Audit & Reimbursement SeniorLocation: This is a virtual position; US based.National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and......
Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & AbuseLocation: This position will work a hybrid model (remote and office). The ideal candidate will live within 50......
Pharmacy Internal AuditorLocation: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.A proud member of the......
Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & AbuseLocation: This position will work a hybrid model (remote and office). The ideal candidate will live within 50......
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Location: This is a virtual role. The preferred candidate will live within 50 miles of one of our listed California Elevance Health PulsePoint locations.The Behavioral Health Case Manager 1 is......
Location: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance......
***$5,000 Sign On Bonus***LTSS Service CoordinatorLocation: This is primarily a field based position. Candidate would need to reside in one of the following counties: Escambia, Broward, Volusia, Marion, Pinellas, Hillsbor...
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Provider Contract Cost of Care Analyst Senior Location: This position will work a hybrid model (remote and in office one day per week). Ideal candidates will live within 50 miles of......
Marketplace Facilitated Enroller (Bilingual Chinese/Korean)Location: This is a field-based position including outdoor and indoor marketing. Candidates will work in provider offices, clinics, community-based organizations,...
Audit & Reimbursement SeniorLocation: This is a virtual position; US based.National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and......
Associate ActuaryLocation: Elevance Health operates in a Hybrid Workforce Strategy, providing various levels of flexibility while also ensuring that associates have opportunities to connect in-person. Unless in a designat...
JR139503 Genetic Counselor ReviewerThe genetic counselor reviewer (GCR) is responsible for authorization requests and determining their appropriateness per designated clinical guidelines, clinical policies, and client rul...
Location: This is a Virtual role , Must be located within 50 miles of a Pulse PointSchedule: 9:30am-6:00pm , Rotating weekend shifts.Responsible for conducting preauthorization, out of network and appropriateness......
Pharmacist ClinicalLocation: Virtual with 1-3 days/week in the field meeting with providers around Northern Florida. The ideal candidate will live within 50 miles of the Tampa, Florida PulsePoint location.A proud......
West Chester Township, Ohio
9 days
Location: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance......
Pharmacy Internal AuditorLocation: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.A proud member of the......
Location: This is a virtual role. The preferred candidate will live within 50 miles of one of our listed California Elevance Health PulsePoint locations.The Behavioral Health Case Manager 1 is......
Winston Salem, North Carolina
9 days
The Children and Families Specialty Plan is looking to hire a Director of Care Management to lead the care management team in Medicaid Regions 1 and 2 in the state of North......
Provider Collaboration Manager Sr (Value-Based Contracting) JR138366Location: Candidates must reside within 50 miles and 1-hour commute each way of our Manchester, NH Elevance Health location. Candidates in nearby states ...
Provider Economics DirectorLocation: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of......
Audit & Reimbursement SeniorLocation: This is a virtual position; US based.National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and......
Manchester, New Hampshire
9 days
Provider Contract/CofC Analyst Sr.Location: This position will work a hybrid model (remote and in-office, 1 - 2 days per week). Candidates must live within 50 miles of one of Elevance’s......
$10,000 sign on bonus!Position specific details: The successful hire will be a Michigan licensed NP and will provide in-home and virtual remote palliative care in the Grand Rapids, MI, area. ......
JR140167 Provider Relationship Account Manager (TPA)Carelon Behavioral Health, Inc. is enthusiastically supporting the launch of the Statewide School-Based Fee Schedule project by the Department of Health Care Services (D...
Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & AbuseLocation: This position will work a hybrid model (remote and office). The ideal candidate will live within 50......
Clinical Provider Auditor IISupports the Payment Integrity line of businessLocation: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will......
Provider Network Management Director (JR136035)Location: Must reside in New Hampshire or outlying state and requires residence within 50 miles and 1 hour commute of our Manchester, NH office.Hybrid Work Strategy:......
***$6,000 Sign On Bonus***LTSS Service Coordinator - ClinicianLocation: This is a field based position. Candidate would need to reside in one of the following counties: Lee, Sarasota, Hillsborough, Pinellas, Escambia, Duv...
Actuarial Director - Wellpoint GICPreferred Location: Woburn, MA. This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our......
Audit & Reimbursement SeniorLocation: This is a virtual position; US based.National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and......
Be Part of an Extraordinary Team Medical Management Specialist ILocation: Remote, but candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.Shift: Part-Time Days,......
Location: This is a virtual role. The candidate will live within 50 miles of one of our Florida Elevance Health PulsePoint locations in Miami or Tampa Florida. Schedule: 12 noon- 8:30 pm......
Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & AbuseLocation: This position will work a hybrid model (remote and office). The ideal candidate will live within 50......
Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & AbuseLocation: This position will work a hybrid model (remote and office). The ideal candidate will live within 50......
Business Information Developer ConsultantLocation: This position will work a hybrid model (remote and in office 1 - 2 days per week). Ideal candidates will live or be willing to relocate to......
