Bilingual RN Care Manager Remote Flexible - Spanish Speaking Arc Care IncBilingual RN Care Manager Remote Flexible - Spanish SpeakingCalifornia, CARemote$80,000–$95,000 / yearWe seek a full-time Registered Nurse Care Manager to play a critical role in our whole-person, interdisciplinary care model by supporting patient-driven care plans to drive improved outcomes for individuals living with Serious Mental Illness, Substance Use Disorder, experiencing homelessness, and/or those who have high medical needs. Our work is powered by a deeply collaborative team of nurses, social workers, community health workers, and medical professionals working alongside product, technology, and operations to close care gaps and improve outcomes for high-need patients.
NewAppeals RN - Care Management Per Diem - REMOTE Providence Health & ServicesAppeals RN - Care Management Per Diem - REMOTETorrance, CARemote$57.28–$88.92 / hourRequsition ID: 449883 Company: Providence Jobs Job Category: Care Management Job Function: Clinical Care Job Schedule: Per-Diem Job Shift: Day Career Track: Nursing Department: 7000 UTILIZATION MGMT CA SOCAL Address: CA Torrance 21311 Madrona Ave Work Location: PMI Madrona-Torrance Workplace Type: Remote 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.
RN Utilization Review - Per Diem - REMOTE Providence Health & ServicesRN Utilization Review - Per Diem - REMOTEIrvine, CARemote$57.28–$88.92 / hourRequsition ID: 434193 Company: Providence Jobs Job Category: Health Information Management Job Function: Revenue Cycle Job Schedule: Part time Job Shift: Multiple shifts available Career Track: Nursing Department: 7000 UTILIZATION MGMT OCHD Address: CA Irvine 15480 Laguna Canyon Rd Work Location: Providence System Offices Discovery Park-Irvine 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.
RN Utilization Review - Per Diem - REMOTE Providence St. Joseph HealthRN Utilization Review - Per Diem - REMOTEIrvine, CARemoteThe Utilization Management RN must effectively and efficiently manage a diverse workload in a fast-paced, rapidly changing regulatory environment, demonstrating excellent negotiation, communication, problem-solving, and decision-making skills. 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.
Healthcare Revenue Cycle Billing Specialist II (SNF) Wipfli Advisory LLCHealthcare Revenue Cycle Billing Specialist II (SNF)Irvine, CaliforniaRemote$23–$30 / hourFull timeAs 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.
NewAppeals RN - Care Management Per Diem - REMOTE Providence St. Joseph HealthAppeals RN - Care Management Per Diem - 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.
Senior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (REMOTE) (Exempt) (Non-Union) University of Southern CaliforniaSenior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (REMOTE) (Exempt) (Non-Union)Alhambra, CaliforniaRemoteThe Senior RI Specialist also coordinates with Keck Medical Center of USC Administration, IS, Compliance, Clinical Informatics and Integration personnel on technology projects impacting charge entry, charge dictionaries, and charge, and provides data derived from multiple entities of Keck Medical Center of USC for the management and support of critical decisions and functions related the Chargemaster, CDM Maintenance, and the improvement of charge capture. As a subject matter expert in the area of compliance and pricing of services, the Senior RI Specialist responds to inquiries regarding Chargemaster issues and is responsible for supervising meetings for projects associated with educating and communicating to clinical revenue generating departmental staff regarding the CDM Maintenance process, coding updates, compliance issues, and charge capture improvement.
Senior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (Remote) (Exempt) (Non-Union) University of Southern CaliforniaSenior Revenue Integrity Specialist - Clinical Rev Integrity - Full Time 8 Hour Days (Remote) (Exempt) (Non-Union)Los Angeles, CARemote$99,507–$130,000 / yearThe Senior RI Specialist also coordinates with Keck Medical Center of USC Administration, IS, Compliance, Clinical Informatics and Integration personnel on technology projects impacting charge entry, charge dictionaries, and charge, and provides data derived from multiple entities of Keck Medical Center of USC for the management and support of critical decisions and functions related the Chargemaster, CDM Maintenance, and the improvement of charge capture. As a subject matter expert in the area of compliance and pricing of services, the Senior RI Specialist responds to inquiries regarding Chargemaster issues and is responsible for supervising meetings for projects associated with educating and communicating to clinical revenue generating departmental staff regarding the CDM Maintenance process, coding updates, compliance issues, and charge capture improvement.
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.
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.
NewTelephonic Triage RN - Remote Call Center (PMs) Medcor IncTelephonic Triage RN - Remote Call Center (PMs)CARemoteTo preserve our pioneering, entrepreneurial spirit, we impart our values through the ongoing Better@Medcor campaign: encouraging our advocates to make a conscious choice to practice our values, to celebrate and recognize each other via our peer recognition program, and to support one another during tough times. Our nurses must be able to visualize an injury while on the phone and clarify details about the injury while following our propriety algorithms to guide the triage of the injured worker.
Healthcare Compensation Consultant (Physician & Total Rewards) Pyramid Consulting, IncHealthcare Compensation Consultant (Physician & Total Rewards)Los Angeles County, CARemote$42–$45 / hourBy applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Build and maintain advanced Excel models using formulas, Pivot Tables, lookups, and data validation.
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.
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.
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.
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.
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.