Manager, Care Management SCAN Health PlanManager, Care ManagementLong Beach, CaliforniaRemoteManages the daily operations and continuous quality improvement of care management programs at SCAN to ensure the delivery of high quality, evidence-based care with a focus on addressing the medical, behavioral health, and social needs of members. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.
Market Manager Monogram Health IncMarket ManagerCalifornia, CARemote$102,000–$169,000 / yearReporting to the Market Physician Executive and matrixed to the General Manager, the Market Manager will be charged with achieving company Organizational Key Results, Key Performance Indicators, and Financial Health of the Market. The Market Manager will work closely with Regional/Market and Centralized clinical and operations Leaders to deliver quality patient care and overall patient and staff experience.
Care Manager - RN COPE HEALTH SOLUTIONSCare Manager - RNCARemote$80,000–$110,000 / yearOur comprehensive NCQA certified population health management platform and highly experienced team brings deep expertise, experience, proven tools, and processes to improve financial performance and quality outcomes for all types of payers and providers. Position Description: The Care Manager (CM) RN will lead a multidisciplinary healthcare team in a primary care / telephonic setting, focusing on coaching and coordination of care for patients needing navigation, addressing nursing care needs and follow up after clinical events.
RN Clinical Consultant Titanium Healthcare IncRN Clinical ConsultantCARemoteAssociate's degree in nursing Minimum 1+ years of experience as an RN working in a healthcare setting, such as a medical clinic or acute care hospital A current and unrestricted CA state RN license Experience using an EHR Distraction-free home workspace with a secure internet connection. POSITION SUMMARY The RN Clinical Consultant is a key member of Titanium Healthcare's Enhanced Care Management (ECM) program, providing clinical oversight and guidance to support high-quality, coordinated care for complex member populations.
Bilingual (Spanish/English) Transitions of Care Advanced Practice Provider Devoted Health IncBilingual (Spanish/English) Transitions of Care Advanced Practice ProviderCARemoteThat'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 ProviderCARemoteThat'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.
NewRegional Operations Manager (IKC) DaVita IncRegional Operations Manager (IKC)El Segundo, CARemote$104,000–$150,000 / yearThe following duties and responsibilities generally reflect the expectations of this position but are not intended to be all inclusive: Lead operational execution of new models of care for chronic kidney disease (CKD) Medicare Advantage (MA) patients for the RN role, including overseeing the achievement of critical quality and performance measures, including STARs metrics such as hypertension and diabetes control, medication adherence, nephrologist visits, and optimal starts. The ideal candidate will be responsible for leading a team of IKC RNs who case manage dialysis and CKD patients; Candidate will also manage two supervisors and support the non-clinical IKC care coordinators, whom they manage; responsible for team performance, productivity, and creating a special place to come to work.
Clinical Retention Specialist (West Region - AZ, CO, HI, ID, KS, MT, NE, NV, OR, UT, WA) Insulet CorpClinical Retention Specialist (West Region - AZ, CO, HI, ID, KS, MT, NE, NV, OR, UT, WA)CARemote$87,200–$130,850 / yearInsulet's flagship innovation, the Omnipod 5 Automated Insulin Delivery System, integrates with a continuous glucose monitor to manage blood sugar with no multiple daily injections, zero fingersticks, and can be controlled by a compatible personal smartphone in the U.S. or by the Omnipod 5 Controller. Identify early indicators of disengagement or churn through data assessment and analytics in partnership with the data science teams and collaborate with Customer Success teams to deploy targeted, regionally informed save strategies.
Bilingual Spanish Community Health Worker (Orange County) SHPCA SCAN Health PlanBilingual Spanish Community Health Worker (Orange County)Santa Ana, CaliforniaRemote$21.78–$31.52 / hourPerform Enhanced Care Management (ECM) activities related to specific Populations of Focus (POF): Individuals Experiencing Homelessness, Individuals At Risk for Avoidable Hospital Or ED Utilization, Adults Living In the Community At Risk of LTC Institutionalization, Adult Nursing Facility Residents Transitioning Back to the Community. Perform assessments for Medi-Cal/Medicare dual-eligible members referred to Complex Care Management for Long-Term Services and Supports (LTSS) and assist the Registered Nurse in determining Nursing Facility Level of Care.
Bilingual Spanish Community Health Worker (Orange County) SCAN Health PlanBilingual Spanish Community Health Worker (Orange County)Santa Ana, CaliforniaRemotePerform Enhanced Care Management (ECM) activities related to specific Populations of Focus (POF): Individuals Experiencing Homelessness, Individuals At Risk for Avoidable Hospital Or ED Utilization, Adults Living In the Community At Risk of LTC Institutionalization, Adult Nursing Facility Residents Transitioning Back to the Community. Perform assessments for Medi-Cal/Medicare dual-eligible members referred to Complex Care Management for Long-Term Services and Supports (LTSS) and assist the Registered Nurse in determining Nursing Facility Level of Care.
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.
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.
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.
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.
Credentialing Data Entry Clerk MedPOINT ManagementCredentialing Data Entry ClerkSherman Oaks, CARemoteFull timeMedPOINT Management is a leading Independent Physician Association (IPA) management company based in Sherman Oaks, CA, dedicated to supporting healthcare providers and delivering high-quality managed care services. This is a great opportunity to build a career in healthcare administration while playing a vital role in ensuring provider data accuracy and compliance.