Manager, Clinician Appeals (Active RN License REQ''''D) CorroHealth IncManager, Clinician Appeals (Active RN License REQ''''D)FLRemoteThe ideal candidate WILL HAVE an active, unrestricted RN license (compact preferred), will be a strong communicator who can confidently engage with hospital executives, physicians, and clients to explain medical scenarios, discuss denial trends, and provide clear education on documentation improvements. This individual will lead high-performing clinical teams in the development of clinically accurate, persuasive, and compliant appeal communications to payers, while ensuring operational excellence, clinical integrity, and alignment with financial goals.
CCM Case Management RN Oscar Health IncCCM Case Management RNFlorida, FLRemote$32.60–$42.79 / hourAbout the role: Telephonic case management role in which you will educate members on improving health outcomes, assist with transitions from care settings, participate in process improvement and other pilot programs as they arise, and work with the Clinical Concierge Specialist and other Oscar teams to ensure exceptional care for our members. Work with non-clinical teammates in assisting members to navigate the healthcare system, including coaching non-clinicians on how they can add value to all member interactions.
Urgent Care Nurse Practitioner Included Health IncUrgent Care Nurse PractitionerFlorida, FLRemote$59.13–$65.04 / hourWe're seeking board certified Nurse Practitioners licensed in Florida (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.
Associate Clinical Editor RELX Group plcAssociate Clinical EditorFlorida, FLRemote$71,600–$119,400 / yearIf performed in Colorado, the base pay range is $71,600 - $119,400.If performed in Illinois, the base pay range is $75,200 - $125,500.If performed in Chicago, IL, the base pay range is $78,700 - $131,400.If performed in Maryland, the base pay range is $75,200 - $125,500.If performed in Ohio, the base pay range is $68,000 - $113,400. Responsibilities: Review, update, and revise assigned content based on scheduled and triggered review cycles, as well as customer needs and requests, and current events in health care such as guideline update under the guidance of a Clinical Editor.
Bilingual (Spanish/English) Transitions of Care Advanced Practice Provider Devoted Health IncBilingual (Spanish/English) Transitions of Care Advanced Practice ProviderFLRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Proficiency with complex medication reconciliation and guideline-directed medical therapy, especially for heart failure, COPD, diabetes, atrial fibrillation/anticoagulation, and hypertension - including recognizing duplicate, inappropriate, or contraindicated medications and adjusting regimens safely.
Transitions of Care Advanced Practice Provider Devoted Health IncTransitions of Care Advanced Practice ProviderFLRemoteThat's why we're gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company - one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Proficiency with complex medication reconciliation and guideline-directed medical therapy, especially for heart failure, COPD, diabetes, atrial fibrillation/anticoagulation, and hypertension - including recognizing duplicate, inappropriate, or contraindicated medications and adjusting regimens safely.
Flex Nurse Educator - Miami, FL IQVIA Holdings IncFlex Nurse Educator - Miami, FLMiami, FLRemote$80,000–$85,000 / yearIQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide.
Flex Nurse Educator - Pompano Beach, FL IQVIA Holdings IncFlex Nurse Educator - Pompano Beach, FLPompano Beach, FLRemote$80,000–$85,000 / yearIQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide.
Onsite Care Coordination Nurse Humana IncOnsite Care Coordination NurseFLRemote$71,100–$97,800 / yearWork at Home Requirements: 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.
Case Management RN Oscar HealthCase Management RNMiami, FLRemote$32.60–$42.79 / hourEducate members on improving health outcomes, assist with transitions from care settings, participate in process improvement and other pilot programs as they arise, and work with support teams to ensure care for our members. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience.
Oncology Account Executive BillionToOneOncology Account ExecutiveSouth Miami, FLRemote$168,346–$184,186 / yearAt BillionToOne, we've built a category-defining, publicly traded company on Nasdaq where transparency fuels trust, collaboration drives breakthroughs, and every contribution moves the needle on our mission to make life-changing diagnostics accessible to all. Unity Confirm enables non-invasive confirmation for high-risk screening results through the capture of intact circulating fetal cells using BillionToOne's Fetal Cell Capture Technology.
