Medical Assistant at Slidell
Slidell, LA
Addresses the total patient, inclusive of medical, psychosocial, behavioral, cultural, and spiritual needs Involves the individual patient and caregiver, as appropriate, in decision maki...

Behavioral Health Advocate - Remote / Field Based in Omaha NE
Omaha, NE
Manage caseload of members with behavioral health concerns Utilize advanced clinical skills to engage and motivate members via a recovery, health, and wellness oriented approach Assist m...

Provider Customer Service Representative - Remote in IN
Indianapolis, IN
Serves as the advocate for providers by demonstrating accountability and ownership to resolve issues Quickly and appropriately triage contacts from healthcare professionals (i.e. physici...

Provider Customer Service Representative - Remote in New Mexico
Minnetonka, MN
Serves as the advocate for providers by demonstrating accountability and ownership to resolve issues Quickly and appropriately triage contacts from healthcare professionals (i.e. physici...

Clinical Appeals Representative - Cypress, CA
Cypress, CA
Receive appeal or grievance documentation and determine relevant details (e.g., what member is requesting) Enter appeals and grievances details within the system and audit against provid...

Field Based Case Manager RN - Frisco, TX
Frisco, TX
Visit members in the hospital prior to discharge Provide a complete continuum of quality care through close communication with members via in person or on phone interaction Support membe...

Complex Customer Care Representative - Las Vegas, NV
Las Vegas, NV
Handle escalated calls, resolving more complex customer issues Demonstrate outstanding service to identify the source of the caller's issue and work to resolve the inquires in a timely a...

Complex Customer Care Representative - Las Vegas, NV
Las Vegas, NV
Handle escalated calls, resolving more complex customer issues Demonstrate outstanding service to identify the source of the caller's issue and work to resolve the inquires in a timely a...

Bilingual (English / Spanish) Complex Customer Care Representative - Las Vegas,
Las Vegas, NV
Handle escalated calls, resolving more complex customer issues Demonstrate outstanding service to identify the source of the caller's issue and work to resolve the inquires in a timely a...

Community Health Worker - Field Based in Craven County, New Bern, NC - No weeke
New Bern, NC
Linking members to applicable community resources Complete field visits for high risk, hard to reach members Telephonic outreach to targeted members Keep the member out of the hospital b...

Bilingual (English/Spanish) Complex Customer Care Representative - Las Vegas, NV
Las Vegas, NV
Handle escalated calls, resolving more complex customer issues Demonstrate outstanding service to identify the source of the caller's issue and work to resolve the inquires in a timely a...

Senior Clinical Quality RN - HEDIS, Remote in Las Vegas, NV
Las Vegas, NV
Perform HEDIS medical record review for physician offices throughout the state of Nevada Complete inter rater reliability testing and required computer training successfully in order to...

HSS Clinical Care Coordinator - Wyandotte County, KS
Overland Park, KS
Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care Identify and initiate referrals fo...

Senior Clinical Admin Nurse - Hybrid in Columbia, TN
Columbia, TN
Provide members with tools and educational support needed to navigate the health care system and manage their health concerns effectively and cost efficiently Assist members with adverse...

Audit Analyst
Minnetonka, MN
Assist audit management or audit lead in the execution of internal audits including audit planning, detailing control procedures, and the related testing and reporting in accordance with...