Work From Home Customer Service (Entry Level) Globe Life AIL - Lisa RusselWork From Home Customer Service (Entry Level)Bellingham, WARemoteFull timeWith 100% remote flexibility, world-class mentorship, and a leadership-driven culture, AO provides the tools and environment high performers need to thrive—both professionally and financially. AO is seeking driven, ambitious professionals ready to step into a leadership-focused role within a fast-growing, fully remote organization.
Work From Home Customer Service (Entry Level) - Globe Life AIL Lisa RusselWork From Home Customer Service (Entry Level) - Globe Life AILBellingham, WashingtonRemoteWith 100% remote flexibility, world-class mentorship, and a leadership-driven culture, AO provides the tools and environment high performers need to thrive—both professionally and financially. AO is seeking driven, ambitious professionals ready to step into a leadership-focused role within a fast-growing, fully remote organization.
Remote Care Management Nurse Cambia Health SolutionsRemote Care Management NurseBurlington, WARemoteFull timeAs 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. Oversees a collaborative process with the member and those involved in the member's care to assess, plan, implement, coordinate, monitor and evaluate care as needed - all in service of creating a person-focused health care experience.
Pharmacy Services Technician Cambia Health Solutions IncPharmacy Services TechnicianBurlington, WARemote$20.50–$30.80 / hourAssist with auditing and investigations of medication-related claims, cases, and providers to identify misuse of medications, misuse of resources, substance abuse, and erroneous and fraudulent billing practices; investigate and organize workflow for claims referred to Pharmacy Services for review and allowable determination including miscellaneous J codes, providers on review, and reconsiderations. Support wellness and disease state management programs for Pharmacy Service and corporately which contribute to NCQA accreditation and ongoing quality improvement; contribute to and support the corporation's quality initiatives through process improvement teams and by encouraging team and individual contributions toward quality improvement efforts.
Temporary Customer Service Professional I Cambia Health Solutions IncTemporary Customer Service Professional IBurlington, WARemote$19–$22.25 / hour6 months of customer service call center experience; or 6 months of customer service experience in insurance, retail, banking, hospital, medical office or similar industry with extensive customer contact; or equivalent combination of education and experience. As the face of Cambia, our CSPs play multiple roles - listener, problem-solver, investigator and advocate - all in service of making our members' health journeys easier and days brighter.
Utilization and Care Management Nurse Cambia Health Solutions IncUtilization and Care Management NurseBurlington, WARemote$34.20–$55.70 / hourAs a member of the Clinical Services team, our Utilization and Care Management Nurses provide utilization and care management (such as prospective concurrent, retrospective review, post-discharge care coordination) to best meet the member's specific healthcare needs and to promote quality and cost-effective outcomes and appropriate payment for services - all in service of making our members' health journeys easier. Must have at least one of the following: Bachelor's degree (or higher) in a health or human services-related field (psychiatric RN or Masters' degree in Behavioral Health preferred for behavioral health); or Registered nurse (RN) license (must have a current unrestricted RN license for medical care management).
Clinical RFP Coordinator Cambia Health Solutions IncClinical RFP CoordinatorBurlington, WARemote$76,500–$103,500 / yearAs a member of the Clinical Program Management team, the Clinical RFP Coordinator & Communications Specialist partners with the Marketing and Sales teams by representing clinical areas of the company in business acquisition and retention opportunities. What You Will Do at Cambia: Facilitates responses to RFPs, RFIs, and surveys for clinical areas in collaboration with sales bid response teams and other divisions to ensure timely delivery of high-quality responses.
Utilization Management Inpatient Clinical Specialist Cambia Health Solutions IncUtilization Management Inpatient Clinical SpecialistBurlington, WARemote$25.90–$37.30 / hourWhat You Will Do at Cambia: You'll utilize clinical knowledge and critical thinking to research and review IP UM requests, ensuring completeness of information and taking action to obtain necessary details, while also completing non-clinical tasks to close cases accurately and efficiently. You'll perform detailed research and problem-solve using sound decision-making skills to ensure IP UM case accuracy and completeness, and contribute to continuous improvement by identifying opportunities for improvement within systems and workflows.
Clinical Pharmacist Consultant Cambia Health Solutions IncClinical Pharmacist ConsultantBurlington, WARemote$121,600–$164,500 / yearAs a member of the Pharmacy Services team, our Clinical Pharmacist Consultant provides professional and clinical pharmacy expertise in making or guiding clinical decisions based on best practices by applying evidence-based medicine evaluations to determine the best quality medication choices that represent the best value in efficacy, safety and affordability. Advanced responsibilities may include analyzing health care cost information, development of position papers, medication coverage policies, formulary monographs and class reviews, cross-functional projects, and/or initiatives related to the provision of pharmacy benefits that impact safety, quality and affordability - all in service of making our members' health journeys easier.
Appeals Clinician I Cambia Health Solutions IncAppeals Clinician IBurlington, WARemote$76,500–$103,500 / yearAs a member of the Clinical Services team, our Appeals Clinician I utilizes clinical expertise to complete the clinical component of all appeal types to resolve member and/or provider appeals - all in service of making our members' health journeys easier. Active licensure or certification, in a state or territory of the United States, in a health or human services discipline that allows the professional to conduct an assessment independently as permitted within the scope of practice for the discipline (e.g.