Utilization Review Supervisor RN CorVel Healthcare CorporationUtilization Review Supervisor RNRancho Cucamonga, CARemote$77,960–$120,368 / yearPart timePay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.
Director, Market Access Strategy iRhythm Holdings IncDirector, Market Access StrategyCARemote$170,000–$221,000 / yearCollaborate with Payer Marketing, HEOR, Clinical, and Legal/Compliance partners to translate clinical and real‑world evidence into compelling, compliant payer value propositions and scientific communications. Independently design, negotiate, and execute innovative payer contracts, including value‑based care, outcomes‑based agreements, shared savings, subscription models, and episodic/bundled arrangements.
NewGrievance and Appeals Nurse (State) Centene Corporation GroupGrievance and Appeals Nurse (State)CARemote$27.02–$48.55 / hourReview clinical data to determine claim payment based on company policies and National Committee for Quality Assurance (NCQA) guidelines, including overturning denied claims, upholding the denials and submitting cases to the Medical Director for review. Position Purpose: Facilitate medical necessity grievance, appeals and denials including disposition of denials notification letters, review of clinical information to determine if medical necessity criteria are met.
Medical Science Liaison CORE - West Azurity Pharmaceuticals IncMedical Science Liaison CORE - WestCARemoteMedical Affairs at Azurity Pharmaceuticals, a privately held company delivering innovative medicines for overlooked patients across 50+ countries, drives scientific and clinical initiatives with a portfolio of 40+ brands spanning 10 dosage forms and 9 therapeutic areas. As an industry leader in providing unique, accessible, and high-quality medications, Azurity leverages its integrated capabilities and vast partner network to continually expand its broad commercial product portfolio and robust late-stage pipeline.
Medical Science Liaison Anti-Infectives - West Azurity Pharmaceuticals IncMedical Science Liaison Anti-Infectives - WestCARemoteMedical Affairs at Azurity Pharmaceuticals, a privately held company delivering innovative medicines for overlooked patients across 50+ countries, drives scientific and clinical initiatives with a portfolio of 40+ brands spanning 10 dosage forms and 9 therapeutic areas. MSLs are the field scientific experts in anti-infectives and treatment options within this therapeutic area and will support strategic Medical Affairs initiatives, evidence-generation activities, and field readiness efforts associated with the continued growth of the anti-infectives portfolio.
Senior Medical Science Liaison - Solid Tumor - Southern CA/AZ Takeda Pharmaceutical Co LtdSenior Medical Science Liaison - Solid Tumor - Southern CA/AZCARemote$169,400–$266,200 / yearResponsible for establishing relationships and engaging in peer-to-peer level scientific discussions around emerging data, treatment guidelines, molecular pathways, mechanism of action Takeda Oncology products including clinical outcomes and research opportunities. The actual base salary offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
Utilization Management Clinician Behavioral Health Night Shift - 4 Days CVS Health CorpUtilization Management Clinician Behavioral Health Night Shift - 4 DaysCARemote$54,095–$142,576 / yearAbility to manage crisis calls, apply clinical judgment to assess risk, determine support needs, and coordinate appropriate interventions, including escalation for suicide risk, self-harm concerns, and welfare checks when necessary. Join our Utilization Management team and help ensure members receive timely, appropriate behavioral health services while making a meaningful impact on outcomes.
Online Adjunct Instructor - Foundations of Adult-Gerontology Primary Care Nurse Practitioner Practice Rasmussen College LLCOnline Adjunct Instructor - Foundations of Adult-Gerontology Primary Care Nurse Practitioner PracticeCARemoteAbout Us: Rasmussen University, a university accredited by the Higher Learning Commission, an institutional accreditation agency recognized by the U.S. Department of Education (www.hlcommission.org), is dedicated to changing lives and the communities it serves through innovative educational programs. Student support and outreach that supports the success of students is accomplished through faculty availability to students in all courses through synchronous or asynchronous communication and meetings to help students achieve the learning objectives for their course(s).
Senior Medical Science Liaison - West Region SpringWorks Therapeutics IncSenior Medical Science Liaison - West RegionCARemote$167,500–$220,000 / yearMSL being able to develop and maintain an advanced scientific, medical, and product knowledge base, ability to communicate key insights learned, and disseminate critical scientific data to external stakeholders; including but not limited to academic/scientific/clinical experts, payers, and patient organizations. Essential Duties and Responsibilities: Identify Key Opinion Leaders (KOLs) and establish and maintain strong and deep scientific relationships with KOLs across multi-specialty disciplines, connecting to KOLs in academic centers and community practices at the local, regional, and national level.
Account Payable Associate Stratus StaffingAccount Payable AssociatePasadena, CARemote$35–$42We have an open vendor platform and large database of talented applicants covering, Home health, HomeCare, nursing, Hospice, LCT, SNF, ALF, Senior Living, RN LVN, PT, DPT, PTA, OT, SLP, MSW, C-Suite, Administration, Finance, Accounting executives, healthcare management, Travel Nursing, IT, Coding, HIM, Finance, Billing, and a variety of careers from the top ten staffing firms in the country. This role is responsible for managing the accounts payable process, ensuring timely and accurate processing of invoices, managing vendor relationships, maintaining accurate financial records, and maintaining strong relationships with internal teams and external partners.
Medical Director, Utilization Management Home Health, Acute & Post-Acute Clover Health Investments CorpMedical Director, Utilization Management Home Health, Acute & Post-AcuteCARemote$242,300–$315,000 / yearLeveraging CMS Home Health regulations, the Medicare Benefit Policy Manual, National and Local Coverage Determinations (NCD/LCD), Milliman Care Guidelines, and Clover Health clinical policies, you will help ensure consistent, evidence-based decision-making that supports high-quality member care. You''ll partner closely with the Home Health RN Lead, Utilization Management nurses, providers, and cross-functional teams to improve clinical outcomes, promote appropriate utilization, and advance Clover''s commitment to delivering exceptional Home Health services.