NewAppeals RN - Care Management Full-time - REMOTE Providence Health & ServicesAppeals RN - Care Management Full-time - REMOTETorrance, CARemote$57.28–$88.92 / hourRequsition ID: 449880 Company: Providence Jobs Job Category: Care Management Job Function: Clinical Care Job Schedule: Full time Job Shift: Day Career Track: Nursing Department: 7000 UTILIZATION MGMT CA SOCAL Address: CA Torrance 20555 Earl St Work Location: Providence Administrative Offices-Earl Street Workplace Type: On-site Pay Range: $57.28 - $88.92 Our not-for-profit network provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care, and even our own Providence High School.
Healthcare Revenue Cycle Billing Specialist II (SNF) Wipfli LLPHealthcare Revenue Cycle Billing Specialist II (SNF)Irvine, CARemote$23–$30 / hourAs a Specialist II in Wipfli's Healthcare Consulting Practice, you'll work independently with a variety of healthcare clients, skilled nursing facilities, independent living, and assited living, delivering services such as financial and operational analysis, regulatory readiness, and strategic support. Under the direction of a Senior Consultant, the Specialist II provides business services independently for the firm''s more complex clients, ensuring delivery is timely, accurate and serves the client''s needs in accordance with company policies and procedures.
NewRN Case Manager – Managed Care REMOTE TEEMA GroupRN Case Manager – Managed Care REMOTELos Angeles, CARemote$39–$41Care Coordination : Work closely with interdisciplinary teams, including physicians, case managers, social workers, and other healthcare professionals, to develop and implement individualized care plans for patients. This role involves assessing, monitoring, educating, and supporting patients in managing their diseases to improve overall health and quality of life while reducing unnecessary hospitalizations and emergency care.
NewAppeals RN - Care Management Full-time - REMOTE Providence St. Joseph HealthAppeals RN - Care Management Full-time - REMOTETorrance, CARemoteTogether, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. The Care Management Recovery Advocate (CMRA) is responsible for providing overall management and communication of clinically-based appeals between Providence Health and Services, California Region (PH&S) outside payers.
Revenue Cycle Auditor RN -Remote Providence Health & ServicesRevenue Cycle Auditor RN -RemoteCalifornia, CARemoteRequsition ID: 428089 Company: Providence Jobs Job Category: Revenue Cycle Operations Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Day Career Track: Nursing Department: 4001 SS RC REV INTEGRITY Address: CA Irvine 15480 Laguna Canyon Rd Work Location: Providence System Offices Discovery Park-Irvine Workplace Type: Remote Pay Range: $See Posting - $See Posting The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
NewConsulting Manager, Program Manager- Healthcare Cognizant Technology Solutions CorpConsulting Manager, Program Manager- HealthcareLong Beach, CARemote$100,000–$129,500 / yearYou will be a valued member of the Cognizant Consulting Healthcare Practice and work collaboratively with client executives, business leaders, technology teams, vendors, and cross-functional stakeholders to deliver complex transformation outcomes. As a Consulting Manager, Claims Modernization (QNXT Migration) Program Manager, you will make an impact by leading large-scale healthcare payer transformation initiatives focused on claims platform modernization and QNXT migration programs.
NewConsulting Manager, Claims modernization Program Manager (healthcare) Cognizant Technology Solutions CorpConsulting Manager, Claims modernization Program Manager (healthcare)Long Beach, CARemote$105,000–$129,500 / yearYou will be a valued member of the Healthcare Consulting team and work collaboratively with business leaders, product owners, architects, UX/UI teams, API developers, vendors, and client stakeholders to successfully execute complex claims modernization initiatives. In this role, you will combine program leadership, stakeholder management, and healthcare domain expertise to drive the successful delivery of enterprise-scale transformation programs while enhancing member and provider experiences.
Commercial & Healthcare Regulatory Counsel Alto IncCommercial & Healthcare Regulatory CounselCARemote$135,000–$185,000 / yearPhysical requirements for this role include the ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, stoop, bend, and reach for equipment and supplies, make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers, and lift, carry, push, pull, and move light objects up to 20 pounds. Issue-spot and provide practical guidance on applicable laws and regulations, such as the Anti-Kickback Statute (AKS), Stark Law, False Claims Act, FDA/DEA requirements relevant to pharmacy and telehealth operations, state pharmacy/professional licensing, PBM contracting/network participation, and HIPAA/HITECH.
