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Managed Care Remote Jobs
37 fresh jobs found
Care Coordinator - Cook County, IL
- Remote IL CHI METRO
Humana
LTSS
Human services
Social Work
Managed Care
BI
Case Management
Wellness
Microsoft Word
Assessment
+15
Entry
Mid
Full Time
USD 52K+
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Social Work Case Manager - Monroe, WI
- Work at Home - Wisconsin
Humana
Healthcare Coordination
Human services
Network
Social Work
Managed Care
BI
Care management
Case Management
Wellness
+8
Mid
Full Time
USD 47K+
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Senior Project Manager (Medicaid Network Implementation)
- Remote US
Humana
Value-Based Payment
Provider Strategy
Network implementation
Network Development
PMP
Provider Relations
Network
Six Sigma
Managed Care
+19
Senior
Full Time
USD 84K+
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Medical Director - Florida
- Remote US
Humana
Health claims review
Discharge planning
Medical background
Rehabilitation
Medical interpretation
Clinical Standards
Coding practices
National Guidelines
InterQual
+31
Exec
Mid
Full Time
USD 199K+
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UM Coordinator - LHB
- Work From Home (HB)
Health Care Service Corporation
Healthcare Management
Nursing
Managed Care
Written communication
Insurance
Interpersonal
Communication
Mid
Full Time
USD 55K+
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Program Manager, Operations Integration *Remote*
- Renton, WA, United States
Providence
Ambulatory Care
Performance Improvement
Population health
Visio
Managed Care
Word
PowerPoint
Strategic planning
Consulting
+2
Mid
Full Time
USD 66K+
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Value-Based Programs Lead
- Remote US
Humana
Provider reimbursement
Managed care operations
Social Determinants of Health
Value-based care
Network
Managed Care
BI
Modeling
Wellness
+21
Senior
Mid
Full Time
USD 102K+
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Manager, Care Management
- Work at Home - Virginia
Humana
Analyzing
Microsoft Office Applications
Technical knowledge
Managed Care
Care management
Assessment
Wellness
Data
Medicaid
+14
Mid
Full Time
USD 84K+
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Telephonic Case Manager
- Phoenix, AZ, USA
Ethos Risk Services
RN License
Medical Record Review
Workers Compensation
Managed Care
Critical thinking
Microsoft Office
Customer service
Communication
Mid
Full Time
USD 85K+
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Patient Account Representative - Remote
- United States
Tenet Healthcare
Call Center Environment
ACE
Revenue cycle process
Remittance Review
Claim Submission
Basic Computer
Hospital billing
Commercial Insurance
Insurance collections
+18
Entry
Mid
Full Time
USD 43K+
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Denial Specialist - Remote
- United States
Tenet Healthcare
Appeals generation
EOB validation
Documentation compilation
Clinical consultations
Business letter writing
Payer guidelines
HCPCS/CPT coding
Call Center Environment
ICD-9
+16
Mid
Full Time
USD 51K+
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Research Scientist
- Remote US
Humana
Data acquisition
Analyzing
Clinical Informatics
Biostatistics
PySpark
Population health
Epidemiology
Analytic
SAS
+27
Mid
Full Time
USD 69K+
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Sr Clinical Strategist (Iowa)
- Work At Home-Iowa
CVS Health
Data interpretation
Clinical expertise
Case Management
Managed Care
Outlook
Microsoft Excel
Teams
Collaboration
Excel
+3
Senior
Mid
Full Time
USD 78K+
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Patient Account Representative- Remote - WA STATE RESIDENTS ONLY
- WA, United States
Tenet Healthcare
Medicare/Medicaid Knowledge
Call Center Environment
ACE
Remittance Review
Claim Submission
Revenue cycle process
Basic Computer
Hospital billing
Medical Records
+17
Entry
Mid
Full Time
USD 49K+
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Case Manager- Jefferson County, WI
- Work at Home - Wisconsin
Humana
Human services
Healthcare Coordination
Social Work
BI
Care management
Case Management
Wellness
Managed Care
HIPAA
+6
Mid
Full Time
USD 47K+
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Details
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Tester I, Benefit Configuration - Remote
- Appleton, WI, US
Navitus Health Solutions
Pharmacy claims processing
Reporting tools
Pharmacy network rates
Pharmacy benefits
Formulary management
NCPDP
Claims adjudication
Claims processing
Configuration
+10
Mid
Full Time
USD 38K+
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Value Based Care Compliance Manager - Remote
- United States
Tenet Healthcare
Healthcare Regulations
Compliance program management
Healthcare industry expertise
Managed Care
Audit
Technical
HIPAA
Computer
Regulatory Compliance
+13
Mid
Full Time
USD 89K+
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Social Work Care Coach - Neillsville, WI
- Work at Home - Wisconsin
Humana
Computer applications
Health promotion
Human services
Social Work
BI
Managed Care
Assessment
Wellness
HIPAA
+14
Mid
Full Time
USD 47K+
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Details
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Medical Director - North Central Region - Medicaid
- Remote US
Humana
Health claims review
Coding practices
Medical background
Population health management
Clinical Standards
Medical interpretation
Discharge planning
Rehabilitation
National Guidelines
+35
Exec
Senior
Full Time
USD 199K+
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Details
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Senior Accreditation Professional
- Remote US
Humana
Long-Term Services and Supports (LTSS)
NCQA Health Plan Accreditation
