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Nursing Jobs
SHIFT: Work From Home SCHEDULE: Full-time Are you looking for an organization that places integrity over their bottom line? Here at HCA Healthcare, our everyday decisions are founded on compassion. Apply today and join a team that is dedicated to serving others in need. We want to ensure your needs are met. We offer a variety of comprehensive medical, dental,
This position works under the direction of the CQM Manager. The individual in this role will focus on investigating behavioral health potential quality issues, patient safety events, and sentinel/serious reportable events and utilization issues by conducting retrospective chart and focused reviews. Participate on quality committees. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on
Start date: 2/17/2020 Hours: M-F 8-4:30 Location: Remote Pay: $30-$33 Duties The Clinical Medical Record Abstraction/Over-read nurse works under the direction of the HEDIS Clinical Lead and other company personnel. These home-based positions are responsible for working independently to review, abstract pertinent medical record information, and/or validate accuracy of abstraction in accordance with multiple study criteria. The information to be abstracted will be obtained
• Applies medical judgment to adjudication of cases/claims. • Reviews request for denial reconsideration and appeals. • Manually price and review claims for appropriateness of care or coverage, may include drugs and medical supplies. • Work directly with client to provide input in accordance with program policy or procedural requirements. A min of 2 years clinical exp req’d Min 1
We are looking to hire a Drug Safety Assistant for our team! It can be for Remote basis within U.S. Responsible for assisting with the smooth running of the PV&DSS Department to ensure all adverse events are processed to the required standard and submitted to the client and the regulatory agencies (if required) within the agreed upon timelines. This post
SHIFT: Work From Home SCHEDULE: Full-time Are you looking for an organization that places integrity over their bottom line? Here at HCA Healthcare, our everyday decisions are founded on compassion. Apply today and join a team that is dedicated to serving others in need. At HCA Healthcare, you have options. Choose from a variety of benefits to create a customizable
Description The Associate Director, Payment Integrity uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our financial recovery. The Associate Director, Payment Integrity requires a solid understanding of how organization capabilities interrelate across department(s). Responsibilities Humana Government Business is responsible for administering the military healthcare
RESPONSIBLE FOR: Reviewing clinical documentation to facilitate the accurate representation of the severity of illness, expected risk of mortality, and complexity of care by improving the quality of the physician’s clinical documentation. This work involves extensive record review and interaction with physicians, HIM/Coding professionals, nursing staff, and case management. Through collaboration with Coding professionals, educates the patient care team on
***Position is remote, can live anywhere in the US. However, must be willing to work 8am-5pm PST schedule. Responsible for investigating and processing the most complex grievances and appeals requests from members and providers. Primary duties may include, but are not limited to: Conducts investigations and reviews of member and provider grievances and appeals. Reviews prospective, inpatient, or retrospective medical
Grievance & Appeals Analyst II Responsible for reviewing, analyzing and processing non-complex pre service and post service grievances and appeals requests from customer types (i.e. member, provider, regulatory and third party) and multiple products (i.e. HMO, POS, PPO, EPO, CDHP, and indemnity) related to clinical and non-clinical services, quality of service, and quality of care issues to include executive and
NP & PA Jobs
We are looking to hire a Drug Safety Assistant for our team! It can be for Remote basis within U.S. Responsible for assisting with the smooth running of the PV&DSS Department to ensure all adverse events are processed to the required standard and submitted to the client and the regulatory agencies (if required) within the agreed upon timelines. This post
Description The Associate Director, Payment Integrity uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our financial recovery. The Associate Director, Payment Integrity requires a solid understanding of how organization capabilities interrelate across department(s). Responsibilities Humana Government Business is responsible for administering the military healthcare
