• AI Product Manager - AI Center of Excellence…

    Prime Therapeutics (Austin, TX)
    …we make. **Job Posting Title** AI Product Manager - AI Center of Excellence - Remote **Job Description** **Prime is standing up a new AI Center of Excellence! We are ... we are a different kind of PBM. We're reimagining pharmacy solutions to provide the care we would want...about simplifying health care, let's build the future of pharmacy together. Prime Therapeutics LLC is proud to be… more
    Prime Therapeutics (10/14/25)
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  • Team Lead East - Senior Director, US Medical…

    Merck (Austin, TX)
    …Excellence, People Leadership, Personnel Administration, Pharmaceutical Medical Affairs, Pharmacy Regulation, Project Human Resource Management, Project Management, ... by site or organization, with Friday designated as a remote -working day, unless business critical tasks require an on-site...not apply to roles that have been designated as " remote ". The salary range for this role is $206,200.00… more
    Merck (11/20/25)
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  • AS400 Synon Technical Lead ( Remote )

    Cognizant (Austin, TX)
    …testing and provide technical support throughout the project lifecycle **Work model: Remote ** We strive to provide flexibility wherever possible. Based on this ... role's business requirements, this is a remote position open to qualified applicants in the **United...you stand out** + Prior experience in healthcare or pharmacy systems (RxClaim) + Familiarity with deployment validation and… more
    Cognizant (11/25/25)
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  • Coding Quality Auditor, HEDIS * Remote

    Providence (Lubbock, TX)
    …of review of outpatient medical records, hospital records, clinical lab and pharmacy records + Be responsible for collecting data based on standardized methodologies ... an "as needed basis" to fill in for staff vacancies.** **Providence welcomes 100% remote work for applicants who reside in the following states:** + Alaska +… more
    Providence (11/21/25)
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  • Remote Medical Director

    Centene Corporation (Austin, TX)
    …benefits including a fresh perspective on workplace flexibility. **We're Hiring: Remote Medical Directors** Centene Corporation is a leading provider of ... effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals. +… more
    Centene Corporation (11/07/25)
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  • Case Manager, Registered Nurse - Fully…

    CVS Health (Austin, TX)
    …do it all with heart, each and every day. **Position Summary** **This is a remote work from home role anywhere in the US with virtual training.** American Health ... years' current or previous experience in Oncology, Transplant, Specialty Pharmacy , Pediatrics, Medical/Surgical, Behavioral Health/Substance Abuse or Maternity/ Obstetrics… more
    CVS Health (12/02/25)
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  • Patient Account Services Specialist…

    CVS Health (Austin, TX)
    …including but not limited to 8-hour work shifts from 8:00am-8:00pm EST (Monday-Friday) + Remote Role **What you will do:** + Develop a deep understanding of CVS ... collections practices, and/or infusion services. + 1 year experience in pharmacy billing and reimbursement. **Education** + Verifiable High-school diploma or GED… more
    CVS Health (12/02/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Austin, TX)
    …highly preferred Work hours: Monday- Friday 8:00am - 5:00pm Central time Remote position **Essential Job Duties** * Performs clinical/medical reviews of previously ... experience as needed (such as specialties in: surgical, ob/gyn, home health, pharmacy , etc.), or equivalent combination of relevant education and experience. *… more
    Molina Healthcare (11/14/25)
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  • Representative, Provider Relations HP…

    Molina Healthcare (Dallas, TX)
    …would occur to discuss and resolve issues related to utilization management, pharmacy , quality of care, and correct coding. * Independently delivers training and ... presentations to assigned providers and their staff, answering questions that come up on behalf of the Health plan. May also deliver training and presentations to larger groups, such as leaders and management of provider offices (including large multispecialty… more
    Molina Healthcare (11/28/25)
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  • Senior Analyst, Quality Analytics & Performance…

    Molina Healthcare (Austin, TX)
    …+ Analysis and reporting related to Managed care data like Medical Claims, Pharmacy , Lab and HEDIS rates. + Assist Quality department with HEDIS measure deep ... dive to support HEDIS audit and revenue at risk reporting. + Calculate and track HEDIS rates for all intervention outcome and for overall markets and LOB. + Work in an agile business environment to derive meaningful information out of complex as well as large… more
    Molina Healthcare (11/27/25)
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