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....
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......
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......
Manager Clinical Quality – HEDIS (JR142001)Location: This position is part of our Hybrid 1 workplace strategy and requires work in the local office at least 1 day each week. Will......
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Actuarial Director - Stop LossLocation: 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......
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......
Nutritional Consultant Sr Location: Open to any Elevance Health office location (Pulse Point).Hours: This position will work Monday Thru Friday on 9:00am-5:30 pm, ET. Although this position is virtual, Our Ideal......
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Business Change Manager, Senior – Special Investigation Unit - Fraud and AbuseLocation: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles......
Business Information ManagerLocation: This position will work on hybrid model (remote and office). Candidates must live within 50 miles of one of our Elevance Health PulsePoint locations. Ideal locations include;......
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...
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......
A proud member of the Elevance Health family of companies, Carelon Behavioral Health, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life su...
Location: Virtual; within 50 miles of any Elevance Health PulsePoint locationShift: Monday – Friday; 11:30am – 8:00pm ETThe Behavioral Health EAP Consultant II is responsible for providing 24/7 Behavioral Health......
Technology Compliance Auditor AdvisorLocation: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.The......
Corporate Communications Director Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.The......
Location: This is a virtual position , must be located within 50 miles of an Elevance Health Pulse Point.Shift: Monday-Friday , 8am-5pmResponsible for the discovery, validation, recovery, and adjustments of......
Location: This is a Virtual role , Must be located within 50 miles of a Pulse PointSchedule: Monday- Friday 9:30am-6:00pm , Rotating weekend shifts.Responsible for conducting preauthorization, out of network......
Business Information Consultant - AILocation: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one 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......
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......
Location: Virtual; within 50 miles of any Elevance Health PulsePoint locationShift: See example schedules below; Training will be up to 3 weeks on day shift, hours, 8:30am - 5:00pm schedule......
The Medical Director, Cardiology is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers. In this role, you will participate in pre-authorizatio...
Nurse/CPC - Clinical Fraud Investigator II - SIU Fraud & AbuseLocation: Alternate locations may be considered. This position will work a hybrid model (remote and office). The ideal candidate will......
Medicaid Product Management Director for VisionLocation: Alternate locations may be considered. This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of......
Competitive Intelligence Developer SeniorLocation: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.The......
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...
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...
Location: This is a Virtual role , Must be located within 50 miles of a Pulse PointSchedule: Monday-Friday 9:30am-6:00pm , Rotating weekend shifts.Responsible for conducting preauthorization, out of network and......
Security Analyst IIILocation: Ideal candidates will live or be willing to relocate to within 50 miles of one of our Pulse Point locations.Work Hours: Monday to Friday, 8:00 am to......
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...
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......
A proud member of the Elevance Health family of companies, Carelon Behavioral Health, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life su...
Clinical Operations Associate Medical DirectorCarelon Medical Benefits ManagementLocation: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will liv...
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......
Clinical Engine Designer Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint office locations.Preferred......
Provider Network Manager Sr – Contracting (JR141375)Location: St. Louis or Chicago preferred. Qualified candidates must reside within 50 miles and 1-hour commute each way of an open 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......
VoC Analysis & Insights ManagerLocation: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint......
A proud member of the Elevance Health family of companies, Carelon Research, formerly HealthCore, Inc., works with life sciences companies, payers and providers, and government and academic organizations to provide......
Business Information Analyst IILocation: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.The......
Nurse/CPC - Clinical Fraud Investigator Senior - SIU Fraud & AbuseLocation: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate......
Financial ConsultantLocation: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.The Financial Consultant......
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...
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......
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......
Hours: 10am-630pm ESTLocation: The successful hire will be required to be within 50 miles of one of our company locations (Pulse Point).Please note: The Peer Specialist Certification is required for......
Provider Contract/Cost of Care ConsultantWe are offering a $5,000 sign-on bonus for this position.Location: This position will work a hybrid I model (remote and in office 1-2 days per week).......
Director, Program Management – Strategic Initiatives Execution Location: Alternate locations may be considered. This position will work a hybrid model (remote and office). The Ideal candidate will live within 50......
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......
Clinical Operations Associate Medical DirectorCarelon Medical Benefits ManagementLocation: Alternate locations may be considered. The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint loca...
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