Centene Corporation

Medicaid regulations Clinical Review Medical necessity Acute care Discharge planning Health Services Medical management Clinical knowledge Utilization management +9

USD 93K+

Clinical Review Clinician - Appeals
Remote-NY, United States

Centene Corporation

Clinical reviews Appeals processing Clinical data analysis Interdepartmental Collaboration Ncqa standards Medicaid regulations Appeals Clinical Review Medical necessity +19

USD 52K+

TeleHealth Registered Nurse (Registry)
Remote-TX, United States

Centene Corporation

Health management Care Planning Triage Home Health Patient Assessment Procedures Health Services Medical management Clinical knowledge +10

USD 95K+

(RN) Oncology Nurse Case Management Lead Analyst -Evernorth Health Services - Remote
Pennsylvania Work at Home, United States

The Cigna Group

Shared Decision Making Oncology nursing Disease Prevention Nurse Case Management Digital Messaging Health promotion Behavior Change Internet Research Telephonic Communication +32

Senior Mid Full Time

USD 76K+

Senior Director, Utilization Management
Remote-MO, United States

Centene Corporation

Ncqa standards Healthcare Management Procedures Health Services Medical management Utilization management Policy Development RN Health Insurance +15

Senior Full Time

USD 157K+

Pharmacy Technician I
Remote-MI, United States

Centene Corporation

Client inquiries Pbm system Specialty drugs Prior authorizations Coverage determination Pharmacy Technician Triage Health Services Medical management +6

Entry Mid Full Time

USD 53K+

Pharmacy Operations Coordinator I-4
Remote-CA, United States

Centene Corporation

Formulary setup Program Coordination Claims analysis Pharmacy operations Pharmacy Technician Health Services Medical management Claims Health Insurance +7

USD 64K+

Authorization Specialist II
Remote-MS, United States

Centene Corporation

Healthcare eligibility Authorization processes Authorization requests Insurance coverage Referrals Procedures Health Services Prior authorization Medical management +10

Entry Mid Full Time

USD 55K+

Autism Service Navigator
Remote-LA, United States

Centene Corporation

Health instruction Goal development Autism spectrum disorder Medical referrals Behavioral health services Pediatrics Clinical assessment Psychology Referrals +15

USD 68K+

Senior Director, Utilization Management
Remote-NY, United States

Centene Corporation

Ncqa standards Healthcare Management Procedures Health Services Medical management Utilization management Policy Development RN Health Insurance +15

Senior Full Time

USD 157K+

Autism Clinical Care Analyst
Remote-LA, United States

Centene Corporation

Autism spectrum disorder Insurance funding knowledge Behavioral support planning Treatment plan evaluation Applied Behavior Analysis Treatment plans Behavioral Analysis Clinical assessment Health Services +8

Entry Mid Full Time

USD 68K+

Medical Director - Southeast Region
Remote US, United States

Post-acute services Outpatient services Grievance and appeals processes Clinical group practice management Inpatient rehabilitation Commercial health insurance Coding practices Medical background Hospitalist +82

Exec Senior Full Time

USD 223K+

Behavioral Health Strategy Principal
Remote US, United States

Quality Initiatives Clinical Decision Making Evidence-Based Approaches Development programs Chronic Condition Management Home health services Clinical programs Collaborative relationships Health outcomes +77

Senior Full Time

USD 138K+

Long Term Care Functional Screen Manager & Liaison
Work at Home - Wisconsin, United States

Functional screening Long Term Care Family Care Microsoft Office Applications Health Services BI Policy Development Travel Network +39

USD 71K+

Clinical Pharmacist (MTM Support) Bilingual Spanish
Remote-FL, United States

Centene Corporation

Telephonic Medication Reviews Drug Therapy Optimization Patient Profile Review Multidisciplinary Team Collaboration Drug therapy Pharmacy Software Medication therapy management Clinical pharmacy Health Services +9

USD 105K+

Claims Representative - Remote
California Work at Home, United States

The Cigna Group

Dental claims Virtual collaboration tools Insurance terminology ICD-10 codes Computer Applications Document review CPT codes WebEx ICD +24

Entry Mid Full Time

USD 38K+

Rx Clinical Programs Pharmacy Technician Representative 2
Remote US, United States

Computations Financial assistance resources Medication assistance Bilingual English and Spanish Development programs Home health services Clinical programs Medication Adherence Prescription +30

