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Health Services Remote Jobs

120 fresh jobs found

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

Medication therapy Computational Computations Development programs Prescription Home health services Medication Adherence Pharmacy Technician Clinical programs +34

Entry Mid Full Time

USD 40K+

Senior Pharmacy Resolution Specialist
Remote-MI, United States

Centene Corporation

Pharmacy retail Authorization requests Audit Preparation Pharmacy operations Pharmacy Technician Data gathering Guidelines Prior authorization Medical management +18

Senior Mid Full Time

USD 64K+

Pharmacy Technician Representative 2
Remote US, United States

Development programs Computations Prescription Home health services Medication Adherence Pharmacy Technician Call center Operations Bilingual English/Spanish Home Health +31

Entry Mid Full Time

USD 40K+

Director of Product Management - Remote
Tennessee Work at Home, United States

The Cigna Group

Continuous product discovery Software development practices Cigna Analytic Health Services Competitive analysis Team Development Data-driven decision making Process Optimization +28

Exec Senior Full Time

USD 151K+

Clinical Programs Pharmacy Technician 2
Remote US, United States

Medication assistance Assist Financial resources Financial assistance resources Development programs Computations Prescription Home health services Medication Adherence +32

USD 40K+

Medical Director--Claims Management
Remote US, United States

Inpatient care Clinical patient care Computer-Based Review Outpatient services Home health services Grievance and appeals processes Clinical reference materials CMS policies Post-acute care +87

Exec Senior Full Time

USD 223K+

Medical Director - Florida
Remote US, United States

Clinical patient care Health claims Managed Care Knowledge Post-acute services Home health services Family practice Inpatient rehabilitation Hospitalist National Guidelines +73

Exec Senior Full Time

USD 223K+

Program Manager
Remote-AZ, United States

Centene Corporation

Quality process improvement Healthcare Reporting Analysis Tools Data Aggregation Training materials Staff training Healthcare Management Program Design Independent Judgment +33

USD 68K+

Retention Field Representative - Brooklyn (Cantonese, Mandarin)
Remote-NY, United States

Centene Corporation

Cantonese Home visits Mandarin Facets Researching Medical management Health Services Network Health care +21

Entry Mid Full Time

USD 44K+

Director, Utilization Management
Remote-OH, United States

Centene Corporation

Ncqa standards Provider experience Healthcare Management NCQA Utilization Medical management Performance Improvement Health Services Training and Development +27

Exec Senior Full Time

USD 124K+

Head Start Grantee Specialist- Region VI- REMOTE
Nationwide Remote Office (US99), United States

ICF Remote-first

Computer software systems Head start operations Fiscal operations Family Engagement Program operations Virtual platforms Training and Technical Assistance Management systems HOME +40

Exec Mid Full Time

USD 67K+

Medical Policy Analyst
Remote-MO, United States

Centene Corporation

Medical literature research Abuse management Medical policy development Clinical Practice Guidelines Technology assessments Waste management Evidence-based medicine Fraud Management Payment Integrity +18

Entry Mid Full Time

USD 68K+

Utilization Management Behavioral Health Registered Nurse
Remote US, United States

Clinical patient care Behavioral Change Interpreting Criteria Microsoft Office Word Social service agencies Clinical Nursing Health promotion LESS Registered Nurse +54

USD 71K+

Financial Project Senior Analyst - Remote
Tennessee Work at Home, United States

The Cigna Group

Billing Management Cigna Macros Technical Specifications Access Management Reconciliation Pivot Tables Health Services Client Communication +28

Senior Mid Full Time

USD 61K+

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+

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

Centene Corporation

Service authorization Medical appropriateness Authorization requests Health management systems Clinical reviews Health management Medicaid regulations Clinical Information Clinical Review +25

Senior Mid Full Time

USD 60K+

RN Clinical Review Clinician_Appeals
Remote-CA, United States

Centene Corporation

Appeals processes Interdepartmental Collaboration Ncqa standards Clinical reviews Medicaid regulations Researching NCQA Clinical Review Guidelines +27