This is a remote position that covers WA, OR, CA, AZ, CO. The candidate must be located in one of those states. This role is to be the single point of contact to provide case management support to Cosentyx patients. The Patient Services Liaison is responsible for coordinating and delivering resources and information to support the patient and their experience
We are looking for a clinical product development associate (physician, pharmacist, or nurse practitioner) to work with our team of physicians, pharmacists, and nurses in developing the medical content used in our products. We are searching for a candidate who is enthusiastic in improving healthcare, thrives in a rapidly moving startup atmosphere, and has a passion for creatively tackling complex
This position is for the Safety Call Center, where associates are responsible for collecting adverse event information, product complaint information and providing medical information to consumers and HCPs. The work is typically fast-paced, requiring the ability to multi-task throughout the day on various activities, and to be able to work comfortably and simultaneously in multiple technological systems and programs (eg Call
Looking for a Tech-Savvy Nurse Practitioners who want great work-life balance and have aspirations to grow with a wonderful company! The Nurse Practitioner provides exemplary telemedicine experiences for patients seeking contraceptive services through The Pill Club. The Nurse Practitioner works closely with patient care coordinators, triage nurses, and pharmacy in a positive start-up environment. The Nurse Practitioner must demonstrate expertise
Are you looking for an innovative primary care practice model that uses technology and healthcare data to empower patients to take greater ownership and accountability over their healthcare? At Forward, we believe that the future of medicine combines the best attributes of healthcare professionals with the efficiency and grace of innovative technology. We’re looking for Nurse Practitioners who are certified
We’re looking for Nurse Practitioners (NPs) who are certified by the Board of Nursing, who have 5+ years of primary care experience, and who are interested in working to define Nurse Practitioner clinical quality standards in telemedicine. Ideal candidates will be strong communicators who are motivated to provide high quality, constructive, clinical feedback to peer NPs. You can read Forward’s story here, as
LovetoKnow.com is a growing internet content site that aims to help people solve problems, get advice, and find information from authoritative experts. We are currently looking for a staff writer to join our editorial team. We are looking for writers with a solid background in the medical field. This includes doctors, nurses, paramedics, and so on. While strong writing skills are
Chamberlain College of Nursing is seeking Part Time Online Visiting Professors interested in teaching students in our RN to BSN Program. We build long-term relationships with superior nurse educators who are experts in their field and committed to providing the finest in practitioner-focused education. This is 100% ONLINE teaching, an incredibly flexible and convenient way to share your experience and knowledge with those who aspire to enjoy the
Mental Health Jobs
ProtoCall Remote Crisis Counselor: Telecommuting Position ProtoCall is a resilient team that works around the clock to provide immediate help for those in crisis. We are hiring fully remote Counselors and Social Workers. If you have a Master’s degree and are licensed or registered with your state board we are interested in discussing this work from home opportunity with you. What does
This position works under the direction of the CQM Manager. The individual in this role will focus on investigating behavioral health potential quality issues, patient safety events, and sentinel/serious reportable events and utilization issues by conducting retrospective chart and focused reviews. Participate on quality committees. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on
The Patient Success team is responsible for working directly with patients to connect them to mental healthcare providers. We respond to referrals from a patient’s Primary Care Provider and proactively reach out to patients who have untreated or mismanaged mental health needs. As a member of the Patient Success team, you will work directly with patients to administer mental health assessments
Med Exam Group, LLC is looking for qualified candidates to perform Independent Medical Examinations for our clients. The ideal candidate has experience working with military personnel or veterans and has a minimum of 6 months experience providing tele-mental health services. This is a remote position in which the right candidate would complete extensive tele-mental health evaluations with guidance and supervision.
