Act as the initial point of contact for prior authorization requests from members and providers. Maintain accurate documentation of approvals and denials and determine when complex requests require pharmacist assistance.
Remote Jobs & Work From Home Positions in United States (127,940)
Remote in = United States
Lead the Provider Performance function by collaborating with Med Affairs and analytics teams to improve clinical outcomes and medical costs. Drive the execution of strategic projects, monitor network provider performance, and implement innovative clinical strategies across the enterprise.
Lead the strategy, solutioning, and execution of a value stream within the Aetna One Advocate product team to create a connected healthcare journey. Drive product discovery and align cross-functional teams to deliver measurable outcomes for members, advocates, and clients.
The Senior Solutions Architect creates transformational designs and architectural visions to address client needs in secure networking. They manage a book of accounts, lead discovery conversations, and develop technical proposals and statements of work.
Lead high-performing IT teams to drive innovation and digital transformation while overseeing critical infrastructure, security, and support services. Collaborate with business stakeholders to deliver strategic solutions that advance the company's mission in science and healthcare.
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Lead a team of Business Development Executives to drive growth for the Human Resources Consulting practice in the West Region. Responsible for achieving annual sales targets, coaching the sales team, and collaborating across different business practices to provide integrated client solutions.
Manage electrical power system study and design projects from kickoff to final delivery, including scoping, analysis, and reporting. Lead field data collection and coordinate with subcontractors and clients to ensure technical accuracy and project completion.
Lead the strategy, financial growth, and operational excellence of the Agentic Managed Detection & Response practice. Drive the transition to AI-driven security operations while managing P&L and strategic technology partnerships.
Manage electrical power system study and design projects from kickoff to final delivery, including scoping, analysis, and reporting. Lead field data collection and coordinate with subcontractors and clients to ensure technical accuracy and project completion.
Provide engineering and design support for new installations and retrofits by building power system models and performing calculations. Create one-line diagrams and schematics while collecting field data at client facilities.
Provide engineering and design support for new installations and retrofits by building power system models and performing calculations. Create one-line diagrams and schematics while collecting field data at client facilities.
The Principal Scientist plans and directs complex interdisciplinary environmental remediation and restoration projects. They serve as a technical expert, preparing habitat function models and providing regulatory compliance consulting services.
Serve as an escalation point for complex technical issues, providing high-quality support via chat and ticketing systems. Lead junior analysts and identify process improvements to enhance the efficiency of the Technology Solution Center.
Lead the design and implementation of cloud infrastructure and CI/CD pipelines while ensuring system reliability. Mentor a team of DevOps engineers and collaborate with product teams to implement SRE principles and continuous improvements.
Provide global category leadership to deploy strategies that drive value and sustainability across the supply chain. Manage complex supplier relationships and lead cost-saving initiatives through spend analysis and strategic sourcing activities.
The News Assistant is responsible for monitoring federal and state court dockets, regulatory databases, and congressional hearings to pitch story ideas. The role eventually evolves to include reporting and writing news articles.
Develop and refine cognitive models of early literacy to support the design and validation of educational products. Conduct quantitative and qualitative research to evaluate product effectiveness and student learning outcomes for PreK-5 grades.
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The News Assistant is responsible for monitoring federal and state court dockets, regulatory databases, and congressional hearings to pitch story ideas. The role eventually evolves to include reporting and writing news articles.
The News Assistant is responsible for monitoring federal and state court dockets, regulatory databases, and congressional hearings to pitch story ideas. The role eventually evolves to include reporting and writing news articles.
Acts as a liaison between members and community-based service providers to facilitate quality, cost-effective care. Responsibilities include monitoring member wellbeing through home visits, adjusting care plans, and collaborating with stakeholders to resolve barriers to medical care.
Supervise multiple teams of examiners and technical staff handling liability claims for clients. Monitor workloads, provide technical direction on claims adjudication, and maintain professional client relationships.
The Director assists the VP of Strategy in developing and monitoring strategic initiatives and coordinating multi-disciplinary teams for regional plans. They manage market position assessments and provide data-driven analysis to senior executives to achieve strategic goals.
The Key Account Manager is responsible for growing and maintaining customer accounts within the pulp and paper industry in the Fernandina Beach region. This includes leading account strategy, managing technical service programs, and identifying new business opportunities to increase profitability.
Insomniac - Ticketing Manager
Live Nation Entertainment
·
Full Time
·
2 Weeks Ago
Live Nation Entertainment
Oversee ticketing operations and box office management for large-scale music festivals, coordinating between internal divisions and external vendors. Responsibilities include building ticketing pages, managing budgets, and supervising on-site staff during events.
Neuroscience Territory Account Specialist – New York City
Novartis
·
Full Time
·
2 Weeks Ago
Novartis
Lead strategic engagement with healthcare providers and key accounts to drive product demand and improve patient outcomes. Coordinate with cross-functional teams and use digital tools to provide tailored access support and personalized customer experiences.
Responsible for driving clinical trial strategies and study designs for diagnostic products in the US and EU regions. This includes acting as a liaison with regulatory bodies and partnering cross-functionally to align clinical programs with market access needs.
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The Virtual Registered Nurse provides remote and bedside patient management within an inpatient setting. This role involves collaborating with providers, patients, and families to ensure effective, patient-centered care.
Workers' Compensation Claims Specialist (REMOTE - AZ, CO, WV, SD)
Creative Risk Solutions
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Full Time
·
2 Weeks Ago
Creative Risk Solutions
The specialist is responsible for investigating, evaluating, and resolving lost time Workers' Compensation claims, including litigated cases. They must manage communications between insured parties and the insurance company while maintaining accurate claim data and processing payments.
Sr. Workers' Compensation Claims Specialist, Supervisor (REMOTE)
Creative Risk Solutions
·
Full Time
·
2 Weeks Ago
Creative Risk Solutions
Oversee high-quality claims handling for complex and litigated workers' compensation cases while providing expertise to CRS customers. Lead and coach a team of claims specialists, managing their performance, career development, and daily workflows.
Oversee ticketing operations and box office management for large-scale music festivals, coordinating between internal divisions and external vendors. Responsibilities include building ticketing pages, managing budgets, and supervising on-site staff during events.
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