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Description Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..
Description Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..
Description Job Description Summary Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to ..
... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..
Description Job Description Summary The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations ..
Clinician/ Intake Specialist, Flexible Schedule, Sign-on bonus (Full Time) Location: Providence,RI All staff must be vaccinated for COVID-19 prior to starting work, unless a certified medical exemption accommodation is granted. Proof ..
Crisis Clinician/ Intake Specialist (Full Time) Location: Providence,RI All staff must be vaccinated for COVID-19 prior to starting work, unless a certified medical exemption accommodation is granted. Proof of vaccination must ..
Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..
Crisis Clinician/ Intake Specialist **3,000 Sign on bonus (Full Time) Location: Providence,RI **3,000 Sign on bonus Position Summary: Exciting opportunity to become a member of our dynamic behavioral health emergency services ..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Crisis Clinician/ Intake Specialist (Full Time) Location: Providence,RI Position Summary: Exciting opportunity to become a member of our dynamic behavioral health emergency services team. As a member of this team, you ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
Substance Abuse Specialist, LCDP, $27- $33 Hour, Night Shift (Full Time) Location: East Providence, RI Looking for a challenge? Exciting opportunity to join Rhode Island's first 24/7 behavioral health triage center! ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Crisis Clinician/ Intake Specialist, Flexible Schedule, Sign-on bonus (Full Time) Location: Providence,RI All staff must be vaccinated for COVID-19 prior to starting work, unless a certified medical exemption accommodation is granted. ..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
Description Humana's Marketing organization is seeking an experienced Market Research Lead to join the Market Research Department working remote anywhere in the U.S. This is a newly added role that will ..