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10 fresh jobs found
Clinical Review Clinician - Appeals (RN)
Remote-TX, United States Centene Corporation logo Centene Corporation
Clinical data analysis Appeals processing Interdepartmental Collaboration Clinical reviews Ncqa standards Medicaid regulations Clinical Review Appeals Medical necessity +18
Mid Full Time
USD 95K+
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Medical Director - Post-Acute Care - Evernorth Home-based Care - Remote
Tennessee Work at Home, United States The Cigna Group logo 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+
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Quality Improvement Abstractor
Remote-TN, United States Centene Corporation logo Centene Corporation
CHIPRA Quality Initiatives Quality measures Data Abstraction Ncqa standards Microsoft Applications HEDIS Medical Coding Microsoft Access +17
Mid Full Time
USD 95K+
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Credentialing Specialist II
Seattle-600 University St., Ste. 400 (10345), United States Centene Corporation logo Centene Corporation
Provider data management Ncqa standards Fast-paced Environment Credentialing Health Insurance Managed Care Data Management Access Insurance +6
Mid Full Time
USD 77K+
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Clinical Review Clinician - Appeals
Remote-NY, United States Centene Corporation logo Centene Corporation
Clinical reviews Appeals processing Clinical data analysis Interdepartmental Collaboration Ncqa standards Medicaid regulations Appeals Clinical Review Medical necessity +19
Mid Full Time
USD 52K+
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Senior Director, Utilization Management
Remote-MO, United States Centene Corporation logo Centene Corporation
Ncqa standards Healthcare Management Procedures Health Services Medical management Utilization management Policy Development RN Health Insurance +15
Senior Full Time
USD 157K+
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Senior Director, Utilization Management
Remote-NY, United States Centene Corporation logo Centene Corporation
Ncqa standards Healthcare Management Procedures Health Services Medical management Utilization management Policy Development RN Health Insurance +15
Senior Full Time
USD 157K+
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Complex Case Manager (Remote with field travel in Greater Columbia region)
Kennewick, Washington, United States; Yakima, Washington, United States; Seattle, Washington, United States Community Health Plan of Washington logo Community Health Plan of Washington
Care management software Workflow systems Ncqa standards Community Resources Discharge planning Care Coordination Social Work Software Applications Utilization management +16
Mid Full Time
USD 83K+
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Credentialing Specialist III
Work From Home - AZ, United States Avēsis logo Avēsis
Hearing industry OIG Vision industry Provider applications NPDB Payer credentialing standards PSV CAQH Provider Credentialing +26
Senior Full Time
USD 36K+
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RN Quality Clinical Management Lead Analyst, Work from Home, Anywhere, USA
Pennsylvania Work at Home The Cigna Group logo The Cigna Group
Patient Disease Processes Database navigation Ncqa standards Quality of care HEDIS Medical Record Review Quality review Health Services Quality improvement +35
Senior Mid Full Time
USD 73K+
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