USD 95K+

Head Start Grantee Specialist - Region X
Washington Remote Office (WA99), United States

ICF Remote-first

Fiscal operations Head start operations Computer software systems Family Engagement Program operations Virtual platforms Training and Technical Assistance Organizational Change Management systems +40

Exec Mid Full Time

USD 67K+

Behavioral Analyst, BCBA
Remote-TX, United States

Centene Corporation

Applied Behavioral Analysis Behavioral Analysis Managed care experience HIPAA regulations Community outreach Medical management Health Services HIPAA Compliance Procedures +15

Entry Mid Full Time

USD 55K+

Senior Director, Continuous Improvement Provider Engagement
Remote-MO, United States

Centene Corporation

Data-driven recommendations Provider experience Provider engagement Healthcare operations Healthcare administration Methodologies Performance Improvement Health Services Cross-functional Teams +34

Senior Full Time

USD 145K+

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+

Medical Director - Pediatric Otolaryngology- EviCore
Florida Work at Home, United States

The Cigna Group

Evidence-based reviews Evidence-Based Decision Making Evidence-based medical reviews Medical case reviews Case Management Software Federal Laws Automated processes Computer Applications Cigna +25

Exec Senior Full Time

USD 203K+

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+

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

Centene Corporation

Patient Profile Review Drug Therapy Optimization Multidisciplinary Team Collaboration Drug therapy Software management Medication therapy management Clinical pharmacy Telephonic Communication Medical management +13

USD 105K+

Supervisor, Clinical Grievance and Appeals
Remote-MO, United States

Centene Corporation

Appeals management Grievance Grievances Ncqa standards Quality Metrics NCQA Regulatory reporting Medical necessity Appeals +31

USD 68K+

Remote Medical Director - Texas
Remote-TX, United States

Centene Corporation

Culturally diverse care Medical management programs Health care quality Health financing Provider network development Government programs Clinical quality improvement Health administration Accreditation Standards +41

Exec Senior Full Time

USD 231K+

Network Performance Advisor
Remote-FL, United States

Centene Corporation

Risk contracting Utilization metrics Value-based contracting Network transformation Network performance Quality Metrics Network development Cross-functional Communication HEDIS +28

USD 55K+

Technical Support Senior Analyst – Remote - Evernorth
Connecticut Work at Home, United States

The Cigna Group

Case installation Bpl Healthcare terminology C programming Cigna Contract Analysis MS Access Facets MS PowerPoint +36

Senior Mid Full Time

USD 60K+

Authorization Specialist II
Remote-FL, United States

Centene Corporation

Healthcare eligibility Healthcare Policies Authorization processes Authorization requests Insurance coverage Researching Guidelines Adjudication Utilization +19

Entry Mid Full Time

USD 55K+

Senior ICE Specialist
United States of America : Remote

IT software IT Hardware Medical technologies Electrophysiology Medical science Health Services Technical communication Branded generic medicines Nutritionals +16

Senior Mid Full Time

USD 75K+

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

Centene Corporation

Health management systems Health management Medicaid regulations Guidelines Medical necessity Clinical Review Discharge planning Utilization Acute care +20

USD 95K+

Director, Government Affairs
Remote, WA

Legislative Advocacy Policy Writing Human services Government Affairs Social services Public Policy Health Services Stakeholder engagement

Exec Mid Full Time

USD 159K+

TeleHealth Registered Nurse - Registry
Remote-TX, United States

Centene Corporation

Obstetrics Health management Patient Assessment Guidelines Care Planning Clinical Information Home Health Triage Medical management +16

USD 95K+

Market Entry Capture Strategy Lead
Remote US, United States

Managed care operations Delegation Operational expertise Strategy Consulting Operational strategy Healthcare Management Network development Articulate Qualitative Research +71