Provider Contract/CofC Analyst Sr.Location: This position will work a hybrid model (remote and in-office, 1 - 2 days per week). Candidates must live within 50 miles of one of Elevance’s......
Location: Field associates spend 4-5 days per week in-person with patients, members or providers in the following counties: Wayne, Fayette, Rush, Union, and Franklin counties.The Case Manager- LCSW/LSW/LMSW/LMHC/LMFT (als...
Centers Health Care is a member of the Elevance Health family of companies, serving as a premier network of skilled nursing, rehabilitation, and senior care services. Our goal is to......
Internal Audit ManagerElevance Health supports a hybrid workplace model (virtual and in-office) with PulsePoint sites used for collaboration, community, and connection. This position will take part in the hybrid workforce...
Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & AbuseLocation: This position will work a hybrid model (remote and office). The ideal candidate will live within 50......
East Hartford, Connecticut
9 days
Bilingual Behavioral Health Care Coordinator***$1,500 Sign-On Bonus******Seeking a BH Care Coordinator in Connecticut with expertise in case management, human services, family and/or community resources.***Location : This...
Location: This position is located in the state of Kansas and must reside within 50 miles of our Topeka or Olathe PulsePoint.The Clinical Quality Program Specialist is responsible for supporting......
Audit & Reimbursement SeniorLocation: This is a virtual position; US based.National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and......
Be Part of an Extraordinary Team Medical Management Specialist ILocation: Remote, but candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.Shift: Part-Time Days,......
Title: Utilization Management Representative IILocation: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.The Utilization Management...
Provider Economics DirectorLocation: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of......
The Wellness & Recovery Specialist is responsible for care coordination activities focused on the Wellness and Recovery of members.Location: Remote. The ideal candidates will reside in the following states: Washington...
Pharmacy Internal AuditorLocation: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.A proud member of the......
Marketplace Facilitated Enroller (Bilingual Chinese/Korean)Location: This is a field-based position including outdoor and indoor marketing. Candidates will work in provider offices, clinics, community-based organizations,...
Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & AbuseLocation: This position will work a hybrid model (remote and office). The ideal candidate will live within 50......
Job Title: Customer Care Representative I - FEPLocation: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of our Elevance Health PulsePoint......
Location: This is a Virtual role , Must be located within 50 miles of a Pulse PointSchedule: 9:30am-6:00pm , Rotating weekend shifts.Responsible for conducting preauthorization, out of network and appropriateness......
Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & AbuseLocation: This position will work a hybrid model (remote and office). The ideal candidate will live within 50......
Senior Outreach Care SpecialistLocation : This is a community, field based position (3-5 days per week). We are seeking candidates that reside in the following counties in Indiana : Clark,......
Actuarial Director - Wellpoint GICPreferred Location: Woburn, MA. This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our......
Internal Audit ManagerElevance Health supports a hybrid workplace model (virtual and in-office) with PulsePoint sites used for collaboration, community, and connection. This position will take part in the hybrid workforce...
Clinical Provider Auditor IISupports the Payment Integrity line of businessLocation: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will......
Be Part of an Extraordinary Team BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus......
Manchester, New Hampshire
9 days
Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & AbuseLocation: This position will work a hybrid model (remote and office). The ideal candidate will live within 50......
Bilingual Behavioral Health Care Coordinator***$1,500 Sign-On Bonus******Seeking a BH Care Coordinator in Connecticut with expertise in case management, human services, family and/or community resources.***Location : This...
***$5,000 Sign On Bonus***LTSS Service CoordinatorLocation: This is primarily a field based position. Candidate would need to reside in one of the following counties: Escambia, Broward, Volusia, Marion, Pinellas, Hillsbor...
Location: This position is located in the state of Kansas and must reside within 50 miles of our Topeka or Olathe PulsePoint.The Clinical Quality Program Specialist is responsible for supporting......
Carelon Medical Benefits Management is currently seeking a Board-Certified Surgeon (or other surgical subspecialties beyond general surgery) to participate in pre-authorization and quality improvement solutions for a wide...
Software Engineering ManagerLocation: This position will work a hybrid model (remote & office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint office locations.National......
Internal Audit ManagerElevance Health supports a hybrid workplace model (virtual and in-office) with PulsePoint sites used for collaboration, community, and connection. This position will take part in the hybrid workforce...
Location: This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.The Strategic Sourcing......
Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health PulsePoint location.Schedule: First shift PST daytime hoursThe Behavioral Health Care Manager I is responsible for perfor...
Pharmacy Internal AuditorLocation: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.A proud member of the......
Location: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance......
Location: This is a field position and the candidate should reside in Dallas, TX.The LTSS Service Coordinator - Clinician working under the direction/supervision of an RN, with overall responsibility for......
The Med Mgmt Nurse CA is responsible for review of the most complex or challenging cases that require nursing judgment, critical thinking, and holistic assessment of member’s clinical presentation to......
Provider Contract/CofC Analyst Sr.Location: This position will work a hybrid model (remote and in-office, 1 - 2 days per week). Candidates must live within 50 miles of one of Elevance’s......
