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...

On Site RN Case Manager - Community Transitional Center - San Diego, CA
San Diego, CA
Assess, plan, implement, coordinate, monitor, and evaluate case management activities for offenders being released from state and local prison and for those currently residing at the Com...

Senior Clinical Administrative Coordinator - Richardson, TX
Richardson, TX
Make calls to qualified members to provide information and answer questions about health plan programs. Provide "best in class" customer service to enrollees Meet established productivit...

Director Compensation, UHC Global - Remote
Minnetonka, MN
The UHC Director Compensation will lead all total rewards related strategies and activities in support of the Segment goals including Provide a full spectrum of consulting and analytical...

HSS Clinical Coordinator RN - Telephonic
New York, NY
Serve as primary care manager for members with complex medical/behavioral needs Engage members telephonically to complete a comprehensive needs assessment, including assessment of medica...

Health Plan CEO, Illinois - Community & State
Minnetonka, MN
Create an overall vision for the health plan team to ensure they can navigate a rapidly changing industry and leverage innovation to capture opportunities for growth and/or improvement D...

HSS Clinical Care Coordinator - Johnson County, KS Market
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...

Associate Director, Healthcare Economics - Remote
Minnetonka, MN
Partners with business leaders to scope, create and execute business analytics using the appropriate data aggregation and visualization tools Creates backlog and prioritization methodolo...

Medical Coder
Wausau, WI
Receive assigned provider inquiries and perform a code review on both professional and facility claims Make determinations on cases after a coding review is complete Review various edits...