Senior Mid Full Time

USD 115K+

Market VP, Value-Based Care Business Development
Remote US, United States

Durable Medical Equipment Infusion Healthcare relationships Development programs Post-acute care Home health services Chronic Condition Management Home Care Home Health +54

Exec Senior Full Time

USD 203K+

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

Centene Corporation

Service authorization Medical appropriateness Authorization requests Health management systems Clinical reviews Health management Medicaid regulations Guidelines Clinical Information +23

USD 95K+

Head Start Health Specialist Region VI-REMOTE
Nationwide Remote Office (US99), United States

ICF Remote-first

Maternal and child health Trauma informed practices Environmental health HOME Training and Technical Assistance Conferences Health administration Health education Community Health +32

Exec Mid Full Time

USD 67K+

Head Start Health Specialist- Region III- REMOTE
Nationwide Remote Office (US99), United States

ICF Remote-first

Early childhood mental health Maternal and child health Environmental health HOME Conferences Training and Technical Assistance Management systems Health administration Health education +35

Senior Mid Full Time

USD 67K+

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

Centene Corporation

Health management systems Health management Medicaid regulations Guidelines Clinical Review Medical necessity Discharge planning Utilization Acute care +20

USD 95K+

Intake Representative I
Remote-FL, United States

Centene Corporation

Authorization Systems Clinical Information Tracking Medical management Quality Standards Health Services Claims processing Claims Call Center +15

Entry Full Time

USD 53K+

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

The Cigna Group

Shared decision making Disease prevention Oncology nursing Digital Messaging Cigna Telephonic Communication Health promotion Cultural Sensitivity Behavior Change +33

Senior Mid Full Time

USD 76K+

Healthcare Economics Analyst - Remote
Tennessee Work at Home, United States

The Cigna Group

Replication Medical analysis Healthcare metrics Claims Data Healthcare economics Actuarial Analysis Cigna Client-facing Cost Management +42

USD 96K+

Housing Management Specialist II
Remote-NV, United States

Centene Corporation

Housing management Permanent supportive housing Transitional housing programs Fair housing Client assessment Eligibility Determination Housing regulations Community collaboration Continuum of care +35

USD 55K+

Grievance & Appeals Coordinator I
Remote-NY, United States

Centene Corporation

Grievance Claims research Grievance resolution Grievances Managed care experience Researching HEDIS Organizing Appeals +17

Entry Mid Full Time

USD 64K+

Senior Manager, Claims Configuration Operations
Remote-MO, United States

Centene Corporation

Claims Configuration Data Sources Medical management Quality Standards Health Services Operations Management Quality improvement Claims Business strategy +23

Senior Full Time

USD 105K+

Supervisor, Behavioral Health Utilization Management
Remote-FL, United States

Centene Corporation

Regulations Compliance UM Guidelines Accreditation Standards Clinical Supervision Medical necessity Utilization Accreditation Utilization Review +28

USD 73K+

Medical Director - Plastic Surgery
Florida Work at Home, United States

The Cigna Group

Evidence-based reviews Evidence-Based Decision Making Evidence-based medical reviews Medical case reviews Case Management Software Federal Laws Automated processes Computer Applications Cigna +25

Exec Senior Full Time

USD 203K+

Medical Director - Medicaid N. Central
Remote US, United States

Health claims review Computer-Based Review Post-acute services Grievance and appeals processes Post-acute care Humana policies Family practice Clinical group practice management Medical interpretation +92

Exec Senior Full Time

USD 223K+

Grievance & Appeals Coordinator I
Remote-AZ, United States

Centene Corporation

Grievance Claims research Grievances Managed care experience Researching Claims resolution Organizing Appeals Tracking +16

USD 38K+

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

Centene Corporation

TruCare Health management systems InterQual Guidelines Health management Medicaid regulations Clinical Review Medical necessity Discharge planning +22

USD 52K+

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