• Clinical Compliance Medical Director

    Elevance Health (Grand Prairie, TX)
    …to false claims strongly preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement ... (AOA). + Requires active unrestricted medical license to practice medicine or a health profession. + Clinical training and practice as a primary care physician… more
    Elevance Health (09/24/25)
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  • Quality/Risk Specialist II - Full Time…

    Henry Ford Health System (Detroit, MI)
    …continuum of services - from primary and preventative care to complex and specialty care, health insurance , a full suite of home health offerings, virtual ... of events which may injure patients, lead to malpractice claims , and cause loss to the health care system. The QRS II collaborates with multidisciplinary … more
    Henry Ford Health System (09/24/25)
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  • Nurse Case Mgr I (US)

    Elevance Health (Washington, DC)
    …coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site ... make an impact:** + Ensures member access to services appropriate to their health needs. Conducts assessments to identify individual needs and a specific care… more
    Elevance Health (09/24/25)
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  • Associate Actuary

    Elevance Health (Louisville, KY)
    …models. + Responsible for recommendations on pricing, marketing, product design, claims , premium and enrollment administration of business unit. + Responsible for ... strongly preferred. + Medicare experience preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed… more
    Elevance Health (09/23/25)
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  • Prior Authorization Intake Specialist, Michigan…

    McLaren Health Care (Flint, MI)
    …Services to bring you the Hoosier Healthwise and Healthy Indiana Plan health insurance programs. Learn more about MDwise, Inc. at https://www.mdwise.org/ ... Group (MIG) is a fully owned subsidiary of McLaren Health Care Corporation and is the parent company of...and knowledge of Medicare, HMO, PPO, TPA, PHO and Managed Care functions (eg administration, medical delivery, claims processing,… more
    McLaren Health Care (09/22/25)
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  • Case Manager Registered Nurse, Michigan - McLaren…

    McLaren Health Care (Flint, MI)
    …and Medicaid to bring members the Hoosier Healthwise and Healthy Indiana Plan health insurance programs. Learn more about MDwise, Inc. at https://www.mdwise.org ... Group (MIG) is a fully owned subsidiary of McLaren Health Care Corporation and is the parent company of...TPA, PHO and Managed Care functions including understanding of claims administration, including CPT-4 codes, revenue codes, HCPCS codes,… more
    McLaren Health Care (09/22/25)
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  • Medical Assistant Certified

    Virginia Mason Franciscan Health (Issaquah, WA)
    …tasks, such as scheduling appointments, maintaining medical records, and processing insurance claims + Providing excellent customer service to patients ... **Job Summary and Responsibilities** **Join Virginia Mason Franciscan Health in Beautiful Issaquah!** Are you a passionate and organized individual looking for a… more
    Virginia Mason Franciscan Health (09/21/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Indianapolis, IN)
    …coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically. **How you ... + Ensures member access to services appropriate to their health needs. + Conducts assessments to identify individual needs...as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
    Elevance Health (09/20/25)
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  • Clerk II

    Elevance Health (Latham, NY)
    …cleans and maintains various types of equipment for purposes of filming claims , correspondence and other related documents. + Receives, sorts, and distributes ... $17.80 to $26.71 Locations: New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition… more
    Elevance Health (09/20/25)
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  • Clinical Risk Manager - Risk Management

    UNC Health Care (Chapel Hill, NC)
    …risk management consultation to all physician and employees insured by UNC Health 's self- insurance programs. Prepares and presents reports to management ... inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. **Summary** : The… more
    UNC Health Care (09/19/25)
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