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......
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......
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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......
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...
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......
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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......
Winston Salem, North Carolina
16 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......
Manchester, New Hampshire
16 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......
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......
***$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......
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......
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......
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
16 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...
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......
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......
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......
Manchester, New Hampshire
16 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...
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 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......
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 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......
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
16 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......
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.....
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......
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: 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......
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......
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......
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......
Please note: This role has a field component where the successful hire would be meeting with members in-person either in homes and/or in facilities. The hire would need to be......
Referral & Resource SpecialistLocation: This is a remote position. Candidates must reside in one of the following states : MASSACHUSETTS, NEW HAMPSHIRE, CONNECTICUT, RHODE ISLAND OR NEW YORK. Build the......
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......
Oncology Medical Director- Commercial National Division Location: Alternate locations may be considered. This position will work a hybrid model (remote and office). The ideal candidate will must live within 50......
Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health PulsePoint location.Schedule: First shift PST daytime hoursBehavioral Health Case Manager II The Behavioral Health Case M...
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 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......
Be Part of an Extraordinary Team 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......
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......
DLP EngineerLocation: 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.The DLP......
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......
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......
DLP EngineerLocation: 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.The DLP......
Clinical Provider Auditor IISupports Payment Integrity & Behavioral Health Location: This is a field position expected to be in clinic 60% of the time (2-3 days/week) with the other 40%......
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......
Consumer Experience Analytics & Insights Analyst SeniorLocation: This position will work a hybrid model (remote and in office 1 - 2 days per week). Ideal candidates will live within 50......
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......
Medical Director- West Region Medicaid Location: Alternate locations may be considered. This position will work a hybrid model (remote and office). The ideal candidate will must live within 50 miles......
Woodbridge Township, New Jersey
16 days
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....
Consumer Experience Analytics & Insights Analyst SeniorLocation: This position will work a hybrid model (remote and in office 1 - 2 days per week). Ideal candidates will live within 50......
Location: Field associates spend 4-5 days per week in-person with patients, members or providers.The LTSS SERVICE COORDINATOR is responsible for conducting service coordination functions for a defined caseload of individu...
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....
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......
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......
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......
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......
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....
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......
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......
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......
Location: Field associates spend 4-5 days per week in-person with patients, members or providers The RN Case Manager (LTSS Service Coordinator- RN) is responsible for overall management of member's case within......
Be Part of an Extraordinary Team A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving and life-giving infusible and injectable drug......
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...
Be Part of an Extraordinary Team A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving and life-giving infusible and injectable drug......
Blue Ridge Manor, Kentucky
16 days
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...
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...
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 field-based role where the majority of time is working out in the field/community. Candidates must live in Kansas to be considered.......
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......
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......
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......
Be Part of an Extraordinary Team A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving and life-giving infusible and injectable drug......
Be Part of an Extraordinary Team A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving and life-giving infusible and injectable drug......
Be Part of an Extraordinary Team A proud member of the Elevance Health family of companies, Carelon Global Solutions, formerly Legato Health Technologies is a managed service delivery organization, providing information....
Be Part of an Extraordinary Team A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving and life-giving infusible and injectable drug......
Be Part of an Extraordinary Team A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving and life-giving infusible and injectable drug......
Distribution AssociateThe Distribution Associate is responsible for preparing items for shipment, processing incoming stock, and restocking packing supplies. How you will make an impact:Picks product, packages shipments ...
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......
Behavioral Health Outreach Care SpecialistLocation : This is a field-based role where the majority of time is working out in the field/community. Candidates must live in Kansas to be considered.......
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......
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