Utilization Management Registered Nurse Humana IncUtilization Management Registered NurseSCRemote$71,100–$97,800 / yearWork-at-Home Information: 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.
NewRegistered Nurse - Managed Care Coordinator - (13234) InGenesisRegistered Nurse - Managed Care Coordinator - (13234)Columbia, SCRemoteAs the industry landscape shifts with new challenges in patient care, quality and compliance requirements, workforce retention, and operational efficiencies, we deliver strategic, data-driven solutions that include redefining workforce management and clinical service delivery. With decades of experience, InGenesis has grown into one of North America’s most trusted Healthcare Services Firms, which includes comprehensive health and workforce solutions.
Remote Registered Nurse (RN) Case Manager ValerisRemote Registered Nurse (RN) Case ManagerColumbia, South CarolinaRemoteBacked by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. calling and working with the patient’s insurance payer to determine coverage benefits, anticipated out-of-pocket costs associated with their therapy and resources for financial assistance, where applicable based upon needs communicated by the patient.
IT Healthcare Consultant Business Analyst - Advanced (Clinical Analyst & Coding Specialist InterSources Inc.IT Healthcare Consultant Business Analyst - Advanced (Clinical Analyst & Coding SpecialistColumbia, SCRemoteInterSources Inc , is a Small, Woman, and Minority-Owned Business Enterprise, ISO/IEC 27001, SOC 2 Type 2 certified company with massive 18+ years of diversified experience in providing IT Consulting Services, Artificial Intelligence, Data Analysis, Application Development, Cloud Services, Cybersecurity, Digital Marketing, ERP Management, Custom Software Development, Web Development, UI/ UX Design, System Integration, QA Support etc. Job Title: IT Healthcare Consultant – Business Analyst - Advanced (Clinical Analyst & Coding Specialist) ( 11013).
Appeals Registered Nurse Wisconsin Physicians Service Insurance CorpAppeals Registered NurseColumbia, SCRemoteWe are open to remote work in the following approved states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin. The Appeals Nurse examines medical records and claims information for first-level appeal cases to determine whether services provided were medically necessary and meet Medicare coverage guidelines in accordance with Medicare regulations and policies.
NewField Care Manager Behavioral Health Humana IncField Care Manager Behavioral HealthSCRemote$65,000–$88,600 / 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. Individuals must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.