Sales Director, Healthcare Genesys Cloud Services IncSales Director, HealthcareCARemote$156,800–$275,800 / yearYou will serve as an executive sponsor for key customers, shape go-to-market strategy, and help customers leverage AI-powered customer experience transformation to achieve measurable business outcomes. Our platform connects people, systems, data and AI to help organizations deliver more personalized service, improve operational efficiency and build stronger customer relationships.
Service Excellence Manager - RN (Remote) Access TeleCare LLCService Excellence Manager - RN (Remote)CARemoteDuties include building effective relationships with client stakeholders, developing clinician workflows, supporting new program implementation, creating action plans to support service performance, and interfacing with clinicians to facilitate clinical excellence. Build and maintain positive working relationships with partner facility clinical staff; train partner staff on tasks that promote clinical workflow efficiency such as cart coordination, and address concerns in a timely manner.
NewClinical Care Transition Educator / RN - Part-time Remote Option Care Health IncClinical Care Transition Educator / RN - Part-time RemoteLos Angeles, CARemote$46.60–$77.67 / hourEvaluate, educate, and train patients, caregivers, and facility staff about how OCH services & products will be facilitated in an alternative site, in-home, or virtually in order to ensure successful transition of patients to an Option Care Health delivery model. 100% local travel to and from partnerships facilities, community hospitals, and medical practice offices to sell Option Care Services, process referrals and provide live education and training support to patient/caregiver and referral sources.
Inside Sales Agent-Healthcare Call Center 26-00240 Alura Workforce SolutionsInside Sales Agent-Healthcare Call Center 26-00240Aliso Viejo, CARemote$20–$25 / hourAn innovative leader in ophthalmology, they deliver an exceptional patient experience through advanced technology and a team of highly skilled, experienced surgeons — trusted by more than 3,000 referring eye doctors nationwide. We're looking for a high energy, people focused Inside Sales Call Center Agent who excels at building trust, influencing decisions, and guiding patients toward life-changing vision correction procedures.
Inside Sales Agent-Healthcare Call Center Alura Workforce SolutionsInside Sales Agent-Healthcare Call CenterRemote, CARemote$20–$25 / hourAn innovative leader in ophthalmology, they deliver an exceptional patient experience through advanced technology and a team of highly skilled, experienced surgeons — trusted by more than 3,000 referring eye doctors nationwide. We're looking for a high energy, people focused Inside Sales Call Center Agent who excels at building trust, influencing decisions, and guiding patients toward life-changing vision correction procedures.
Virtual Primary Care Nurse Practitioner - Remote Included HealthVirtual Primary Care Nurse Practitioner - RemoteLos Angeles, CARemoteStarting base salary for you will depend on several job-related factors, unique to each candidate, which may include education; training; skills; years and depth of experience; certifications and licensure; our needs; internal peer equity; organizational considerations; and understanding of geographic and market data. The ideal candidate is skilled at managing their own patient panel, fostering lasting relationships, and working closely with a multidisciplinary team to deliver compassionate, patient-centered care.
Senior Interior Designer | Healthcare Northern ImpactSenior Interior Designer | HealthcareLos Angeles, CaliforniaRemoteMid-size Los Angeles & San Diego Architecture + Interiors studio has received acclaim for its award-winning healthcare designs for clients including Kaiser Permanente, UCLA, UCI, and Children’s Hospital Los Angeles. Demonstrates a thorough knowledge of Interior Design / Interior Architecture including design concept development, presentation techniques, design documentation, construction documentation, construction administration, and materials / finishes selection and specifications.
Care Review Clinician (RN) Remote Molina Healthcare IncCare Review Clinician (RN) RemoteCARemoteResponsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
NewRN Call Center Nurse Per Diem - Remote UnitedHealth Group IncRN Call Center Nurse Per Diem - RemoteTorrance, CARemote$29–$52 / hourThe 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.
NewRN Call Center Nurse - CA Remote UnitedHealth Group IncRN Call Center Nurse - CA RemoteTorrance, CARemote$28.94–$51.63 / hourThe 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.
Clinical Document Improvement Specialist (Remote) ATD Technology LLCClinical Document Improvement Specialist (Remote)Orange, CARemote$60–$65ATD Technology, LLC is a certified minority woman owned business that creates opportunities to match qualified individuals with client programs while meeting all parties' financial and technical goals. Proactively solicits clarification from physicians and other healthcare providers when further specificity is needed to ensure accurate quality data and appropriate reimbursement.
Healthcare Analyst II Cohere Health Technologies LLCHealthcare Analyst IICARemote$85,000–$92,000 / yearBy unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately. With an enterprise approach that streamlines payer-provider decision-making across the care continuum-including policy, prior authorization, payment accuracy, and more-the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.