Insurance Sales Representative (Remote/Hybrid | Local Territory) The Compass Business GroupInsurance Sales Representative (Remote/Hybrid | Local Territory)Kuna, IdahoRemoteOur mission-driven team thrives on service, integrity, and results empowering you to make a meaningful impact while building a successful career. At Compass Business Group , we help protect families, teams, and small businesses through supplemental insurance solutions.
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.
Healthcare Cost Reporting/Reimbursement Manager - Remote Eligible Eide Bailly LLPHealthcare Cost Reporting/Reimbursement Manager - Remote EligibleBoise, IDRemote$95,000–$135,000 / yearLocation: Any state with an Eide Bailly office Work Arrangement: In-office, hybrid, or remote with the ability to come into an Eide Bailly office as needed Typical Day in the Life In this role, you will lead healthcare financial projects, including Medicare and Medicaid cost report services for a variety of healthcare facilities, while also supporting other reimbursement initiatives as needed. A typical day as a Healthcare Reimbursement Manager might include the following: Overseeing cost report preparation and reimbursement engagements to ensure objectives are met, including supporting staff development, addressing client needs, and maintaining engagement profitability.
Program Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd)Boise, IDRemoteFull timeTechnical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.
Director, Medical Document Optimization TriWest Healthcare AllianceDirector, Medical Document OptimizationBoise, IDRemoteFull timeLeadership: Ability to set strategic direction and translate organizational goals into operational plans; successfully leads and develops staff across varying styles and levels; provides clear expectations, effective coaching, and timely feedback; leads through a subordinate manager and drives accountability at all levels of the department. Problem Solving / Analysis: Ability to solve complex operational and systems-related problems through systematic analysis of data, workflows, and processes; exercises sound judgment in ambiguous or high-stakes situations; identifies root causes and implements durable solutions with a realistic understanding of organizational constraints.
RN Health Care Facility Surveyor Greenlife Healthcare StaffingRN Health Care Facility SurveyorBoise, IDRemote$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.
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.
Clinical Quality Reviewer TriWest Healthcare AllianceClinical Quality ReviewerBoise, IDRemoteFull timeo Bachelor's in Nursing or Certified Professional in Healthcare Quality (CPHQ) o 1 or more years team lead or supervisory experience o 1 year experience in Quality Management o 1 year experience with data analysis and reporting o Experience with InterQual or similar criteria sets o General knowledge of Medicare, Veterans Administration, or other government health care programs. Technical Skills: General knowledge of Medicare, Veterans Administration, or other government health care programs; knowledge in the application of clinical criteria: InterQual, Milliman, PAS-LOS, ICD-9-CM, DSM, CPT-4, and HCPCs; Proficient with Microsoft Word and Excel.
Chief of Staff to the Chief Operating Officer TriWest Healthcare AllianceChief of Staff to the Chief Operating OfficerBoise, IDRemoteFull timeTechnical Skills: Proficient in current trends in health care management with emphasis in customer service, network management, utilization and financial trends; collaboration skills to work with TriWest management team across multiple locations; networking skills with all levels, including subcontractors. • Works on multiple high level projects including logistical coordination, data analysis, contract management and written communications in support of various business initiatives of high visibility, applying project management tools and methodologies and leadership skills to meet or exceed deadlines.
Clinical Quality Study Analyst TriWest Healthcare AllianceClinical Quality Study AnalystBoise, IDRemoteFull timeTechnical Skills: General knowledge of Medicare, Veteran's Administration, TRICARE, or other government health care programs; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint. Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.