Cactus Communications is a pioneer in language services, serving more than 60,000 clients across 116 countries. We engage a global team of highly skilled freelance editors who are experts in various academic fields. Cactus Communications has consistently ranked among the top 20 on the global list of the Top 100 Companies for Telecommute Jobs (Forbes.com) since 2016. We’re currently looking for specialist freelance copyeditors
Adjunct Professors in the MFT programs teach graduate courses within a programmatic core discipline as assigned and/or guide doctoral candidates through doctoral dissertation requirements (as Chair or committee member). This position also provides content expertise to the Dean in areas of Marriage and Family Therapy. Primary responsibility is to engage students, offer excellent feedback, and inspire students to achieve course
The School of Social and Behavioral Sciences, Department of Psychology, is seeking an Adjunct Professor in the following areas of specialization(s): Health Psychology Adjunct faculty members teach courses within a programmatic core discipline as assigned, guide doctoral candidates through doctoral dissertation requirements (as Chair or committee member), and teach doctoral courses. Primary responsibility is to engage students, offer excellent feedback, and
Position Description Consistent with and supportive of CTU’s mission (to provide industry-relevant higher education to a diverse student population through innovative technology and experienced faculty, enabling the pursuit of personal and professional goals), Adjunct Faculty members provide quality and innovative instruction and meaningful engagement with our students to successfully achieve the relevant course, program, and degree level outcomes and support
We are BKA Content, and we pride ourselves on being an actual content provider, not just an automated content broker. Our goal is to become a trusted extension of all businesses, and we need your help! We’re looking for experienced Blog Writers with high-level editing abilities to write and edit blogs that provide tips, guides and helpful information on how families can help
What you’ll be doing: Be part of the solution that takes peer-reviewed, evidence-based approaches to care for patients Coordinate care, track, and report on members over the course of treatment Provide high-touch telephonic support, psychoeducation, and triage to patients Assist patients with coordination of appointments to providers (Spring’s Telehealth therapists and physicians) Manage client crises with support of clinical directors
Allied Health Jobs
We are looking to hire a Drug Safety Assistant for our team! It can be for Remote basis within U.S. Responsible for assisting with the smooth running of the PV&DSS Department to ensure all adverse events are processed to the required standard and submitted to the client and the regulatory agencies (if required) within the agreed upon timelines. This post
Description The Associate Director, Payment Integrity uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our financial recovery. The Associate Director, Payment Integrity requires a solid understanding of how organization capabilities interrelate across department(s). Responsibilities Humana Government Business is responsible for administering the military healthcare
RESPONSIBLE FOR: Reviewing clinical documentation to facilitate the accurate representation of the severity of illness, expected risk of mortality, and complexity of care by improving the quality of the physician’s clinical documentation. This work involves extensive record review and interaction with physicians, HIM/Coding professionals, nursing staff, and case management. Through collaboration with Coding professionals, educates the patient care team on
Grievance & Appeals Analyst II Responsible for reviewing, analyzing and processing non-complex pre service and post service grievances and appeals requests from customer types (i.e. member, provider, regulatory and third party) and multiple products (i.e. HMO, POS, PPO, EPO, CDHP, and indemnity) related to clinical and non-clinical services, quality of service, and quality of care issues to include executive and
The Care Coordinator is responsible for assisting the Care/Case Managers with non-clinical activities such as creating cases and events; providing telephonic outreach to members, providers and community-based organizations; handling member mailings; faxing clinical requests and Individual Health Care Plans on behalf of the care/case managers. The Care Coordinator is assigned to a care management call center or a specific department
We are BKA Content, and we pride ourselves on being an actual content provider, not just an automated content broker. Our goal is to become a trusted extension of all businesses, and we need your help! We’re looking for experienced Blog Writers with high-level editing abilities to write and edit blogs that provide tips, guides and helpful information on how families can help
The Utilization Management Representative is responsible for coordinating cases for precertification and prior authorization review. Primary duties may includes, but are not limited: Managing incoming calls or incoming post services claims work. Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. Refers cases requiring clinical review to a Nurse reviewer. Responsible
The Auditor, DRG Coding & Clinical Validation position has an extensive background in either facility-based nursing and/or inpatient coding and has a high level of understanding in reimbursement guidelines specifically an understanding of the MS-DRG, AP-DRG and APR-DRG payment systems. This position is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of Cotiviti
We are looking for a clinical product development associate (physician, pharmacist, or nurse practitioner) to work with our team of physicians, pharmacists, and nurses in developing the medical content used in our products. We are searching for a candidate who is enthusiastic in improving healthcare, thrives in a rapidly moving startup atmosphere, and has a passion for creatively tackling complex
This position is for the Safety Call Center, where associates are responsible for collecting adverse event information, product complaint information and providing medical information to consumers and HCPs. The work is typically fast-paced, requiring the ability to multi-task throughout the day on various activities, and to be able to work comfortably and simultaneously in multiple technological systems and programs (eg Call
