Utilization Management Manager – Remote Nonprofit Role Yamhill Community CareUtilization Management Manager – Remote Nonprofit RoleMcMinnville, ORRemoteACM (Accredited Case Manager) through AMCA (American Case Management Association), CCM (Certified Case Manager) CCMC (Commission for Case Manager Certification), Board certification in Nursing Case Management (RN-BC) through ANCC (American Nurses Credentialing Center), CPHQ (Certified Professional in Health Care Quality) through NAHQ (National Association of Health Care Quality). Master’s degree in Nursing or other Healthcare related field, Five (5) years of relevant clinical nursing or healthcare related experience, Experienced in physical and behavioral health integration, Experience with Coordinated Care Organization (CCO) / Medicaid Managed Care, Three (3+) years of experience with Utilizations Management, Equivalent combination of education and experience will be considered.
Remote Care Management Nurse Cambia Health Solutions IncRemote Care Management NurseSalem, ORRemote$36.80–$49.80 / hourAs a member of the Clinical Services team, our Care Management RN's provide clinical care management (such as case management, disease management, and/or care coordination) to best meet the member's specific healthcare needs and to promote quality and cost-effective outcomes. Collaborates with physician advisors, internal and external customers, and other departments to resolve claims, quality of care, member or provider issues, and identifies problems or needed changes, recommending resolutions and participating in quality improvement efforts.
Global Healthcare Segment Head - Global Marketing & Sales Hitachi LtdGlobal Healthcare Segment Head - Global Marketing & SalesSalem, ORRemoteYou will also work closely with Hitachi business units and regional growth teams to position Hitachi to priority players in this market with a cohesive value proposition, bringing together the domain experts in medical systems and products (Hitachi High-Tech), Operational infrastructure experts (eg Hitachi Energy, Hitachi High Tech, Hitachi Building systems, JR Automation) and Hitachi's digital group companies (digital, data, AI), as a full range of capabilities to help Hitachi build its reputation and become a trusted partner for AI era, sustainable healthcare, particularly in the fields of Bio pharmaceutical development and delivery, diagnostics and cancer treatment. Support cross Hitachi solution development, providing market intelligence and customer validation, assisting SSIB with insight, incubation and PoC projects, proposing commercialization models for successful incubations that integrate OT scale up in medtech with digital & AI (AIOps) applied to enhanced patient outcomes (e.g. and predictive diagnostics) treatment development as well as operational optimization e.g.
Business Subject Matter Expert at Remote Syntricate Technologies IncBusiness Subject Matter Expert at RemoteSalem, ORRemoteThe selected candidate will collaborate with business partners, technical teams, vendors, and Medicaid stakeholders to validate system functionality and support a successful marketplace implementation. The Oregon Health Authority (OHA) is seeking an experienced Business Subject Matter Expert (UAT) to support the State-Based Marketplace (SBM) Transition Project.
Remote Medical Director, Appeals Centene Corporation GroupRemote Medical Director, AppealsORRemote$236,500–$449,300 / yearLicense/Certifications: Active Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association's Department of Certifying Board Services. Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals.
NewRemote Medical Director, Inpatient Medicare Centene Corporation GroupRemote Medical Director, Inpatient MedicareORRemote$236,500–$449,300 / yearCollaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals. License/Certifications: Board certification in a medical specialty recognized by the American Board of Medical Specialists or the American Osteopathic Association's Department of Certifying Board Services.
Senior Compensation Consultant - Remote Providence Health & ServicesSenior Compensation Consultant - RemoteOregon, ORRemoteRequsition ID: 449763 Company: Providence Jobs Job Category: Compensation Job Function: Human Resources Job Schedule: Full time Job Shift: Multiple shifts available Career Track: Business Professional Department: 4002 SS HR COMP ADMIN Address: WA Renton 1801 Lind Ave SW Work Location: Providence Valley Office Park-Renton 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. The Senior Compensation Consultant is instrumental in the development and ongoing administration, design, analysis and implementation of various Providence St. Joseph Health compensation programs, including pay for performance, salary structure design and modeling, complex costing scenarios and incentive plans.
Charge Description Master Specialist - Full time, Day, Remote Providence Health & ServicesCharge Description Master Specialist - Full time, Day, RemoteORRemoteRequsition ID: 431486 Company: Providence Jobs Job Category: Patient Financial Services Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 4001 SS RC CHARGE DECR MSTR Address: CA Apple Valley 18300 Hwy 18 Work Location: St Mary Medical Center-Apple Valley 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. As a member of the PSJH System Revenue Integrity Chargemaster (RICDM) team, the CDM Specialist shall ensure that the Chargemaster (CDM) is consistent with all coding and billing regulations and accurately represents services provided.
Senior Data Engineer IS - Remote Providence Health & ServicesSenior Data Engineer IS - RemoteORRemoteRequsition ID: 429173 Company: Providence Jobs Job Category: Development/Engineering Job Function: Information Technology Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 4011 SS IS HI DP 3 Address: OR Portland 4400 NE Halsey St Work Location: Providence Health Plaza (HR) Bldg 1-Portland 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.
