Director, Healthcare Services - REMOTE Molina Healthcare IncDirector, Healthcare Services - REMOTEBoise, IDRemoteRegistered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). At least 8 years of health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
Federal Marketing Principal Specialist (Hybrid Remote: McLean, VA/DC Area) MaximusFederal Marketing Principal Specialist (Hybrid Remote: McLean, VA/DC Area)Boise, IDRemoteFull timeMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. - Responsible for leading the development of sales enablement strategy and client-ready marketing materials, pitch decks, demos, and sales-related support materials, ensuring alignment to marketing objectives and business development outcomes.
Senior Healthcare Internal Audit Consultant Banner HealthSenior Healthcare Internal Audit ConsultantIDRemote$43.77–$72.95 / hourMust possess one of the following certifications within 12 months of hire: Professional designations such as Certified Public Accountant (CPA), Certified Internal Auditor (CIA), Certified Fraud Examiner (CFE), or Certified Healthcare Internal Audit Professional (CHIAP). Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained.
Utilization Management Registered Nurse Humana IncUtilization Management Registered NurseIDRemote$71,100–$97,800 / yearWork-at-Home Information: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.
Advice RN, MIST - Work From Home Sutter HealthAdvice RN, MIST - Work From HomeBoise, IDRemote$38.87–$54.42 / hourIn addition to telephone triage, MIST RNs manage electronic in-basket messages, coordinate care across ambulatory and acute care settings, facilitate prescription renewal workflows in collaboration with licensed providers, identify appropriate hospital and community resources, coordinate referrals and consultations, and perform nursing follow-up to support continuity of care and positive patient outcomes. As integral members of the primary care team, MIST RNs partner closely with physicians, advanced practice providers, clinic staff, and interdisciplinary teams to manage patient communications within the electronic medical record, optimize workflow efficiency, and ensure high-quality, patient-centered care.
RN Health Care Facility Surveyor Impact Recruiting SolutionsRN Health Care Facility SurveyorBoise, IdahoRemote$75,000–$90,000The Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide .
Family Nurse Practitioner - Eagle Care Clinic Spalding UniversityFamily Nurse Practitioner - Eagle Care ClinicEagle, IDRemoteFaculty, staff and students are united by the institutional mission: Spalding University is a diverse community of learners dedicated to meeting the needs of the times in the tradition of the Sisters of Charity of Nazareth through quality undergraduate and graduate liberal and professional studies, grounded in spiritual values, with an emphasis on service and the promotion of peace and justice. With a focus on service and leadership, Spalding offers all students a mission-driven connection to community and comprehensive learning resources while striking a distinctive balance serving the educational needs of both the traditional student and the working student.
RN Health Care Facility Surveyor Greenlife Healthcare StaffingRN Health Care Facility SurveyorBoise, IDRemote$75,000–$90,000 / yearThe Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide.
Manager, Clinical Quality TriWest Healthcare AllianceManager, Clinical QualityBoise, IDRemoteFull timeTechnical Skills: Proficient with the Microsoft Office suite of applications; thorough knowledge of TRICARE policies and procedures; comprehensive knowledge of research methodology that supports evaluation of potential quality issues and/or serious reportable events; proficient applying appropriate data analysis processes; knowledge of managed care principles and methods; knowledge in the application of clinical criteria. Responsible for leading and directing a team of clinical and non-clinical staff that provide Clinical Quality Review services and interventions for beneficiaries and providers under the direction of the Director of Clinical Quality Management (CQM).
Urgent Care Nurse Practitioner Included Health IncUrgent Care Nurse PractitionerIdaho, IDRemoteWe're seeking board certified Nurse Practitioners licensed in Idaho (multi licensed strongly preferred) with broad clinical expertise and a passion for improving healthcare access and quality. In this role, you'll deliver virtual comprehensive care to patients of all ages across a wide range of conditions, while working closely with our provider and support teams.
Remote Nurse Care Manager - NY, NV, MI, MN, ID, IL, HI, DC, CA, AK PharmD Live CorpRemote Nurse Care Manager - NY, NV, MI, MN, ID, IL, HI, DC, CA, AKIDRemoteDeliver personalized care management and coordination services Conduct patient assessments and develop individualized care plans Support chronic disease management (e.g., diabetes, hypertension, CHF, COPD) Provide education on disease states, medications, and self-management strategies Utilize motivational interviewing techniques to enhance adherence and engagement Collaborate with providers and care teams to align treatment plans Identify care gaps, risks, and barriers to optimal outcomes Maintain accurate, compliant, and timely documentation Support care transitions and follow-up coordination. Strong clinical judgment and attention to detail Excellent communication and interpersonal skills Ability to build rapport and trust in a remote setting Patient-centered, outcomes-driven mindset Self-motivated and able to work independently High level of professionalism and accountability.
Remote Care Management Nurse Cambia Health Solutions IncRemote Care Management NurseBoise, IDRemote$36.80–$49.80 / hourAs a member of the Clinical Services team, our Care Management RN's provide clinical care management (such as case management, disease management, and/or care coordination) to best meet the member's specific healthcare needs and to promote quality and cost-effective outcomes. Collaborates with physician advisors, internal and external customers, and other departments to resolve claims, quality of care, member or provider issues, and identifies problems or needed changes, recommending resolutions and participating in quality improvement efforts.
Remote Care Management Nurse Cambia HealthRemote Care Management NurseBoise, IDRemote$35.21–$47.63 / hourAs a member of the Clinical Services team, our Care Management RN's provide clinical care management (such as case management, disease management, and/or care coordination) to best meet the member's specific healthcare needs and to promote quality and cost-effective outcomes. Collaborates with physician advisors, internal and external customers, and other departments to resolve claims, quality of care, member or provider issues, and identifies problems or needed changes, recommending resolutions and participating in quality improvement efforts.