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Medicaid Remote Jobs

308 fresh jobs found

Utilization Management Review Nurse
Remote US, United States

Interpreting Criteria Health Plan Experience Clinical Nursing Rehabilitation Medical Services Health outcomes Acute care Consumer Experiences Registered Nurse +46

USD 71K+

Sr Programmer Analyst (UNIX/C/SQL) - Remote: Tucker, GA
Atlanta, GA, US, 30084

Gainwell Technologies

Test Scripting Object Oriented Design and development Testing Tools Claims systems Batch Applications development Development Methodologies Software Development Methodologies +36

Senior Mid Full Time

USD 80K+

Perinatal Mental Health Specialist (LA License)
United States

Diagnostic interventions Software adaptability Perinatal mental health Wellness goals Substance abuse disorders Individualized care plans Group care Healthcare practice Emergency Services +31

Senior Full Time

USD 80K+

Provider Services Analyst
Remote, United States

NAIC guidelines Post-Payment Adjudication Coordination of benefits Audit tools Payment Healthcare Billing Adjudication Exchange Collection +28

Entry Mid Full Time

USD 52K+

Senior Full Stack Software Engineer
Remote US, United States

Holistic approach TDD Vue.js Test Driven Development Consumer Experiences Back-End Development Efficiency Node Software Applications +60

Senior Full Time

USD 106K+

Manager, Provider Network
Remote-TX, United States

Centene Corporation

Network account management Quality Initiatives Provider Contracting Claims payment Supervisory Procedures Contracting Claims Network +16

USD 86K+

Senior Data Scientist
Remote IL CHI METRO, United States

Time Series DataRobot Gradient boosting Random Forest Regression analysis Statistical models Cluster analysis Predictive models Neural Networks +81

Senior Full Time

USD 129K+

Senior Program Delivery Professional
Remote US, United States

Report creation Program delivery Interoperability Healthcare IT EHR Healthcare experience EPIC Validation EMR +36

Senior Mid Full Time

USD 86K+

MarketPoint Senior Sales Compliance Professional
Remote US, United States

Metrics and reporting Regulatory Analysis Metrics Reporting Investigative CMS Risk Healthcare services Vision Wellness +32

Senior Mid Full Time

USD 86K+

Customer Support Representatives
Anchorage, AK, US, 99503

Gainwell Technologies

Telephone Experience Fax machines Telephone technology Organizational functions HMS Oral and written directions Help desk software Computer software Help Desk +23

Entry Mid Full Time

USD 35K+

Provider Engagement Administrator III
Remote-WA, United States

Centene Corporation

HBR analysis Claims reimbursement Claims billing Value based performance Cost and utilization Interpersonal relationships Network performance Provider engagement Provider Relations +29

Senior Mid Full Time

USD 68K+

Support Representative, Customer Success
Remote US, United States

Lucid Strategic execution Financial tracking Rating Process Flows Process documentation Operational Support Administrative Tasks Efficiency +67

USD 44K+

Clinical Review Clinician - Appeals (RN)
Remote-TX, United States

Centene Corporation

Clinical data analysis Appeals processing Interdepartmental Collaboration Clinical reviews Ncqa standards Medicaid regulations Clinical Review Appeals Medical necessity +18

USD 95K+

Clinical Review Nurse - Concurrent Review (RN)
Remote-TX, United States

Centene Corporation

NICU experience Health management systems Health management Medicaid regulations Clinical Review Acute care Discharge planning Medical necessity Medical Records +16

USD 95K+

Lead Enterprise Architect
Remote US, United States

Healthcare payer domain Business capabilities Value streams Hybrid Architecture Portfolio Rationalization Total Cost of Operations Technical innovation IT leadership IT Architecture +82

Senior Full Time

USD 142K+

Senior Data Scientist – Model Risk Management
Remote US, United States

Statistical Analytics Analytic Data manipulation Risk Predictive Modeling Data Mining SAS Presentations BI +48

