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Posted (Sep 02, 2026)
BASIC FUNCTION: Under supervision, this position is responsible for providing support to members, clinicians, and physicians in the processing of Physical Health clinical appeals including ...
BASIC FUNCTION: Under supervision, this position is responsible for providing support to members, clinicians, and physicians in the processing of Physical Health clinical appeals including
Posted (Sep 01, 2026)
Remote Eligibility Representative Position Overview The Eligibility Representative is responsible for performing analytical and administrative functions to support Medicare enrollment and ...
Eligibility Representative Position Overview The Eligibility Representative is responsible for performing analytical and administrative functions to support Medicare enrollment and
Posted (Aug 31, 2026)
Remote Review Nurse SUMMARY DESCRIPTION: The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare ...
Review Nurse SUMMARY DESCRIPTION: The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare
Remote Clerk III SUMMARY DESCRIPTION: The Clerk III staff will work under the supervision of the Senior Director or department designee and serve as a ...
Clerk III SUMMARY DESCRIPTION: The Clerk III staff will work under the supervision of the Senior Director or department designee and serve as a
Work At Home Position Overview: The pharmacist will be responsible for medication therapy management (MTM) services, including outbound calls for comprehensive medication reviews (CMR) and delivering ...
Position Overview: The pharmacist will be responsible for medication therapy management (MTM) services, including outbound calls for comprehensive medication reviews (CMR) and delivering
Posted (Aug 28, 2026)
Fully remote (never coming onsite) Position Summary The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an ...
Position Summary The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an
Posted (Aug 27, 2026)
Remote in Chicago area Position Summary The Skills Strategy Contractor will support enterprise skills initiatives by identifying, mapping, and validating skills for job profiles while contributing to ...
Position Summary The Skills Strategy Contractor will support enterprise skills initiatives by identifying, mapping, and validating skills for job profiles while contributing to
Posted (Aug 26, 2026)
Fully remote (never coming onsite) Position Summary The Pharmacist/Clinician is an operation-based role that conducts criteria based & clinical review of medical data collected to perform prior ...
Position Summary The Pharmacist/Clinician is an operation-based role that conducts criteria based & clinical review of medical data collected to perform prior
Fully remote (never coming onsite) Summary: The Licensed Practical Nurse (LPN)/Licensed Vocational Nurse (LVN) will provide processing and communication of Commercial Prior ...
Summary: The Licensed Practical Nurse (LPN)/Licensed Vocational Nurse (LVN) will provide processing and communication of Commercial Prior
Posted (Aug 19, 2026)
Fully remote Position Summary The Credentialing Specialist ensures clinicians successfully pass the client credentialing process. This role is responsible for assisting ...
Position Summary The Credentialing Specialist ensures clinicians successfully pass the client credentialing process. This role is responsible for assisting
Posted (Aug 18, 2026)
Remote Position Summary This position takes in-coming calls from members, providers, etc providing professional phone assistance to all callers through the criteria based prior ...
Position Summary This position takes in-coming calls from members, providers, etc providing professional phone assistance to all callers through the criteria based prior
Posted (Aug 14, 2026)
Fully remote Position Summary As a Clinical Pharmacist Advisor Medicare you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. You will ...
Position Summary As a Clinical Pharmacist Advisor Medicare you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. You will
remote in any state except, NY, CA, HI and AK Description: Nurse Case Management Senior Analyst Delivers specific delegated tasks assigned by a supervisor in the Nurse Case ...
Description: Nurse Case Management Senior Analyst Delivers specific delegated tasks assigned by a supervisor in the Nurse Case
Posted (Jul 22, 2026)
Remote Description: The Senior EDI Application Developer is a full stack engineer who designs, develops, and integrates solutions to solve business and technical requirements across EDI ...
Description:
The Senior EDI Application Developer is a full stack engineer who designs, develops, and integrates solutions to solve business and technical requirements across EDI
Posted (Jul 01, 2026)
Remote Description: Fiber Analyst and Project Lead Job Summary Candidates will be responsible for managing the end-to-end testing of dark fiber ...
Description: Fiber Analyst and Project Lead Job Summary Candidates will be responsible for managing the end-to-end testing of dark fiber
Posted (Jun 25, 2026)
Remote Description: Government Programs Care Manager III. For this position, formerly Nurse Case Management Senior Analyst, through the care management process, will promote the ...
Description: Government Programs Care Manager III. For this position, formerly Nurse Case Management Senior Analyst, through the care management process, will promote the
Posted (Apr 09, 2026)
Remote Description: Evaluates clinical service requests made by an organization's members and providers. Uses clinical judgment in conjunction with organization's criteria to adjudicate ...
Evaluates clinical service requests made by an organization's members and providers. Uses clinical judgment in conjunction with organization's criteria to adjudicate
Posted (Jan 14, 2026)
Fully remote (never coming onsite) Description: The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to ...
Description: The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to
