Fraud and Waste Investigator Humana IncFraud and Waste InvestigatorLARemote$65,000–$88,600 / yearThis team of Investigators conducts investigations into allegations of fraud, waste, and abuse involving providers who submit claims to Humana's Louisiana Medicaid line of business. The Investigators conduct interviews, write investigative reports, analyze medical records and billed claims data, as well as collaborate with Humana's Program Integrity partners.
HB Outpatient Coding Educator/Auditor - Remote LCMC HealthHB Outpatient Coding Educator/Auditor - RemoteNew Orleans, LARemoteIdentifies potential areas of compliance vulnerability and risk, develops and identifies potential corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way.
Senior Hospital Contracting Strategist Humana IncSenior Hospital Contracting StrategistLARemote$78,400–$107,800 / 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.
Louisiana Medicaid Inbound Contact Representative Humana IncLouisiana Medicaid Inbound Contact RepresentativeLARemote$39,000–$49,400 / 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. The Inbound Contacts Representative 2 addresses customer needs which may include complex benefit questions, resolving issues, and educating members while also conducting outbound calling campaigns to assist our members.
Enterprise Solutions Engineer - Alabama, Mississippi, Louisiana NetApp IncEnterprise Solutions Engineer - Alabama, Mississippi, LouisianaLARemote$197,200–$255,200 / yearAs an Enterprise Solutions Engineer, you will own the technical relationship with customers while partnering closely with your Client Executive to drive business outcomes, winning together across both existing accounts and net-new opportunities. You will design, architect, and configure solutions across complex enterprise environments, manage multiple deals at various stages (from new logos to long-term strategic accounts), and bring the art of what's possible to every engagement.
Inbound/Outbound Retention Representative ConnectAmerica LLCInbound/Outbound Retention RepresentativeLARemoteAs North America's largest independent provider of connected care, we deliver a growing portfolio of innovative technologies that help bridge the gap between healthcare providers, individuals, and their care partners. Our easy-to-use solutions support health and safety in a way that leads to enhanced quality of life, earlier interventions, reduced hospitalizations and peace of mind for an estimated 10 million lives every year.
Workers Compensation Production Underwriter CopperPoint Insurance CoWorkers Compensation Production UnderwriterLARemote$80,000–$87,000 / yearThe position leads new business development, risk selection, pricing, and agency relationship management within delegated authority, while partnering with underwriting leadership, internal teams, and agency partners to execute territory strategies and achieve short- and long-term business objectives. Evaluates workers compensation submissions by analyzing class codes, exposures, payroll, loss runs, experience modification factors, hazard controls, financial considerations, and overall risk characteristics.
NewMarket Finance Lead HumanaMarket Finance LeadMetairie, LouisianaRemoteWork 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. The Market Finance Lead will partner closely with regional leadership, actuarial, corporate finance, clinical, risk adjustment, market operations, network performance, network contracting, sales/MarketPoint, and value-based care providers.
Intern - Product Strategy Harman International Industries IncIntern - Product StrategyLouisiana, LARemoteMust be currently enrolled in a Bachelor's Degree program or higher at an accredited institution having completed your Sophomore year or later, taking at least one class in the semester/quarter before participation in the internship program, and returning to school for at least one semester upon completion of the internship program. You will run competitive and user research across music discovery, streaming, and short-form content, sit inside the day-to-day work of a product team, and bring back the language, habits, and unmet needs of a younger audience in a form the team can act on.
Associate Chief Medical Information Officer (ACMIO) for Radiology Ochsner Clinic FoundationAssociate Chief Medical Information Officer (ACMIO) for RadiologyNew Orleans, LouisianaRemoteThe ACMIO will collaborate with senior leadership including the Chief Medical Officer (CMO), Chief Nursing Officer (CNO) along with the Chief Information Officer (CIO) to lead clinical transformation across our healthcare enterprise through digital care delivery. Focus will be on value creation for care delivery from current and new digital health technologies, including adoption of our evolving Enterprise Electronic Medical Record system (Epic); clinical analytics; population health and patient facing clinical informatics.
Remote Order Verification / Telepharmacist Pharmacy CareersRemote Order Verification / TelepharmacistNew Orleans, LouisianaRemoteAs a Remote Order Verification Pharmacist (Telepharmacist), you will review and approve medication orders electronically for hospitals and clinics — protecting patients while enjoying remote flexibility. Remote Order Verification Pharmacist – Telepharmacy | Work From Home | Flexible Shifts Including Overnight Use your verification skills from the comfort of home.
