• QA Analyst PBM Implementation - Remote

    Prime Therapeutics (Columbus, OH)
    …work experience; HS diploma or GED is required + 2 years of experience within Claims Processing, Audit, Quality or Pharmacy + Must be eligible to work in the United ... (CPhT) or Licensed Practical Nurse certification if working in Medicare + Healthcare , audit, and/or reporting and metrics environment experience + Experience using… more
    Prime Therapeutics (10/12/25)
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  • Group Underwriter Senior

    Elevance Health (Cincinnati, OH)
    …or benefit change increments or decrement. + Communicates with sales, administration and claims to assess the rating and administrative impact or benefit and plan ... dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with...Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of… more
    Elevance Health (10/11/25)
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  • Utilization Management Rep I (US)

    Elevance Health (Mason, OH)
    …make an impact:** + Managing incoming calls or incoming post services claims work. + Determines contract and benefit eligibility; provides authorization for ... dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with...Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of… more
    Elevance Health (10/11/25)
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  • Customer Care Representative I

    Elevance Health (Columbus, OH)
    …written correspondence regarding insurance benefits, provider contracts, eligibility and claims . + Analyzes problems and provides information/solutions. + Operates a ... dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with...Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of… more
    Elevance Health (10/11/25)
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  • Telephonic RN Nurse Case Manager I

    Elevance Health (Mason, OH)
    …problem solving for members and providers related to access to care, vendors, claims or service issues, etc. **Minimum Requirements:** + Requires BA/BS in a health ... dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with...Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of… more
    Elevance Health (10/10/25)
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  • Investigator Assistant - Payment Integrity SIU

    Elevance Health (Mason, OH)
    …you will make an impact: + Collects, researches, and validates bills and claims data against relevant guidelines + Assists in preparation of statistical and ... dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with...Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of… more
    Elevance Health (10/10/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Cincinnati, OH)
    …of reimbursement, as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of utilization/care management ... dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with...Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of… more
    Elevance Health (10/10/25)
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  • Engineer Lead

    Elevance Health (Mason, OH)
    …troubleshooting support strongly preferred. + Knowledge of payment integrity and claims systems is highly preferred. + Experience with Python, Angular/React and ... dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with...Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of… more
    Elevance Health (10/10/25)
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  • Director II Technology

    Elevance Health (Cincinnati, OH)
    …(Kafka) strongly preferred. + 5-7 years leadership experience within claims strongly preferred. + Managed careexperience strongly preferred. For candidates ... dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with...Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of… more
    Elevance Health (10/09/25)
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  • Business Information Analyst (Population Health)

    Elevance Health (Columbus, OH)
    …performance reports (eg for Population Health trends, HEDIS, monitoring KPIs, claims data, provider data, utilization data) and provides notations of performance ... dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with...Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of… more
    Elevance Health (10/09/25)
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