NewHuman Resources Consultant - Employee Relations - Full time, Day, Remote Providence Health & ServicesHuman Resources Consultant - Employee Relations - Full time, Day, RemoteOregon, ORRemoteRequsition ID: 450531 Company: Providence Jobs Job Category: HR Generalist Job Function: Human Resources Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 4002 SS HR EMPL RELATIONS 1 Address: CA Torrance 4101 Torrance Blvd Work Location: Providence Little Co of Mary Medical Ctr-Torrance 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.
NewRemote Registered Dietitian Or CNS - Flexible Hours, Work From Anywhere Berry StreetRemote Registered Dietitian Or CNS - Flexible Hours, Work From AnywhereSalem, ORRemoteBerry Street empowers independent dietitians to accept insurance and grow thriving private practices by providing comprehensive credentialing, scheduling, referral, and technical support, as well as access to a vibrant, collaborative clinician community. Dietitians working with Berry Street are committed to these pillars of high-quality care: Evidence-based: We provide quality care based on the latest clinical research.
Provider Compensation Consultant - Remote Providence St. Joseph HealthProvider Compensation Consultant - RemoteSalem, ORRemoteThis role combines expertise in healthcare economics, regulatory compliance, and data analytics to design compensation structures that are fair, competitive, and in support of with Providence's strategic initiatives- all with an eye to FMV and commercial reasonableness. Together, 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.
Charge Description Master Specialist - Full time, Day, Remote Providence St. Joseph HealthCharge Description Master Specialist - Full time, Day, RemoteORRemoteAs a member of the PSJH System Revenue Integrity Chargemaster (RICDM) team, the CDM Specialist shall ensure that the Chargemaster (CDM) is consistent with all coding and billing regulations and accurately represents services provided. The CDM Specialist responds to Hospital ministry inquiries regarding Chargemaster issues and is responsible for the training of Hospital ministry staff regarding the CDM Maintenance process, coding updates and charge capture improvement.
Coding Policy Analyst - Remote Providence Health & ServicesCoding Policy Analyst - RemoteOregon, ORRemoteRequsition ID: 432922 Company: Providence Jobs Job Category: Coding Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Multiple shifts available Career Track: Business Professional Department: 5018 HCS MEDICAL MANAGEMENT OR REGION Address: WA Liberty Lake 24021 E Mission Ave Work Location: Liberty Lake 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. The analyst is responsible for monitoring changes to codes, coding guidelines and regulations, and coding edits from external agencies such as AMA, CMS, Medicaid, and specialty societies, and assists with implementation of such changes to the claims adjudication and editing software.
Senior Inside Sales Consultant (Remote/Pacific Time) A Place for Mom IncSenior Inside Sales Consultant (Remote/Pacific Time)Salem, ORRemoteTogether, we simplify the senior care search with free, personalized support - connecting caregivers and their loved ones to vetted providers from our network of 15,000+ senior living communities and home care agencies. This is a high-activity, performance-driven inside sales role focused on re-engaging families, managing a pipeline of opportunities, and converting interest into move-ins.
Senior Claims Manager EPL - Remote Providence Health & ServicesSenior Claims Manager EPL - RemoteORRemoteRequsition ID: 442190 Company: Providence Jobs Job Category: Financial Transactions Job Function: Health Plans Services Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 4008 SS RIS Address: CA Orange 1100 W Stewart Dr Work Location: St Joseph Hospital-Orange 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.
Field Solution Architect, Remote PC Connection IncField Solution Architect, RemoteORRemoteWorking under general supervision of the Solution Architect Manager and relying on experience and judgement to plan and accomplish goals, the Field Solution Architect (FSA) effectively penetrates and drives solutions within targeted accounts and expands penetration in existing accounts. The FSA requires an understanding of both the technology and business objectives of the account to enable the delivery of solutions that will contribute to the success of existing accounts and the acceleration of new customer volume.
Chronic Care Manager (Remote - Compact States) Harris Computer SystemsChronic Care Manager (Remote - Compact States)Salem, ORRemoteCare Managers are expected to complete due diligence on 100% of their assigned patients and complete billable encounters on 90% of the patients they are assigned each month unless patients are unable to participate due to current health conditions. High Speed Internet (Minimum Download - 18mbps/Upload 6mbps) and either a Desktop or Laptop computer in good working order (Has to be operation system of Windows or Mac) NO Chromebooks, iPads, or tablets.
Remote Medical Coder II - (MUST LIVE IN THE SALEM AREA) Career StrategiesRemote Medical Coder II - (MUST LIVE IN THE SALEM AREA)Salem, OregonRemoteMaintain NDC updates, NCCN guidelines, and work with A/R and billing teams to resolve claim rejections, troubleshoot billing issues, and ensure claims are processed correctly. Stay current with updates on medical treatments, procedures, diagnosis classifications, payer updates, and coverage changes, and communicate relevant information to providers, supervisors, and the billing team.
Sr. Medical Coding Quality Analyst -Hybrid/Remote Career StrategiesSr. Medical Coding Quality Analyst -Hybrid/RemoteSalem, OregonRemoteExperience: 5+ years of medical coding experience, including 2+ years in multispecialty coding and 2+ years in a quality analyst or leadership role. This is a Contract to hire role, offering $35-$41 an hour, and is on a hybrid remote work schedule and fully remote after first week training.