Lead the strategy and execution of securing national in-network agreements with major commercial payors to scale operations. Manage the credentialing function and a Credentialing Specialist to ensure seamless provider onboarding and billing.
Remote Insurance Jobs (22,680)
Tags = insurance
Lead cross-organizational teams in managing multiple IT infrastructure projects from assessment through deployment. Responsible for schedule management, budget tracking, stakeholder engagement, and adherence to DevSecOps and quality standards.
The role acts as a technical owner for customer-facing data workflows, integrations, and AI-driven automation. Responsibilities include designing technical solutions for customers, building internal tooling, and translating customer patterns into product requirements.
Serve as the primary contact for a designated book of clients, managing renewals, remarketing, and consultative guidance on coverage. Oversee account onboarding and resolve complex client issues while maintaining accurate records in AMS360.
Full-Time Telehealth Dietitian (Salary + Benefits)
Simplex Health
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Full Time
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2 Weeks Ago
Simplex Health
Provide telehealth medical nutrition therapy using a functional and integrative approach to develop personalized root-cause care plans. Manage a consistent patient caseload and collaborate with a clinical team to ensure optimal patient outcomes.
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Full-Time Telehealth Dietitian – Women’s Health (Salary + Benefits) Mountain Time
Simplex Health
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Full Time
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2 Weeks Ago
Simplex Health
Provide telehealth medical nutrition therapy focusing on pregnancy, gestational diabetes, and hormone-related conditions using a functional approach. Responsibilities include monitoring blood glucose logs, developing individualized care plans, and coordinating with referring physicians.
Full-Time Telehealth Dietitian – Women’s Health (Salary + Benefits) Pacific Time
Simplex Health
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Full Time
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2 Weeks Ago
Simplex Health
Provide telehealth medical nutrition therapy focusing on pregnancy, gestational diabetes, and hormone-related conditions using a functional approach. Responsibilities include monitoring blood glucose logs, developing individualized care plans, and coordinating with referring physicians.
Drive growth by acquiring and retaining financial advisors through consultative selling of the Altruist AI platform. Collaborate with internal teams by providing advisor feedback to inform the product roadmap and maintaining accurate records in Salesforce.
The role involves developing and delivering client outputs by synthesizing insights from primary and secondary research. Responsibilities include performing quantitative and qualitative analyses and managing work streams or smaller projects to address client needs.
Supervise day-to-day coding quality operations, including coaching team members and managing workflows to ensure effective resource utilization. Act as a subject matter expert to resolve complex inquiries and assist the Coding Quality Manager with administrative tasks.
Certified Professional Coder
Shawnee Health Service
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Full Time
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2 Weeks Ago
Shawnee Health Service
The role involves completing coding and posting of charges for various provider specialties and hospital visits. Additionally, the coder conducts audits and provides feedback to clinicians for educational and compliance purposes.
Medicaid Rebate Analyst Services Specialist
Conduent State Healthcare, LLC
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Full Time
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2 Weeks Ago
Conduent State Healthcare, LLC
Manage Medicaid Drug Rebate Program activities including invoicing, payment allocation, and accounts receivable reconciliation. Support regulatory compliance through audit documentation and the resolution of manufacturer disputes.
Remote Call Center Representative - Puerto Rico
Conduent Business Solutions of Puerto Rico, Inc.
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Full Time
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2 Weeks Ago
Conduent Business Solutions of Puerto Rico, Inc.
Manage a high volume of inbound calls to provide cardholders with information regarding payments and benefits. Process transactions via web-based applications while maintaining strict confidentiality and compliance with regulations.
Medicaid Rebate Analyst Services Specialist
Conduent State Healthcare, LLC
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Full Time
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2 Weeks Ago
Conduent State Healthcare, LLC
The role manages Medicaid Drug Rebate Program activities, including invoicing, payment allocation, and accounts receivable reconciliation. It also involves researching manufacturer disputes and ensuring regulatory compliance for state rebate programs.
The role involves interpreting clinical criteria to review and approve prior authorization requests for pharmacy and medical claims. It also requires handling inbound and outbound calls to gather information and assisting with appeals processing.
The Personal Care Connector handles inbound and outbound calls to support Medicare members and providers within a call center environment. They are responsible for identifying care gaps, educating members on benefits, and facilitating access to healthcare resources.
Provide front-line customer support by handling inbound inquiries from members, pharmacies, and prescribers. Educate stakeholders on formulary processes and ensure accurate documentation of customer data.
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The Director of Product Marketing will lead market-wide positioning and provider brand marketing to drive growth and repeat business. Key duties include crafting value propositions, executing GTM strategies for new services, and managing a Provider Advisory Board.
Install, configure, and maintain Windows Server operating systems across physical, virtual, and cloud environments including Azure. Manage system health, security hardening, and automation tasks while providing Tier 3 technical support.
Lead the end-to-end strategy, execution, and optimization of high-investment enterprise paid social programs across platforms like Meta and TikTok. Partner with creative and analytics teams to drive scalable growth through data-driven decision making and creative-led performance.
Lead the design and development of custom wire, cable, and connector products from initial requirements through production readiness. Coordinate with suppliers and internal teams to ensure products meet technical specifications, safety standards, and manufacturing needs.
The Senior Manager is responsible for setting the strategy and developing training pathways to increase the competence of the Interventional Urology sales team. This includes overseeing training operations, managing budgets, and leading a team of sales trainers across multiple business units.
Build and manage strategic relationships with external experts in academic and community oncology settings to generate commercial insights. Translate scientific data into actionable business strategies to build brand advocacy and support oncology product launches.
Conduct cybersecurity risk assessments and technology reviews for financial services initiatives, with a heavy focus on AI and Machine Learning governance. Act as a trusted advisor to integrate security controls and risk management throughout the project lifecycle.
The specialist is responsible for retaining policyholders through outbound calls, re-quotes, and analyzing coverage to suggest improvements. They must meet retention targets, cross-sell additional products, and maintain positive relationships with insurance carriers.
Serve as a consultative wound care expert to educate clinicians and drive the adoption of Solventum solutions in post-acute settings. Manage territories to achieve sales targets while providing bedside support for product placement and dressing changes.
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Lead the full project lifecycle for large to extra-large initiatives, ensuring delivery on time, within budget, and to quality standards. Manage resources, mitigate risks, and maintain strong communication with stakeholders through detailed reporting and documentation.
Build and maintain financial models and analytical tools to support pricing, rating, and reporting for stop-loss, reinsurance, and captive programs. Collaborate with actuarial and underwriting teams to automate Excel-based tools and validate model outputs against source data.
2027 Actuarial Intern - Remote
CSAA Insurance Group, a AAA Insurer
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Full Time
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2 Weeks Ago
CSAA Insurance Group, a AAA Insurer
The intern will use statistical analysis to improve product performance, analyze claim trends, and develop pricing solutions. Responsibilities include assisting with rate development, performing competitive analysis, and completing a summer capstone project.
Lead end-to-end UX design and experience strategy for the Digital Order Management software portfolio. Collaborate with cross-functional teams to conduct research, create design artifacts, and ensure outcomes align with business objectives.
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