NewAppeals And Grievances Medical Director Reconsiderations - Remote UnitedHealth Group Inc.Appeals And Grievances Medical Director Reconsiderations - RemoteCypress, CARemote$248,500–$373,000 / yearTotal cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. Communicate with UnitedHealthcare Regional and Plan medical directors and network management staff regarding access, availability, network, and quality issues.
NewManager Of Provider Transition And Growth - Remote Within The Los Angeles Metro Area UnitedHealth Group Inc.Manager Of Provider Transition And Growth - Remote Within The Los Angeles Metro AreaTorrance, CARemote$72,800–$130,000 / yearThe Manager of Provider Transition and Growth, is responsible for leading and overseeing all membership movement activities associated with Primary Care Provider departures, retirements, panel updates, site closures, and strategic provider realignment initiatives across the Optum CA market. Partner extensively with Operations, Provider Network, Market Leadership, Compliance, and external stakeholders to ensure accurate and timely membership movement.
NewAppeals M.D. - Oncologist Required - Remote UnitedHealth Group Inc.Appeals M.D. - Oncologist Required - RemoteCypress, CARemote$248,500–$373,000 / yearTotal cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. Communicate with UnitedHealthcare Regional and Plan medical directors and network management staff regarding access, availability, network, and quality issues.
NewAssociate Director Business Process - Claim And Appeal Operations - Remote In US UnitedHealth Group Inc.Associate Director Business Process - Claim And Appeal Operations - Remote In USLos Angeles, CARemote$112,700–$193,200 / yearThe Associate Director Business Process operates in a highly matrixed environment, managing complex initiatives, advancing cost-efficiency strategies, and delivering data-driven insights that inform decision-making and improve operational outcomes across Claim & Appeal Operations. The Associate Director Business Process, Claim & Appeal Operations serves as a key strategic partner to the Claim & Appeal Operations VP, driving execution of operational, financial, and strategic priorities across the organization.
NewAppeals M.D. Double Boarded Med-Peds Or FM M.D. - Remote UnitedHealth Group Inc.Appeals M.D. Double Boarded Med-Peds Or FM M.D. - RemoteCypress, CARemote$248,500–$373,000 / yearTotal cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. Communicate with UnitedHealthcare Regional and Plan medical directors and network management staff regarding access, availability, network, and quality issues.
NewAssociate Director, Network Pricing - Remote In PST Or MST UnitedHealth Group Inc.Associate Director, Network Pricing - Remote In PST Or MSTCypress, CARemote$112,700–$193,200 / yearThe Associate Director of Healthcare Economics - Network Pricing supports Provider Network contracting and unit cost management activities through financial modeling, analysis of utilization, and reporting (VBC agreements, physicians, hospitals, pharmacies, ancillary facilities, shared/full risk delegation, etc.). Required Qualifications: 5+ years of experience in creating and using financial modeling tools, spreadsheets, and information acquisition tools including experience in interpreting and reviewing financial modeling results to evaluate the financial impact of contract changes and develop forecasts.
Associate Director, Network Pricing - Remote in PST/MST UnitedHealth GroupAssociate Director, Network Pricing - Remote in PST/MSTCypress, CARemote$112,700–$193,200 / yearThe Associate Director of Healthcare Economics - Network Pricing supports Provider Network contracting and unit cost management activities through financial modeling, analysis of utilization, and reporting (VBC agreements, physicians, hospitals, pharmacies, ancillary facilities, shared/full risk delegation, etc.). + 5+ years of experience in creating and using financial modeling tools, spreadsheets, and information acquisition tools including experience in interpreting and reviewing financial modeling results to evaluate the financial impact of contract changes and develop forecasts.
NewClinical Consultant - Physician Associate - Remote UnitedHealth Group Inc.Clinical Consultant - Physician Associate - RemoteCypress, CARemote$91,700–$163,700 / yearPerform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP (The appeals are in response to adverse determinations for medical services related to benefit design and coverage, medical necessity, and the application of clinical criteria of medical policies). Primary Responsibilities: In collaboration with and supervision by an Appeals and Grievances Medical Director, the Physician Associate is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies.
Bilingual/Spanish Board Certified Behavior Analyst Remote BCBA BrightSpring Health ServicesBilingual/Spanish Board Certified Behavior Analyst Remote BCBAAnaheim, CARemoteState Specific Requirements: Illinois: Board Certified Behavior Analysts (BCBA), Licensed Clinical Psychologist, Board Certified Associate Behavior Analyst (BCaBA), or a minimum of a bachelor's degree with 1500 hours of supervised experience performed by a Licensed Psychologist or BCBA. The behavior analysts, therapists, social workers, counselors, and psychologists at SpringHealth combine their expertise to deliver high-quality behavioral services for clients to live more positive, active, and social lives.
Senior Software Engineer, .NET - US Remote PerfectServe IncSenior Software Engineer, .NET - US RemoteCARemote$115,000–$140,000 / yearPerfectServe's cloud-based solutions enhance patient safety and reduce provider burnout by automating workflows, speeding time to treatment, optimizing shift schedules, empowering nurse mobility, and engaging patients in their own care. PerfectServe's mission is to accelerate speed to care by optimizing provider schedules and dynamically routing messages to the right person at the right time in any care setting; advancing patient care and clinical workflows.