Entry Mid Full Time

USD 40K+

Provider Data Lead Analyst - Directory Accuracy Quality Program - Remote
New Hampshire Work at Home, United States

The Cigna Group

Provider Services HCPM Automated processes Provider Contracting Data accuracy Healthcare operations Network Operations Data Validation Pivot Tables +27

Senior Mid Full Time

USD 62K+

Lead Software Engineer
Remote US, United States

Java Spring Visual Studio Code Api gateways Development programs IntelliJ Home health services Azure Cloud Medication Adherence Stakeholder Alignment +67

Senior Full Time

USD 129K+

Utilization Review Clinician - Behavioral Health
Remote-FL, United States

Centene Corporation

Medical appropriateness Healthcare Collaboration Treatment plans Substance abuse Provider education Clinical Review Utilization Review Discharge planning Treatment Planning +18

USD 52K+

Pharmacy Operations Specialist I
Remote-CA, United States

Centene Corporation

Quality process improvement UAT Pharmacy operations Health Services Medical management Health Insurance Managed Care Medicare Medicaid +8

USD 47K+

Clinical Review Nurse - Prior Authorization
Remote-NY, United States

Centene Corporation

Clinical reviews Authorization requests Health management systems Medical appropriateness Medicaid regulations Clinical Review Medical necessity Prior authorization Health Services +15

USD 52K+

Customer Service Representative - Cigna Healthcare - Remote
Texas Work at Home, United States

The Cigna Group

Computer Proficiency Health Services Listening Effective Communication Behavioral health Verbal communication Computer Insurance Customer service +5

Entry Mid Full Time

USD 34K+

Remote Medical Director - Michigan
Remote-MI, United States

Centene Corporation

Clinical practice improvement Health financing Provider network development Medical management programs Health care quality Health administration Personnel management Medical Review Clinical Quality +31

Exec Senior Full Time

USD 221K+

Authorization Specialist IV
Remote-MO, United States

Centene Corporation

Authorization process Healthcare eligibility Payment reviews Authorization processes Authorization requests Insurance coverage Referrals Prior authorization Health Services +13

USD 76K+

Manager, Autism Clinical Care
Remote-LA, United States

Centene Corporation

Functional behavioral analysis Behavioral services Quality of care Medical Review Behavioral Analysis Accreditation Claims resolution Clinical Oversight Provider Relations +21

USD 86K+

Behavioral Health Clinical Liaison, Central Region - VA - Remote
Work At Home-Virginia, United States

Clinical coordination Behavioral health services Addiction recovery Psychiatric care Interdisciplinary Teamwork Navigating multiple systems Mental health services Training and education Clinical Leadership +36

Senior Mid Full Time

USD 80K+

RN Case Manager- NICU- Remote
Pennsylvania Work at Home, United States

The Cigna Group

Shared Decision Making Disease Prevention Digital Messaging Health promotion Behavior Change Internet Research Cultural Sensitivity Clinical Acumen Motivational interviewing +28

USD 76K+

Implementation Manager - Remote
New York Work at Home, United States

The Cigna Group

Pharmacy benefits management Process knowledge Tracking systems Client interaction RFP Spreadsheets Health Services PMP Six Sigma +30

USD 80K+

Senior Director - Evernorth PBM Product (Remote)
Missouri Work at Home, United States

The Cigna Group

Matrix management PBM Specialty Pharmacy Analytic Health Services Financial Acumen Agility Contracting Financial +38

Senior Full Time

USD 173K+

Claims Representative - Remote
Connecticut Work at Home, United States

The Cigna Group

Dental claims Virtual collaboration tools Insurance terminology ICD-10 codes Computer Applications Document review CPT codes WebEx ICD +24

Entry Mid Full Time

USD 34K+

Pharmacy Operations Coordinator I
Remote-AZ, United States

Centene Corporation

Formulary setup Claims analysis Pharmacy operations Health Services Medical management Claims Health Insurance Managed Care Testing +5

USD 64K+

Utilization Review Clinician - Behavioral Health
Remote-MO, United States

Centene Corporation

Education provision Medical appropriateness Healthcare Collaboration Treatment plans Substance abuse Clinical Review Utilization Review Discharge planning Health Services +17

USD 52K+

National Medical Director, Clinical Excellence & Safety
Work at Home - Kentucky, United States

Clinical analytics Team-Based Care Health Informatics Evidence-Based Guidelines Development programs Chronic Condition Management Home health services National Guidelines Clinical Quality +50

Exec Senior Full Time

USD 246K+

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