Appeals & Grievance Case Resolution Specialist AmeriHealth CaritasAppeals & Grievance Case Resolution SpecialistPhiladelphia, PARemoteThe Specialist serves as a key liaison between members, providers, and internal departments to resolve issues effectively, ensuring the integrity of the appeals and grievance process and compliance with CMS, NCQA, URAC, and state regulatory requirements. + Communicate with members, providers, or representative to clarify appeal intent and gather missing documentation including incoming calls, outgoing calls, and phone queue work as assigned.
Psychiatric Mental Health Nurse Practitioner - PMHNP, Remote Blackbird HealthPsychiatric Mental Health Nurse Practitioner - PMHNP, RemoteMount Laurel, NJRemote$72,500–$175,000 / yearIn recruiting for our team, we welcome the unique contributions that you can bring in terms of your education, opinions, culture, ethnicity, race, sex, gender identity and expression, nation of origin, age, languages spoken, veteran status, color, religion, disability, sexual orientation and beliefs. Clinically Excellent: Experience working with children/adolescents as a PMHNP; practiced independently at the top of your scope for at least one year.
Remote Psychiatric Nurse Practitioner, PMHNP - Weekends Blackbird HealthRemote Psychiatric Nurse Practitioner, PMHNP - WeekendsMount Laurel, NJRemote$72,500–$175,000 / yearIn recruiting for our team, we welcome the unique contributions that you can bring in terms of your education, opinions, culture, ethnicity, race, sex, gender identity and expression, nation of origin, age, languages spoken, veteran status, color, religion, disability, sexual orientation and beliefs. Clinically Excellent: Experience working with children/adolescents as a PMHNP; practiced independently at the top of your scope for at least one year.
Lead Analytics Consultant, Real World Data Insights (Pre-sale) HealthVerityLead Analytics Consultant, Real World Data Insights (Pre-sale)Philadelphia, PARemoteAs a Lead Healthcare Data Analyst, Real World Data Solutions (RWDS), you will apply your healthcare data analytics expertise to support pre-sales solutioning, helping clients and internal teams assess data feasibility, shape analytic approaches, and identify the right data assets to support prospective licensing opportunities. Efficiently query multiple data types (medical and pharmacy claims, EMR, lab, chargemaster) using SQL to identify populations of interest in HVM data, apply appropriate inclusion and exclusion criteria, and assess outputs using univariate analysis, distributions, trends, and data investigations.
Psychiatric Mental Health Nurse Practitioner - PMHNP - Remote Blackbird HealthPsychiatric Mental Health Nurse Practitioner - PMHNP - RemotePhiladelphia, PARemote$135,000–$145,000 / yearRelationship-Focused: You excel at building meaningful connections with patients and families, taking the time to understand their needs, provide education, and create a trusting therapeutic relationship that supports engagement in treatment. As a Psychiatric Mental Health Nurse Practitioner at Blackbird Health, you'll play an essential role in delivering comprehensive psychiatric evaluations, treatment planning, and medication management for children, adolescents, and young adults.
Network Contracting & Services Associate Oscar HealthNetwork Contracting & Services AssociatePhiladelphia, PARemote$96,876–$127,149 / yearThe Associate also supports network growth and recruiting efforts by engaging with prospective providers directly; assisting with resolution of provider issues; supporting cost- saving initiatives; assisting with the design and execution of the local network strategy; and ensuring providers across our service area have the information and support they need to provide best-in-class member care. The Associate, Network Contracting is responsible for negotiating and managing contracts with healthcare providers (hospital/health system and individual) to build and maintain a robust network in assigned market/region; while also ensuring access to quality care and optimizing costs by analyzing provider performance and negotiating reimbursement rates, often involving complex contract terms and compliance with regulatory guidelines.
Manager, Network Contracting (Northeast Region) Oscar HealthManager, Network Contracting (Northeast Region)Philadelphia, PARemote$100,602–$132,040 / yearThe Manager of Network Contracting is responsible for leading a team of direct reports focused on negotiating, executing, and analyzing contracts with large, national and/or complex healthcare group/system providers, focusing on maintaining and enhancing the provider network while meeting accessibility, quality, and financial goals. This role leverages negotiation skills and working knowledge of provider financial issues to optimize contracts, and collaborates with providers, hospitals and health systems to achieve successful contracting outcomes, all while supporting cost-saving initiatives and the growth of the provider network for a defined market or region.
NewHotel Booking Specialist | Fully Remote Destination CareersHotel Booking Specialist | Fully RemotePhiladelphia, PennsylvaniaRemoteWe may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. Hotel Booking Specialist | Fully Remote Location: Remote (U.S.) About Us: We are a premier travel agency partnered with an award-winning host agency with over 70 years of experience.
NewBoard-Certified Neuroradiologist - Medical Record Reviewer | Philadelphia, PA Dane Street, LLCBoard-Certified Neuroradiologist - Medical Record Reviewer | Philadelphia, PAPhiladelphia, PARemoteYour primary responsibilities will include reviewing medical records, radiology reports, and relevant neuroimaging documentation; preparing clear and concise clinical summaries; and responding to specific questions from clients related to neuroradiologic findings, diagnoses, imaging appropriateness, and medical care. In this role, you will apply your specialized neuroradiology expertise to conduct comprehensive reviews of clinical cases and provide objective, evidence-based medical advisory opinions.
NewLuxury Travel Consultant SunkissedandmoonlitravelLuxury Travel ConsultantPhiladelphia, PARemoteYou'll support clients in planning and managing high-end travel experiences, handling everything from initial consultation to post-trip follow-up, all from home. We're a growing remote travel team and we're looking for a detail-oriented, client-first professional to join us as a Luxury Travel Consultant.