Behavioral Health Outreach Care SpecialistLocation : This is a hybrid role. Associates will be working from home and out in the community (up to 40% of the time will be......
Provider Relationship Account Manager, Community Engagement Louisiana Crisis HubLocation: This is a field-based position for the state of Louisiana. You must reside within the assigned coverage area within Louisiana.Regio...
***$5,000 Sign On Bonus***LTSS Service CoordinatorLocation: This is primarily a field based position. Candidate would need to reside in one of the following counties: Escambia, Broward, Volusia, Marion, Pinellas, Hillsbor...
Charleston, West Virginia
9 days
Nurse and CPC - Clinical Fraud Investigator II - SIU Fraud & AbuseLocation: This position will work a hybrid model (remote and office). The ideal candidate will live within 50......
Location: This is a field based position. Candidate would need to meet face to face with patients in and around Pottawattamie (and surrounding) Counties, IA. The LTSS Service Coordinator is responsible for conducting......
Location: This is a Virtual role , Must be located within 50 miles of a Pulse PointSchedule: 9:30am-6:00pm , Rotating weekend shifts.Responsible for conducting preauthorization, out of network and appropriateness......
Audit & Reimbursement SeniorLocation: This is a virtual position; US based.National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and......
Manager II GBD Special Programs, LTSSLocation: This position is an Indiana field-based position. This role requires face to face interactions in the field – mileage reimbursed. (hospitals, clinics, members’ homes.)The.....
$10,000 sign on bonus!Position specific details: The successful hire will be a Michigan licensed NP and will provide in-home and virtual remote palliative care in the Grand Rapids, MI, area. ......
Title: Concierge Service AssociateLocation: This position will work an onsite model, where candidates will travel to client location in Normal, IL.The Concierge Service Associate will be responsible for assisting national...
LTSS Service CoordinatorLocation: This is a field based position. Candidate would need to meet face to face with patients in and around the following counties. Candidate will be assigned a territory......
LTSS Service Coordinator - RN Telehealth Location: While this position is fully remote, candidate must reside in the tri-state area (NY, NJ, or CT) and within 50 miles of a PulsePoint.The......
Business Consultant Location: Elevance Health operates in a Hybrid Workforce Strategy, providing various levels of flexibility while also ensuring that associates have opportunities to connect in-person. Unless in a desig...
Diagnosis Related Group Clinical Validation Auditor-Registered Nurse Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.The....
Business Consultant Location: Elevance Health operates in a Hybrid Workforce Strategy, providing various levels of flexibility while also ensuring that associates have opportunities to connect in-person. Unless in a desig...
HEDIS Compliance Audit Specialist / Manager (JR140903)Location: Alternate locations in addition to the posted locations may be considered. This position will work in a hybrid model (remote and office). The......
Centers Health Care is a member of the Elevance Health family of companies, serving as a premier network of skilled nursing, rehabilitation, and senior care services. Our goal is to......
Location: Field associates spend 4-5 days per week in-person with patients, members or providers.The Case Manager- LCSW/LSW/LMSW/LMHC/LMFT (also called the LTSS Service Coordinator - Clinician) has overall responsibility ...
Diagnosis Related Group Clinical Validation Auditor-RN Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.The Diagnosis......
Business Consultant Location: Elevance Health operates in a Hybrid Workforce Strategy, providing various levels of flexibility while also ensuring that associates have opportunities to connect in-person. Unless in a desig...
Staff VP & CIO, Carelon Advanced Primary & Palliative Care Location: Within 50 miles of a PulsePoint office preferably Costa Mesa, CA, Altanta, GA, Indianapolis, IN, or Grand Prairie, TX Summary The Staff......
Location: This is a Virtual role , Must be located within 50 miles of a Pulse PointSchedule: 9:30am-6:00pm , Rotating weekend shifts.Responsible for conducting preauthorization, out of network and appropriateness......
Field Advanced Practice ProviderLocation and position specific details: The successful hire will be a Missouri licensed NP and will provide in-home and virtual remote palliative care in the St.Louis, MO,......
Audit & Reimbursement LeadLocation: This is United States, virtual based position. National Government Services is a proud member of Elevance Health’s family of brands. We administer government contracts for Medicare...
Audit & Reimbursement LeadLocation: This is United States, virtual based position. National Government Services is a proud member of Elevance Health’s family of brands. We administer government contracts for Medicare...
Location: This is a field position and the candidate should reside in Houston, TX.The LTSS Service Coordinator - Clinician working under the direction/supervision of an RN, with overall responsibility for......
Audit & Reimbursement LeadLocation: This is United States, virtual based position. National Government Services is a proud member of Elevance Health’s family of brands. We administer government contracts for Medicare...
Location: This is a virtual position , must be located within 50 miles of the nearest pulse point.Schedule : Monday-Friday 9:30am-6:00pm PSTResponsible for the review of medical records to determine......
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