Director, Healthcare Services (RN) (Remote in Massachusetts) Molina Healthcare IncDirector, Healthcare Services (RN) (Remote in Massachusetts)Springfield, MARemoteRegistered 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 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.
NewSenior Healthcare Network Consultant Humana IncSenior Healthcare Network ConsultantCTRemote$78,400–$107,800 / yearWork at Home Requirements 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. To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
Full Stack Java Engineer - Eden Prairie, MN or Hartford, CT (Hybrid) UnitedHealth Group IncFull Stack Java Engineer - Eden Prairie, MN or Hartford, CT (Hybrid)Hartford, CTRemote$72,800–$130,000 / yearThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. This role is ideal for an engineer who is passionate about leveraging modern tools and technologies-including AI-assisted development practices and public cloud infrastructure (AWS or Azure)-to streamline daily workflows and deliver high-quality health platform solutions.
Registered Nurse Remote Psych Clinical Navigator Part Time Elara CaringRegistered Nurse Remote Psych Clinical Navigator Part TimeCTRemoteWe know there's no place like home, and that's why our teams continue to provide high-quality care to more than 60,000 patients each day in their preferred home setting. The Behavioral Health Clinical Navigator RN optimizes quality of care across the clinical departments by undertaking efforts to review clinical competency and ensure regulatory adherence.
Case Manager Registered Nurse (Remote, East Coast) CVS Health CorpCase Manager Registered Nurse (Remote, East Coast)CTRemote$66,575–$142,576 / yearAssesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client's appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate. Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care.
Case Manager, Registered Nurse - Fully Remote CVS Health CorpCase Manager, Registered Nurse - Fully RemoteCTRemote$54,095–$155,538 / yearBenefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
Registered Nurse RN, 3-11:30 PM, Call Center - Remote in CT UnitedHealth Group IncRegistered Nurse RN, 3-11:30 PM, Call Center - Remote in CTFarmington, CTRemote$29–$52 / hourp>The fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. We have received recent reports of fraudulent LinkedIn messages and emails alleging or claiming to be sent from UnitedHealth Group, UnitedHealthcare, or Optum Executives.
Prior Authorization RN Humana IncPrior Authorization RNCTRemote$71,100–$97,800 / yearThe 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.
NewRemote Registered Nurse (RN) Case Manager ValerisRemote Registered Nurse (RN) Case ManagerHartford, ConnecticutRemoteBacked by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. calling and working with the patient’s insurance payer to determine coverage benefits, anticipated out-of-pocket costs associated with their therapy and resources for financial assistance, where applicable based upon needs communicated by the patient.
Utilization Management Nurse Consultant (Weekend) CVS Health CorpUtilization Management Nurse Consultant (Weekend)Work At Home, CTRemote$29.10–$62.32 / hourEducation: Diploma RN acceptable; Associate degree/BSN preferred, 3+ years of experience as a Registered Nurse, 1+ years of clinical experience in acute or post-acute setting, and 1+ years of Utilization Management / Care Management Experience. Position Summary: Utilize your clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate options to facilitate appropriate healthcare services and benefits for members.
Clinical & Regulatory Manager - Dialysis Operations (RN) - Northeast Region (CT/MA/NY/RI) American Renal Associates Holdings IncClinical & Regulatory Manager - Dialysis Operations (RN) - Northeast Region (CT/MA/NY/RI)Hartford, CTRemoteThis data-driven role serves as the regional clinical subject matter expert by proactively identifying gaps in clinical practice and opportunities to improve patient outcomes, and escalating findings to appropriate corporate clinical and operational leaders to drive aligned, actionable improvements. Summary: The Clinical & Regulatory Manager (CRM) is an RN with dialysis expertise who leads clinical quality, regulatory compliance, and outcome improvement across clinics in Massachusetts, Rhode Island, Connecticut, New York.
RN Health Care Facility Surveyor Greenlife Healthcare StaffingRN Health Care Facility SurveyorAmherst, MARemote$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.
Clinical Documentation Spec 1 / HIM Clinical Document Mgmt Hartford HealthCare CorpClinical Documentation Spec 1 / HIM Clinical Document MgmtFarmington, CTRemotePosition Summary: The Clinical Documentation Specialist (CDS) 1 is responsible for extensive record review, and interaction with physicians, HIM coding professionals, nursing staff and other patient care givers to ensure the accurate representation of patient severity of illness and quality of care. Collaborates with inpatient coders to determine appropriate Diagnosis Related Groups (MS-DRG, APR-DRGs, etc.) and ICD-10 code assignment for compliance, reimbursement, and quality outcomes.
Utilization Management Nurse Consultant - Fully Remote CVS Health CorpUtilization Management Nurse Consultant - Fully RemoteCTRemote$26.01–$74.78 / hourBenefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Urgent Care Nurse Practitioner Included Health IncUrgent Care Nurse PractitionerCTRemoteIn 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. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care.