Senior Mid Full Time

USD 117K+

Manager, Customer Success
Remote US, United States

Performance Tracking Risk KPI Tracking Strategic initiatives CRM Tools BI Travel Accountability Visualization +54

USD 86K+

Claims Research & Resolution Representative
Work at Home - Kentucky, United States

Administrative processes CRM Technology CAS LESS Administrative Tasks Mathematical Listening Claims processing Claims +33

Entry Mid Full Time

USD 43K+

Business Analyst - SDLC - Ohio
Any city, OH, US, 99999

Gainwell Technologies

Business Design Requirements traceability Testing Strategies Requirements Elicitation Defect Resolution Requirements Management Requirements analysis Process modeling Test Cases +49

Entry Mid Full Time

USD 55K+

Pharmacy Coordinator II
Remote-WA, United States

Centene Corporation

Formulary process Grievances Prior authorizations Managed care experience Provider Relations Cost analysis Utilization Review Medical management Prior authorization +16

Entry Mid Full Time

USD 44K+

Payer/ Provider Enrollment Specialist (PT, Temp)
Remote, USA, United States

Athena emr Credentialstream HIPAA Rules HIPAA rules and regulations Technology-driven Cloud-based technology Payer enrollment Athena Credentialing +15

Entry Mid Part Time Full Time

USD 50K+

Experienced Project Manager
Madison, WI, US, 53703-3445

Gainwell Technologies

Project Scheduling Catalyst Management methodology Project Management Methodology Budget development Project Management Software MS Project Edge Staffing +27

Senior Full Time

USD 86K+

Client Policy Manager I
Remote, United States

Medical policy Clinical coding Healthcare Claims CMS guidelines Reimbursement methodologies Claims payment Payment Claims Adjudication Adjudication +29

USD 72K+

.NET C# Developer
Any city, CO, US, 99999

Gainwell Technologies

BizTalk WebForms Object Oriented ADO.NET XSD WSDL WCF Applications development IIS +45

USD 60K+

Licensed Clinical Therapist
Work At Home-Texas, United States

Care Collaboration Licensed Mental Health Counselor Virtual Therapy Delivery Short-term Counseling Problem Solving Therapy Licensed Professional Counselor Electronic health record systems Cognitive Behavioral Therapy Licensed Marriage and Family Therapist +25

USD 52K+

Provider Services Unit Lead - Remote
Any city, WI, US, 99999

Gainwell Technologies

Customer contact operations Cxone MMIS Verint Avaya Team performance Help Desk Written and oral communication Accuracy +35

Senior Mid Full Time

USD 35K+

Community Marketing Representative II-Northeastern Region Indiana (Fort Wayne, IN)
Indiana WFH, United States

Managed care principles Community outreach Microsoft Suite Regulatory requirements CRM systems Managed Care Microsoft PowerPoint Medicare Medicaid +21

USD 53K+

Licensed Clinical Therapist
Work At Home-Florida, United States

Short-term Counseling Care Collaboration Problem Solving Therapy Licensed Mental Health Counselor Virtual Therapy Delivery Licensed Professional Counselor Electronic health record systems Cognitive Behavioral Therapy Licensed Marriage and Family Therapist +24

USD 52K+

Financial Analytics Professional
Remote US, United States

Interpreting Data Financial analytics Microsoft Power BI Analyzing Risk Adjustment Valuation Actuarial Risk SAS +37

Senior Mid Full Time

USD 66K+

Product Research Analyst (Public Healthcare & Medicaid Industry)
Remote (United States)

Policy Research Healthcare policy Healthcare Consulting Public Policy Competitive analysis Database Management Business Analysis Medicaid Technical Expertise +15

Entry Mid Full Time

USD 65K+

Healthcare Data Analyst - Medicaid Finance and Policy
Seattle, Washington, United States; Chicago, Illinois, United States

Healthcare data analysis VBA Healthcare Data Employee Benefits SAS Financial Technical Documentation Statistics Data Modeling +19