Nuclear Medicine Physician Ochsner Clinic FoundationNuclear Medicine PhysicianNew Orleans, LouisianaRemoteThis position includes coverage at Ochsner Medical Center New Orleans - Jefferson Highway (a tertiary / quaternary academic medical center), the Benson Cancer Center, and 3 Ochsner South Shore community hospitals, including Ochsner Kenner Medical Center, the site of our Neuroendocrine Tumor program. Duties include day time coverage of outpatient and hospital inpatient diagnostic examinations and therapeutic nuclear medicine procedures from Ochsner New Orleans South Shore hospitals, outpatient facilities, and urgent care centers.
Territory Sales Manager - Southeast US Intertape Polymer Group IncTerritory Sales Manager - Southeast USLARemoteTrain distributors by utilizing effective sales presentations, product knowledge, competitive knowledge, IPG resources (product specialists, product managers, and regional managers). Establish and justify the value added products, programs and sales/marketing support (packaging specialists support as an integral part) that IPG delivers to ensure that IPG has a favored position in the account.
Pharmacy Technician I CVS Health CorpPharmacy Technician ILARemote$17–$25.65 / hourThe progression path from Level I, Level II, and Level III positions within the Pharmacy Technician Contact Center team is a structured path that encourages advocates to widen their knowledge base, take on more responsibility, demonstrate expertise, and reward team members for their proven success and dedication. Contacts patients and assists/reminds them in obtaining refills on their medications from their respective pharmacy, whether it be retail, independent or mail-order pharmacy.
Case Manager RN CVS Health CorpCase Manager RNLARemote$54,095–$116,760 / yearThe Case Manager RN process includes assessing the member's health status and care coordination needs, inpatient review, and discharge planning, developing, and implementing the case management plan, monitoring, and evaluating the plan and involving the Medical Director as indicated and closing the case as appropriate when the member has met discharge criteria. The Case Manager RN utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.
Sr Construction Defect Liability Claims Examiner Crawford & CoSr Construction Defect Liability Claims ExaminerNew Orleans, LARemoteTo determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements.
Clinical Pharmacist - Prior Authorization CVS Health CorpClinical Pharmacist - Prior AuthorizationLARemote$45.43–$76.15 / hourCollaborates with the technicians and prior authorization team members to process referrals, including answering clinical questions and collecting appropriate clinical/medical data needed to perform clinical assessments and reviews as per the health plan/employer-agreed criteria within the designated service level agreements. One of the crucial responsibilities is to guarantee that the decisions regarding cases are conveyed promptly and efficiently to all the healthcare providers, health plans/employers, patients, and other healthcare professionals following agreed-upon approval & denial management processes.
Remote Prior Authorization Pharmacist Pharmacy CareersRemote Prior Authorization PharmacistNew Orleans, LouisianaRemoteRemote Prior Authorization Pharmacist – Work From Home | Flexible Schedule | High Clinical Impact Transition your clinical skills into a fully remote Prior Authorization Pharmacist role. Review medication requests from home, apply evidence-based criteria, and help patients get the therapies they need — with predictable schedules and zero commute.
Sr Hospital Coder- Remote Ochsner Clinic FoundationSr Hospital Coder- RemoteNew Orleans, LouisianaRemoteUtilizes appropriate coding guidelines to assign ICD and CPT codes; conforms to applicable Medicare, Medicaid and other third-party payer guidelines to ensure receipt of accurate reimbursement; works in collaboration with the Clinical Documentation Improvement team to ensure accurate DRG assignment and works closely with management to resolve problems and meet deadlines. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible.
Business Development Manager Dover CorporationBusiness Development ManagerNew Orleans, LARemote$120,000–$140,000 / yearProviding advanced fuel-dispensing equipment, including clean energy solutions, systems and payment, automatic tank gauging and wet stock-management solutions, DFS comprises the product brands of Wayne Fueling Systems, OPW Fuel Management Systems, ClearView, Tokheim, ProGauge, Fairbanks, LIQAL, AvaLAN, and Bulloch Technologies. Fraudulent Recruiting Disclaimer: Dover Corporation and our affiliated operating companies want to alert applicants to internet job posting fraud, where parties posing as Dover employees, recruiters, or other agents, try to engage with online candidates in an attempt to steal personal and/or financial information.