Spanish Bilingual Certified Pharmacy Technician - Refill & Medication Adherence Shields Health SolutionsSpanish Bilingual Certified Pharmacy Technician - Refill & Medication AdherenceMiami, FLRemotePatient Engagement Specialist, Pharmacy Technician, Certified Pharmacy Technician, CPhT, Specialty Pharmacy Careers, Pharmacy Customer Service Representative, Medication Refill Specialist, Remote Pharmacy Technician, Pharmacy Claims Adjudication, Medication Adherence, Healthcare Customer Service, Patient Care Coordinator, Specialty Pharmacy Jobs, Bilingual Pharmacy Technician, Remote Healthcare Careers, Prescription Refill Coordinator, Pharmacy Operations, Healthcare Support Specialist. Solid computer skills are required, including proficiency in Microsoft Office tools (Outlook, Teams, Word, Excel, and PowerPoint) for communication, documentation, and data management, as well as, navigating the internet and web-based platforms.
Utilization Management Clinician Behavioral Health Night Shift - 4 Days CVS Health CorpUtilization Management Clinician Behavioral Health Night Shift - 4 DaysFLRemote$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.
Utilization Management (UM) Nurse Consultant - Work at Home in EST or CST Zone CVS Health CorpUtilization Management (UM) Nurse Consultant - Work at Home in EST or CST ZoneFLRemote$29.10–$62.32 / hourYour responsibilities will include (but are not limited to): Reviewing services for medical necessity and appropriate benefit use, facilitating efficient discharge planning, and collaborating with providers and facilities to support members with complex needs. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Oncology Account Executive BillionToOne IncOncology Account ExecutiveMiami South, FLRemote$168,346–$184,186 / yearAt BillionToOne, we''ve built a category-defining, publicly traded company on Nasdaq where transparency fuels trust, collaboration drives breakthroughs, and every contribution moves the needle on our mission to make life-changing diagnostics accessible to all. Unity Confirm enables non-invasive confirmation for high-risk screening results through the capture of intact circulating fetal cells using BillionToOne's Fetal Cell Capture Technology.
UM Administration Coordinator II Humana IncUM Administration Coordinator IIFLRemote$40,000–$52,300 / yearAs the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. As part of Humana's Primary Care Organization, which includes CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost.
Utilization Review Nurse Oscar HealthUtilization Review NurseMiami, FLRemote$35–$45.94 / hourWork Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC).
14728 - Sr Project Manager - MSP Implementation (Remote, US) Kelly Services Inc14728 - Sr Project Manager - MSP Implementation (Remote, US)NYRemote$92,400–$123,200 / yearOversee all work streams within MSP implementations which are manager by our dedicated implementation SMEs including: configuration, business process design, supplier onboarding, finance setup, and data migration. Essential Skills, Knowledge & Experiences: Minimum 5 years' experience implementing complex advisory consulting, workforce, or MSP solutions, with proven hands-on MSP implementation.
Broker Dealer Compliance Officer Remote CXG Holdings IncBroker Dealer Compliance Officer RemoteSmithtown, NYRemote$40–$60 / hourFull timeCompliance Exchange Group (CXG) is the market leader in providing a complete turn-key service for Broker Dealers including CMA / NMA services, buying, selling and building Broker Dealers. This includes principal outsourcing on all levels, including CCO, FINOP, CEO, and developing regulatory compliance systems to satisfy FINRA, SEC, state and federal regulators.
Remote Inside Sales Representative ForgeFitRemote Inside Sales RepresentativeNewark, NJRemoteAs a Remote Inside Sales Representative, you’ll play a key role in driving ForgeFit’s growth by reaching out to potential clients, responding to inbound inquiries, and guiding gym owners, fitness directors, and facility managers through the buying process. We’re not just another distributor, we’re a trusted partner in helping fitness facilities grow stronger, perform better, and stay ahead of the competition.