• Clinical Appeals Nurse (RN)

    Molina Healthcare (Omaha, NE)
    …+ Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified Professional in Healthcare Quality + ... Officer on denial decisions. + Resolves escalated complaints regarding Utilization Management and Long-Term Services & Supports issues. + Identifies and reports… more
    Molina Healthcare (08/20/25)
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  • Lead Care Manager

    Prime Healthcare (Kansas City, MO)
    …the surrounding areas. The RN Care Manager requires a strong foundation in healthcare management , proven leadership abilities, and a deep commitment to enhancing ... The Lead Care Manager will be instrumental in guiding care management initiatives, supporting targeted interventions to reduce hospitalizations and emergency visits,… more
    Prime Healthcare (09/06/25)
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  • Quality Improvement & Safety Program Manager…

    Emory Healthcare/Emory University (Atlanta, GA)
    …benchmarks. MINIMUM QUALIFICATIONS: + Bachelor's degree in life science, nursing, healthcare management , business, quality improvement science or related fields. ... the candidate to currently have or will attain Certified Preferred Professional in Healthcare Risk Management certification. + Expected to obtain Professional in… more
    Emory Healthcare/Emory University (09/03/25)
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  • Director of Medical Group Operations

    Prime Healthcare (Des Plaines, IL)
    …#LI-RK1 Qualifications EDUCATION, EXPERIENCE, TRAINING + Bachelor's degree in business or healthcare management is preferred. + Master's degree in business or ... healthcare management preferred. + Minimum of five years of progressively responsible experience in medical practice management required (with direct… more
    Prime Healthcare (09/03/25)
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  • Account Resolution Specialist

    Prime Healthcare (Harlingen, TX)
    …FacilityPrime Healthcare ... Overview Prime Healthcare is an award-winning health system headquartered in...an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360… more
    Prime Healthcare (09/13/25)
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  • Account Representative

    Prime Healthcare (Harlingen, TX)
    …(https://careers-primehealthcare.icims.com/jobs/225627/account-representative/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare ... Overview Prime Healthcare is an award-winning health system headquartered in...an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360… more
    Prime Healthcare (09/13/25)
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  • Medical Claim Review LVN/LPN (CA LVN Required)

    Molina Healthcare (Rochester, NY)
    …Medical Audit Specialists (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional in Healthcare ... Identifies and refers members with special needs to the appropriate Molina Healthcare program per policy/protocol. * Helps with the development and implementation of… more
    Molina Healthcare (09/12/25)
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  • IT Support Specialist I

    Prime Healthcare (Harlingen, TX)
    …(https://careers-primehealthcare.icims.com/jobs/224207/it-support-specialist-i/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare ... Overview Prime Healthcare is an award-winning health system headquartered in...an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360… more
    Prime Healthcare (09/12/25)
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  • Customer Service Representative

    Prime Healthcare (Harlingen, TX)
    …FacilityPrime Healthcare ... Overview Prime Healthcare is an award-winning health system headquartered in...an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360… more
    Prime Healthcare (09/11/25)
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  • Account Resolution Specialist

    Prime Healthcare (Harlingen, TX)
    …FacilityPrime Healthcare ... Overview Prime Healthcare is an award-winning health system headquartered in...an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360… more
    Prime Healthcare (09/10/25)
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