LTSS
Case Management
Wellness
Managed Care
HIPAA
Medicaid
Time Management
+17
Senior
Full Time
USD 76K+
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Growth Strategy Manager
- Remote NY NYC METRO
Humana
Strategy Consulting
Research and Analysis
Nursing
Strategy Development
Wellness
Managed Care
HIPAA
Medicaid
Market Analysis
+15
Senior
Mid
Full Time
USD 135K+
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Sr. Value-Based Programs Professional (Remote US)
- Remote US
Humana
Managed care operations
Provider reimbursement
Social Determinants of Health
Value-based care
Technical knowledge
Modeling
SAS
Wellness
Managed Care
+20
Senior
Mid
Full Time
USD 76K+
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Details
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Coding Auditor & Educator
- Remote, USA
Welbe Health
ICD-10 coding standards
M.E.A.T. concepts
Microsoft Office (Outlook, Word, Excel, PowerPoint)
Managed Care
PowerPoint
Microsoft Office
Excel
Mid
Full Time
USD 67K+
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Patient Account Representative - Remote
- United States
Tenet Healthcare
ACE
Revenue cycle process
Hospital billing
Claim Submission
Remittance Review
Basic Computer
Commercial Insurance
Medical Records
Insurance collections
+15
Entry
Mid
Full Time
USD 43K+
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Details
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Denials Specialist - Remote
- United States
Tenet Healthcare
Microsoft Office (Word, Excel)
Business letter writing
Clinical consultations
Payer guidelines
Hospital billing
HCPCS/CPT coding
Revenue cycle process
CPT coding
Medical Records
+20
Mid
Full Time
USD 51K+
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Details
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Social Worker Care Coach - Baldwin, WI
- Work at Home - Wisconsin
Humana
Human services
Social Work
Healthcare Coordination
Care management
Case Management
Wellness
Managed Care
HIPAA
Medicaid
+5
Mid
Full Time
USD 47K+
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UM Technician (Must Work Hawaii Business Hours) - Remote
- United States
Tenet Healthcare
General Computers
Healthcare industry expertise
Data Entry
Medical terminology
Managed Care
Word
Excel
Customer service
Leadership
Entry
Mid
Full Time
USD 43K+
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Medicaid RPA Analyst
- Remote US
Humana
Productivity
Health Care Sector
Automation Anywhere
Data Reporting
Power Automate
Data Warehousing
Economics
Wellness
Statistics
+18
Entry
Mid
Full Time
USD 59K+
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Prior Authorization Technician - Remote
- United States
Tenet Healthcare
EZ-CAP
Medical Coding
Healthcare industry expertise
Managed Care
Coding
Computer
Word
Compliance
Excel
+1
Mid
Full Time
USD 51K+
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Social Work Case Manager - Blair, WI
- Work at Home - Wisconsin
Humana
Human services
Healthcare Coordination
Social Work
Care management
Wellness
Case Management
Managed Care
HIPAA
Medicaid
+5
Mid
Full Time
USD 47K+
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Details
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Manager, Government Clinical Services-Remote
- Madison, WI, US
Navitus Health Solutions
Clinical Services Management
Formulary management
Pharmacy practice
Healthcare Regulations
Clinical programs
Program development
Population health
Clinical services
Pharmacy
+8
Mid
Full Time
USD 117K+
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Credit Resolution Representative - Remote
- United States
Tenet Healthcare
EPIC
Meditech
Contract Interpretation
Hospital billing
STAR
ACE
PBAR
HCPCS/CPT coding
CPT coding
+15
Entry
Full Time
USD 47K+
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Details
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Patient Account Representative - Remote
- United States
Tenet Healthcare
Claim Submission
Remittance Review
Basic Computer
Revenue Cycle
Commercial Insurance
Insurance collections
Managed Care
Medicaid
Medicare
Entry
Mid
Full Time
USD 43K+
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Details
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Sr. Analyst, Network Contracting-Remote
- Madison, WI, US | Remote, US
Navitus Health Solutions
Pharmacy services
Pharmacy Benefit Management
Business decisions
Claims adjudication
Contract Negotiation
Pharmacy
Database Management
Financial Management
Managed Care
+8
Senior
Full Time
USD 56K+
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Details
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Manager, Pharmacy Network Reporting-Remote
- Madison, WI, US | Remote, US
Navitus Health Solutions
Pharmacy reimbursement methodologies
NCPDP
Claims adjudication
Qlikview
Client Services
Pharmacy
Managed Care
MS Office
Analysis
+9
Senior
Mid
Full Time
USD 70K+
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Revenue Cycle Specialist - Remote
- United States
Tenet Healthcare
Healthcare A/R
Medicare regulations
Patient Financial Services operations
Revenue Cycle
Healthcare industry expertise
Process improvements
Team building
Technical
MS Office Suite
+12
Mid
Full Time
USD 46K+
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Details
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Behavioral Health Medical Director - N. Central Medicaid
- Remote US
Humana
Social Determinants of Health
Psychiatry
National Guidelines
Utilization management
Quality Management
Care management
Wellness
Health Insurance
Population health
+17
Exec
Senior
Full Time
USD 219K+
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Humana
Health Care Service Corporation
Providence
Ethos Risk Services
Tenet Healthcare
CVS Health
Navitus Health Solutions
Welbe Health