Sr Healthcare Economics Consultant - Remote
Minnetonka, MN
Interpret and analyze claims, capitation, membership data, and recommend best approaches in support of underwriting, actuarial and utilization analyses Lead projects to completion by con...

Manager, Sourcing and Procurement - Remote
Minnetonka, MN
Develop, lead and execute category management strategies, conduct sourcing / RFX events, manage suppliers and conduct financial analysis Draft, Review, and lead negotiations of third par...

Clinical Grievances RN - Remote in a PST
Phoenix, AZ
Perform clinical assessment of healthcare services provided to our members for appropriateness Understand relevant state and federal grievance and peer review requirements and accreditat...

Medicare Market Growth Manager - Sales Manager - SW Florida
Fort Myers, FL
Key Agent/Agency Performance Agent Development Mentor, coach and engage key agents/agencies through ongoing business and strategy planning. This includes identifying sales opportunities,...

Customer Service Representative (Empire) - Remote in NY
Lake Katrine, NY
Respond to and resolve on the first call, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims,...

Underwriting Consultant, Local Markets Eastern Region - Remote
Hartford, CT
Primary focus will be on a Local Market book of business Intricate focus on product integration to maximize company financials Work closely with underwriting and local market sales to de...

Underwriting Consultant Local Markets West Region - Remote
Cypress, CA
Primary focus will be on a Local Market book of business Intricate focus on product integration to maximize company financials Work closely with underwriting and local market sales to de...

Clinical Pharmacist
Downers Grove, IL
Perform telephonic outreach to improve health quality outcomes Optimize pharmacy therapy through additional telephonic engagement with providers and pharmacies Oversee pharmacy projects...

Senior Clinical Admin Nurse, Emerging CARE - Remote
Phoenix, AZ
Acts as resource to members calling into a customer service setting addressing medical/health questions Own problem through to resolution on behalf of the member in real time or through...

HSS Coordinator - North Houston, TX
Houston, TX
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 f...

RN Field Clinical Care Coordinator - Star Kids - Spring, TX
Spring, TX
Provide a complete continuum of quality care through close communication with members via in person or on phone interaction Support members with condition education, medication reviews,...

HSS Coordinator-Central Harris County-Downtown, TX
Houston, TX
Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals f...

HSS Coordinator - Sherman, TX
Sherman, TX
Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals f...

HSS Coordinator - Crockett, TX
Crockett, TX
Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals f...

HSS Coordinator-Fort Bend and Matagorda County, TX
Bay City, TX
Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals f...