Director, Healthcare Services - REMOTE Molina Healthcare IncDirector, Healthcare Services - REMOTEDes Moines, IARemoteRegistered 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.
Healthcare Cost Reporting/Reimbursement Manager - Remote Eligible Eide Bailly LLPHealthcare Cost Reporting/Reimbursement Manager - Remote EligibleDes Moines, IARemote$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.
Utilization Management Registered Nurse Humana IncUtilization Management Registered NurseIARemote$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.
UM BH Registered Nurse Humana IncUM BH Registered NurseIARemoteYou will utilize training and engage formerly acquired skillsets to complete medical necessity reviews for behavioral health requested services using clinical judgment and provides referrals to internal stakeholders for further review depending on case findings. The DOW SkillBridge Internship Program provides transitioning military service members time to gain civilian work experience while still on active duty with an employer for a period approved by their command and the DOW, with an average timeline of 90 days.
NewUtilization Management RN Wisconsin Physicians Service Insurance CorpUtilization Management RNDes Moines, IARemote$75,000–$100,000 / yearWe are open to remote work in the following approved states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin. We recognize the benefits of employee engagement as an investment in our workforce-both current and future-to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams.
Nurse Practitioner-Remote Weekend On-Call American Health Companies IncNurse Practitioner-Remote Weekend On-CallDes Moines, IARemoteTruHealth is seeking an advanced practice provider, either a nurse practitioner (NP) or physician assistant (PA) with experience in primary care or internal medicine, preferably with geriatrics focus. If you are an advanced practice registered nurse (APRN or NP) or physician assistant (PA) who enjoys working with the aging population, consider joining the TruHealth team.
Program Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd)Des Moines, IARemoteFull 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 OptimizationDes Moines, IARemoteFull 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.
Behavioral Health Consultant Principal Financial Group IncBehavioral Health ConsultantDes Moines, IARemote$69,300–$126,000 / yearWichita, KS: $69,300 - $94,500 / year Des Moines, IA: $73,150 - $99,750 / year Charlotte, NC: $77,000 - $105,000 / year Chicago/Minneapolis: $84,700 - $115,500 / year Los Angeles/New York City: $92,400 - $126,000 / year Time Off Program Flexible Time Off (FTO) is provided to salaried (exempt) employees and provides the opportunity to take time away from the office with pay for vacation, personal or short-term illness. Must hold an active RN license in good standing and have 2+ years of relevant professional experience Master's level degree or equivalent: Required LMHC (licensed mental health counselor) or LISW (Licensed Independent Social Worker) in good standing.
RN Health Care Facility Surveyor Greenlife Healthcare StaffingRN Health Care Facility SurveyorDes Moines, IARemote$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.
Bilingual RN Case Manager HealthCheck360Bilingual RN Case ManagerDes Moines, IARemoteThis is accomplished by providing onsite biometric screenings, engaging participants through technology and programming, educating the participant with risk-specific targeted communications, and supporting positive behavior change through our Health Coaching and Condition Management programs. The RN Case Manager will assess, plan, implement, coordinate, monitor, and evaluate care for assigned consumers, ensuring quality outcomes and cost-effective treatment.
Chief of Staff to the Chief Operating Officer TriWest Healthcare AllianceChief of Staff to the Chief Operating OfficerDes Moines, IARemoteFull 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.
Urgent Care Nurse Practitioner Included Health IncUrgent Care Nurse PractitionerIARemoteWe're seeking board certified Nurse Practitioners licensed in Iowa (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.
Clinical Quality Reviewer TriWest Healthcare AllianceClinical Quality ReviewerDes Moines, IARemoteFull 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.