650 jobs found

Job Description Job Summary The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care.  This position will be supporting our Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals experience. The candidate must have strong organizational skills, proficient knowledge of MS Excel, able to work on multiple screens simultaneously and be computer literate to keep up with the work. The team works in a very fast and productive environment. Further details to be discussed during our interview process. Remote position with location preference in MI, IL or WI Work hours: Monday- Friday: 8:30am -5:00pm EST. There is Saturday on call and holiday rotation....

JOB DESCRIPTION Job Summary The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for overseeing delegated activities to ensure compliance with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other standards and requirements pertaining to delegation agreements. Contributes to overarching strategy to provide quality and cost-effective member care. This position will support our Corporate Compliance business. The candidate must have an unrestricted LVN licensure. Candidates must be technologically proficient, self-directed, autonomous and experience working from home. Care Management & Waiver Service Auditing experience is highly preferred. Work hours: Monday - Friday 8:00am – 4:00pm Remote position Essential Job Duties Coordinates, conducts and documents pre-delegation and annual assessments as necessary...

The Optum family of businesses, is seeking a Pediatric Clinical Therapist to join our team in Morristown, TN. As a member of the Optum Behavioral Care team, you'll be an integral part of our vision to make healthcare better for everyone.   The therapist is responsible for providing direct clinical services to patients in the Collaborative Care Model (CoCM) in a primary care clinic and will operate in conjunction with Optum Behavioral Care (OBC) to serve as the core member of the hybrid in-person/virtual collaborative care team for OBC clients.   In this cutting-edge team the therapist will interface between patients, PCPs, and psychiatrists to support the mental health and physical health care of patients on an assigned patient caseload from OBC clients. The therapist will have the support of OBC's clinical and operational teams. This is an ideal role for you if you want to be at the center of an innovative model that can successfully improve the wellbeing...

Ready to take control of your career? Say hello to Liveops where flexibility, freedom and meaningful opportunities are just a click away. Liveops is searching for dynamic, Spanish-English bilingual Independent Contractors (ICs) who are eager to deliver exceptional virtual teleservices for industry-leading brands. Whether your background is in healthcare, customer care, finance, or technical support, this is your chance to leverage your skills, broaden your horizons, and build a rewarding home-based business tailored to your strengths.  As an Independent Contractor, you will: Be your own boss Choose when and to whom you provide support services Set your own schedule Provide a distraction-free home office Provide your own home office equipment Handle customer calls, assess needs, and solve problems Requirements: Strong verbal and written English and Spanish skills At least 1 year of phone-based customer support experience Computer skills,...

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate. In this role, you will be instrumental in supporting individuals or families who aspire to a family. As a surrogate, you will take on crucial responsibilities, such as participating in the medical screenings and legal process required for a successful surrogacy journey, traveling to clinics for medical appointments, carrying the pregnancy with care and eventually bringing a new life to this world. This position is for those with a genuine desire to help others and provide meaningful support to those who need it most. If you possess a caring nature, excellent communication skills and the ability to handle sensitive situations, this is your opportunity to make a significant impact on someone's life. Give the miracle of life! It takes a village to grow love. BENEFITS: Total compensation: First-time surrogates...

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate. In this role, you will be instrumental in supporting individuals or families who aspire to a family. As a surrogate, you will take on crucial responsibilities, such as participating in the medical screenings and legal process required for a successful surrogacy journey, traveling to clinics for medical appointments, carrying the pregnancy with care and eventually bringing a new life to this world. This position is for those with a genuine desire to help others and provide meaningful support to those who need it most. If you possess a caring nature, excellent communication skills and the ability to handle sensitive situations, this is your opportunity to make a significant impact on someone's life. Give the miracle of life! It takes a village to grow love. BENEFITS: Total compensation: First-time surrogates...

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate. In this role, you will be instrumental in supporting individuals or families who aspire to a family. As a surrogate, you will take on crucial responsibilities, such as participating in the medical screenings and legal process required for a successful surrogacy journey, traveling to clinics for medical appointments, carrying the pregnancy with care and eventually bringing a new life to this world. This position is for those with a genuine desire to help others and provide meaningful support to those who need it most. If you possess a caring nature, excellent communication skills and the ability to handle sensitive situations, this is your opportunity to make a significant impact on someone's life. Give the miracle of life! It takes a village to grow love. BENEFITS: Total compensation: First-time surrogates...

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate. In this role, you will be instrumental in supporting individuals or families who aspire to a family. As a surrogate, you will take on crucial responsibilities, such as participating in the medical screenings and legal process required for a successful surrogacy journey, traveling to clinics for medical appointments, carrying the pregnancy with care and eventually bringing a new life to this world. This position is for those with a genuine desire to help others and provide meaningful support to those who need it most. If you possess a caring nature, excellent communication skills and the ability to handle sensitive situations, this is your opportunity to make a significant impact on someone's life. Give the miracle of life! It takes a village to grow love. BENEFITS: Total compensation: First-time surrogates...