Rheumatologist (actively practicing) for remote PRN peer reviews DOMA TechnologiesRheumatologist (actively practicing) for remote PRN peer reviewsCARemote$750–$2,000We're growing our network of clinical reviewers and are actively seeking Rheumatologists (must be actively practicing) who are passionate about quality, accountability, and patient outcomes. We combine quality data-driven solutions that fuel answers, technology that advances performance, and clinical expertise that builds trust to create a more efficient path to quality care.
Practitioner Recruiting Director (Remote) Klarity HealthPractitioner Recruiting Director (Remote)Los Angeles, CaliforniaRemoteDemonstrated experience in core functions of physician practice operations, including provider relations, patient flow, revenue cycle, quality, service excellence, purchasing and inventory, and teamwork, and accountability. High level of interpersonal skills, with the ability to effectively manage provider relationships, to promote and maintain positive relationships.
Remote Dietitian Compass Group USA IncRemote DietitianCulver City, CARemote$32–$35 / hourCompass Group employs over 3,000 RDNs across the United States, making us one of the nation's largest employers of Dietitians in a variety of settings: Hospitals and healthcare systems. The company has earned significant recognition, including being named one of Modern Healthcare's "Top 100 Best Places to Work in Healthcare" for five consecutive years, and appearing on Training Magazine's Top 125 Organizations list for six straight years.
Medicare Benefits Consultant (Korean Speaking) remote CA only Lee Hecht HarrisonMedicare Benefits Consultant (Korean Speaking) remote CA onlyLos Angeles, ALRemote$20–$25 / hourThe Medicare Enrollment Specialist serves as a trusted resource for prospective members, providing education on available healthcare coverage options and assisting individuals through the enrollment process. This role requires strong communication skills, attention to detail, and the ability to build rapport over the phone while maintaining compliance with healthcare regulations.
Staff Software Engineer (PACS) - Full Time - Remote Experity IncStaff Software Engineer (PACS) - Full Time - RemoteCARemote$121,400–$161,000 / yearOnePACS is a cloud-based PACS platform supporting radiology groups, teleradiology providers, imaging centers, and healthcare organizations that depend on reliable, high-volume diagnostic imaging workflows. Flexibility - Experity is committed to helping team members face the demands of juggling work, family and life-related issues by offering flexible work scheduling to manage your work-life balance.
Genomics Counselor II (Remote US - PST) Helix OpCo LLCGenomics Counselor II (Remote US - PST)CARemote$115,000–$159,250 / yearAs a Genomics Counselor, you will: Review current clinical guidelines and contribute to writing genetic testing reports as relevant to Helix's hereditary cancer, hereditary cardiovascular disease, pharmacogenomics and/or population genomics presence. Youll also play a direct clinical role - writing reports, fielding provider inquiries, and serving as a knowledgeable point of contact for ordering clinicians navigating complex genomic results.
NewFull Time Profee & Facility Ophthalmology Medical Coder Remote Inventurus Knowledge Solutions LtdFull Time Profee & Facility Ophthalmology Medical Coder RemoteCARemote$28–$32 / hourOur Care Enablement Platform delivers data-driven value and expertise across the care journey, and IKS is a partner for clinician enterprises looking to effectively scale, improve quality, and achieve cost savings through forward-thinking solutions. Our Care Enablement Platform blends advanced AI-powered automation with deep human expertise to relieve administrative burdens, improve clinical workflows, and drive financial sustainability; so clinicians can get back to what they do best.
NewPart Time Facility / Profee Outpatient: ED, Clinic, Ancillary Medical Coder Remote Inventurus Knowledge Solutions LtdPart Time Facility / Profee Outpatient: ED, Clinic, Ancillary Medical Coder RemoteCARemote$25–$28 / hourOur Care Enablement Platform delivers data-driven value and expertise across the care journey, and IKS is a partner for clinician enterprises looking to effectively scale, improve quality, and achieve cost savings through forward-thinking solutions. You will use established coding principles and your knowledge and experience to assign diagnostic and procedural codes after a thorough review of the medical record to obtain the appropriate emergency room codes for procedures, injections, and infusions.
NewRemote Regional Concierge Navigator (Bilingual in Spanish) Alignment Healthcare IncRemote Regional Concierge Navigator (Bilingual in Spanish)CARemote$44,790–$67,185 / yearEffective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors; Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Conducts in-market member engagement including Welcome Calls, New Member Onboarding, JSA Scheduling, High Quality PCP and Provider Terms, Product/Vendor Changes, CAHPS Proxy, Disenrollment Quality Assurance, and Proactive Service Recovery.
Electrical Engineer, Data Centers - Remote (U.S.) AECOMElectrical Engineer, Data Centers - Remote (U.S.)Los Angeles, CARemote$90,000–$125,000 / yearReqID:** J10157426 **Business Line:** B&P - Buildings & Places **Business Group:** DCS **Strategic Business Unit:** East **Career Area:** Engineering **Work Location Model:** Remote **Compensation:** USD 90000 - USD 125000 - yearly We invite you to bring your bold ideas and big dreams and become part of a global team of over 50,000 planners, designers, engineers, scientists, digital innovators, program and construction managers and other professionals delivering projects that create a positive and tangible impact around the world.