NewTravel Operations Manager CherylsloandreamtravelsTravel Operations ManagerNew Jersey, New JerseyRemoteYou will have access to travel suppliers, booking platforms, training resources, and industry tools while developing your own client base and growing your travel business. You should be comfortable using computers, communicating with clients, learning new systems, and taking initiative in building your business.
Consultant - Lims Veeva SystemsConsultant - LimsPhiladelphia, PARemote$70,000–$140,000 / yearUnlike a traditional corporation, whose only legal duty is to maximize shareholder value, PBCs consider their public benefit purpose and the interests of those materially affected by the corporation's conduct-including customers, employees, and the community-in addition to shareholders' interests. Demonstrated work history in stakeholder management, critical thinking skills, ability to conduct complex and technical communications in a wide variety of settings and audiences, and the determination to see client success with solution implementation.
Senior Consultant - Regulatory Operations Software Implementation (Remote) Veeva SystemsSenior Consultant - Regulatory Operations Software Implementation (Remote)Philadelphia, PARemote$80,000–$200,000 / yearDirect experience with systems such as Veeva Vault, PAREXEL/LIQUENT InSight, CSC Regulatory Tracker, ArisGlobal Register, OpenText, SharePoint, Documentum, FirstDoc/FirstPoint, NextDocs, CARA, Salesforce, Workday, Oracle, SAP, Lorenz Docubridge, Extedo eCTD Manager, Master Control, Trackwise, other regulatory information management or submission publishing systems, etc. Unlike a traditional corporation, whose only legal duty is to maximize shareholder value, PBCs consider their public benefit purpose and the interests of those materially affected by the corporation's conduct-including customers, employees, and the community-in addition to shareholders' interests.
Consultant - Post-Implementation (Remote) Veeva SystemsConsultant - Post-Implementation (Remote)Philadelphia, PARemote$70,000–$140,000 / yearUnlike a traditional corporation, whose only legal duty is to maximize shareholder value, PBCs consider their public benefit purpose and the interests of those materially affected by the corporation's conduct-including customers, employees, and the community-in addition to shareholders' interests. We're not just any public company - we made history in 2021 by becoming a public benefit corporation (PBC), legally bound to balancing the interests of customers, employees, society, and investors.
Senior Consultant - Post-Implementation Veeva SystemsSenior Consultant - Post-ImplementationPhiladelphia, PARemote$70,000–$140,000 / yearUnlike a traditional corporation, whose only legal duty is to maximize shareholder value, PBCs consider their public benefit purpose and the interests of those materially affected by the corporation's conduct-including customers, employees, and the community-in addition to shareholders' interests. The Managed Services Consultant is a member of our Professional Services team who provides remote, ongoing, ad-hoc consulting services to our live QMS, Quality Docs (document management), and Training (LMS) customers.
Senior Architect - Commercial Life Sciences (Remote) Veeva SystemsSenior Architect - Commercial Life Sciences (Remote)Philadelphia, PARemote$100,000–$200,000 / yearWe advise our Life Sciences clients with every aspect of their commercial solutions-Application architecture, systems and data integrations or migration, and business process and maturity assessments to ensure customers achieve commercial excellence through integrated master data, compliant commercial content, and multi-channel CRM. As a Senior Architect in the Veeva Commercial Technology Architecture group, you will participate and lead in the business process due diligence, advise on best practices, design, creation of end-user requirements of customer application implementation projects, producing deliverables throughout the full lifecycle delivery of Veeva applications to pharma and medical devices organizations.
NewManager, Customer Identity & Access Management - CIAM Ally Financial IncManager, Customer Identity & Access Management - CIAMPARemote$110,000–$180,000 / yearOur Total Rewards program includes industry-leading compensation and benefits plus additional incentives that are designed to meet your needs and those of your family so you can get the most out of your career and your life, including: Time Away: Program starts at 20 paid time off days in addition to 11 paid holidays and 8 hours of volunteer time off yearly (time off days are prorated based on start date and program varies based on full or part-time status and management level). Supporting your Health & Well-being: flexible health and insurance options including medical, dental and vision, employee, spouse and child life insurance, short- and long-term disability, pre-tax Health Savings Account with employer contributions, Healthcare FSA, critical illness, accident & hospital indemnity insurance, and a total well-being program that helps you and your family stay on track physically, socially, emotionally, and financially.
NewScrum Master SOMERSET STAFFINGScrum MasterBlue Bell, PARemoteIf you are a certified problem-solver ready to facilitate high-impact Sprints and drive efficiency in a complex industry, we want to hear from you. We are seeking a seasoned Scrum Master with 5+ years of experience to lead our software engineering team in a 100% remote capacity.
Data Management Business Systems Analyst Senior AmeriHealth CaritasData Management Business Systems Analyst SeniorNewtown Square, PARemoteIn accordance with established regular communications with Manager, keeps staff apprised of progress, problems, and objectives, and initiatives discussions and solicits input regarding business priorities, plans, and progress. + Assists in managing large scale projects, leads appropriate resources and determines project requirements and deliverables, to ensure successful implementations to meet ACFC user needs.
NewTele-Psychometrist - Contract/1099 Blackbird HealthTele-Psychometrist - Contract/1099Philadelphia, PARemote$25–$35 / hourEngage Patients & Capture Observations: Build quick rapport with pediatric clients over video, manage attention and fatigue during sessions, and document precise behavioral observations regarding effort, affect, and testing validity. Working under the supervision of licensed clinical neuropsychologists, you will ensure test administration fidelity, record detailed behavioral observations, and create an engaging virtual assessment environment for pediatric patients and young adults.