Entry Mid Full Time

USD 55K+

Principal Payment Integrity Product Manager
Any city, TX, US, 99999

Gainwell Technologies

Clinical medical record review Technology architecture Bill audit Payment Integrity Medical Record Review Analytical Techniques Processes Edge Posting +29

Senior Full Time

USD 108K+

Utilization Management Nurse Consultant
Work At Home-Kansas, United States

CM/UM certification IT platforms Med/surg Coverage determination Benefit management Benefit utilization Clinical Criteria RN licensure Clinical Judgment +20

Entry Mid Full Time

USD 52K+

Software Development Engineer in Test- SDET
Remote US, United States

Streaming technologies Azure Cloud Data Models Cloud-native solutions Security Testing Health outcomes Microservices architecture Quality Engineering .NET Core +66

Senior Full Time

USD 106K+

Provider Data Coordinator I
Remote-MS, United States

Centene Corporation

Network Administrative Support Databases Health Insurance Managed Care Medicare Medicaid Data Management Access +8

Entry Full Time

USD 38K+

Utilization Management Nurse Consultant
Work At Home-Michigan, United States

CM/UM certification IT platforms Med/surg Coverage determination Benefit management Benefit utilization Clinical Criteria RN licensure Clinical Judgment +20

Entry Mid Full Time

USD 58K+

Financial Reporting Professional
Remote US, United States

Trend analytics Consumer Experiences BI Healthcare services Vision Wellness Dental Regulations Financial reporting +29

USD 65K+

Content Strategy Lead
Remote US, United States

Editorial Calendar Management Content governance IVR Consumer Experience Human-centered design Due Diligence Healthcare experience Visual design Functions +47

Senior Full Time

USD 104K+

Fraud and Waste Investigator
Remote US, United States

Healthcare payment methodologies MS Access Investigative Ethics Process Development Investigations MS Word Business Operations Claims processing +41

USD 65K+

Utilization Management Behavioral Health Professional
HGB SCA Remote KY, United States

Autism spectrum disorder Interpreting Criteria Tricare Applied Behavioral Analysis Medical Services CPT codes Prevention Productivity Process Management +48

USD 65K+

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+

Care Manager, Telephonic Behavioral Health
HGB SCA Remote TX, United States

Comprehensive care planning Telephonic care management Educational program coordination Solution-oriented approaches Community resource identification Tricare Clinical Nursing Care Planning Motivational interviewing +59

USD 59K+

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+

Community Liaison
Remote-LA, United States

Centene Corporation

Outreach coordination Substance use Accreditation Community Health Substance Use Disorder Social services Social Work Community Engagement Stakeholder communication +33

USD 55K+

Senior IT Portfolio Manager
Remote US, United States

IT portfolio management Apptio Service Now IT leadership Budget planning Power Automate Budget development TDD LESS +70

Senior Full Time

USD 106K+

Senior Process Improvement Professional
Remote US, United States

Graph Creation Lucid NCQA Business practices Business Process Operational processes Lean Six Sigma Consumer Experiences Process design +54

Senior Full Time

USD 78K+

Spanish Bilingual Healthcare Customer Service - 100% Remote Mississippi
MS, US

Continuum Global Solutions

Computer Applications Computer Proficiency Active Listening Healthcare Knowledge Spanish Medicare Medicaid Empathy Verbal communication +8

Entry Full Time

USD 30K+

Billing & Reconciliation Representative
Remote US, United States

Reconciliation Consumer Experiences Pharmacy BI Travel MS Excel Prioritization Healthcare services Billing +24

Entry Mid Full Time

USD 40K+

Field Reimbursement Manager SouthWest/Central Region – Market Access
Remote, United States

Radiopharmaceuticals Billing Processes Molecular Imaging Medical Imaging Patient services Medical Coding HCPCS Radiology Customer Education +37

Senior Mid Full Time

USD 128K+

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

Centene Corporation

Clinical reviews Health management Authorization requests Medical appropriateness Health management systems Medicaid regulations Clinical Review Medical necessity Prior authorization +17

USD 95K+

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