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate. In this role, you will be instrumental in supporting individuals or families who aspire to a family. As a surrogate, you will take on crucial responsibilities, such as participating in the medical screenings and legal process required for a successful surrogacy journey, traveling to clinics for medical appointments, carrying the pregnancy with care and eventually bringing a new life to this world. This position is for those with a genuine desire to help others and provide meaningful support to those who need it most. If you possess a caring nature, excellent communication skills and the ability to handle sensitive situations, this is your opportunity to make a significant impact on someone's life. Give the miracle of life! It takes a village to grow love. BENEFITS: Total compensation: First-time surrogates...

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate. In this role, you will be instrumental in supporting individuals or families who aspire to a family. As a surrogate, you will take on crucial responsibilities, such as participating in the medical screenings and legal process required for a successful surrogacy journey, traveling to clinics for medical appointments, carrying the pregnancy with care and eventually bringing a new life to this world. This position is for those with a genuine desire to help others and provide meaningful support to those who need it most. If you possess a caring nature, excellent communication skills and the ability to handle sensitive situations, this is your opportunity to make a significant impact on someone's life. Give the miracle of life! It takes a village to grow love. BENEFITS: Total compensation: First-time surrogates...

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate. In this role, you will be instrumental in supporting individuals or families who aspire to a family. As a surrogate, you will take on crucial responsibilities, such as participating in the medical screenings and legal process required for a successful surrogacy journey, traveling to clinics for medical appointments, carrying the pregnancy with care and eventually bringing a new life to this world. This position is for those with a genuine desire to help others and provide meaningful support to those who need it most. If you possess a caring nature, excellent communication skills and the ability to handle sensitive situations, this is your opportunity to make a significant impact on someone's life. Give the miracle of life! It takes a village to grow love. BENEFITS: Total compensation: First-time surrogates...

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate. In this role, you will be instrumental in supporting individuals or families who aspire to a family. As a surrogate, you will take on crucial responsibilities, such as participating in the medical screenings and legal process required for a successful surrogacy journey, traveling to clinics for medical appointments, carrying the pregnancy with care and eventually bringing a new life to this world. This position is for those with a genuine desire to help others and provide meaningful support to those who need it most. If you possess a caring nature, excellent communication skills and the ability to handle sensitive situations, this is your opportunity to make a significant impact on someone's life. Give the miracle of life! It takes a village to grow love. BENEFITS: Total compensation: First-time surrogates...

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate. In this role, you will be instrumental in supporting individuals or families who aspire to a family. As a surrogate, you will take on crucial responsibilities, such as participating in the medical screenings and legal process required for a successful surrogacy journey, traveling to clinics for medical appointments, carrying the pregnancy with care and eventually bringing a new life to this world. This position is for those with a genuine desire to help others and provide meaningful support to those who need it most. If you possess a caring nature, excellent communication skills and the ability to handle sensitive situations, this is your opportunity to make a significant impact on someone's life. Give the miracle of life! It takes a village to grow love. BENEFITS: Total compensation: First-time surrogates...

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate. In this role, you will be instrumental in supporting individuals or families who aspire to a family. As a surrogate, you will take on crucial responsibilities, such as participating in the medical screenings and legal process required for a successful surrogacy journey, traveling to clinics for medical appointments, carrying the pregnancy with care and eventually bringing a new life to this world. This position is for those with a genuine desire to help others and provide meaningful support to those who need it most. If you possess a caring nature, excellent communication skills and the ability to handle sensitive situations, this is your opportunity to make a significant impact on someone's life. Give the miracle of life! It takes a village to grow love. BENEFITS: Total compensation: First-time surrogates...

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate. In this role, you will be instrumental in supporting individuals or families who aspire to a family. As a surrogate, you will take on crucial responsibilities, such as participating in the medical screenings and legal process required for a successful surrogacy journey, traveling to clinics for medical appointments, carrying the pregnancy with care and eventually bringing a new life to this world. This position is for those with a genuine desire to help others and provide meaningful support to those who need it most. If you possess a caring nature, excellent communication skills and the ability to handle sensitive situations, this is your opportunity to make a significant impact on someone's life. Give the miracle of life! It takes a village to grow love. BENEFITS: Total compensation: First-time surrogates...

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate. In this role, you will be instrumental in supporting individuals or families who aspire to a family. As a surrogate, you will take on crucial responsibilities, such as participating in the medical screenings and legal process required for a successful surrogacy journey, traveling to clinics for medical appointments, carrying the pregnancy with care and eventually bringing a new life to this world. This position is for those with a genuine desire to help others and provide meaningful support to those who need it most. If you possess a caring nature, excellent communication skills and the ability to handle sensitive situations, this is your opportunity to make a significant impact on someone's life. Give the miracle of life! It takes a village to grow love. BENEFITS: Total compensation: First-time surrogates...