Medical Director Clinical Coverage Review - Pharmacy - Remote
Houston, TX
Review and sign off on proposed pharmacist denials for preservice outpatient medication requests, after review of medical records when provided Conduct coverage review on some medical ca...

Regional Director of Policy - Remote
Minnetonka, MN
Predicts emerging customer (state, health plan and functional partner) needs and develops innovative solutions to meet them Solves unique and complex problems with broad impact on the bu...

Field RN Clinical Coordinator - Morrow and Knox Counties, OH
Mount Vernon, OH
Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs...

National Accounts Strategic Client Executive - Charlotte NC
Charlotte, NC
Solid understanding of both fully insured and self funded marketplace and pricing disciplines Establish and maintain "strong and appropriate" level relationships with customers and consu...

Broker Agent Service Senior Representative - National Remote
Eden Prairie, MN
Manages ongoing relationships and service delivery to clients for one or more accounts Acts as outward facing, dedicated resource for assigned accounts, typically with direct client cont...

Medicare Market Growth Manager - Sales Manager - SW Florida
Fort Myers, FL
Key Agent/Agency Performance Agent Development Mentor, coach and engage key agents/agencies through ongoing business and strategy planning. This includes identifying sales opportunities,...

Associate General Counsel - Remote
Minnetonka, MN
Act as internal counsel on the No Surprises Act and its rulemaking Act as internal counsel on state law regarding out of network reimbursement Act as internal counsel on preemption issue...

Underwriting Consultant, Local Markets Eastern Region - Remote
Hartford, CT
Primary focus will be on a Local Market book of business Intricate focus on product integration to maximize company financials Work closely with underwriting and local market sales to de...

Underwriting Consultant Local Markets West Region - Remote
Cypress, CA
Primary focus will be on a Local Market book of business Intricate focus on product integration to maximize company financials Work closely with underwriting and local market sales to de...

Senior Clinical Admin Nurse, Emerging CARE - Remote
Phoenix, AZ
Acts as resource to members calling into a customer service setting addressing medical/health questions Own problem through to resolution on behalf of the member in real time or through...

HSS Coordinator - North Houston, TX
Houston, TX
Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care Identify and initiate referrals f...

HSS Coordinator - Sherman, TX
Sherman, TX
Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals f...

HSS Coordinator - Crockett, TX
Crockett, TX
Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals f...

HSS Coordinator-Fort Bend and Matagorda County, TX
Bay City, TX
Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals f...

Adult Member Liaison - Hybrid - Phoenix, AZ
Phoenix, AZ
Provide advocacy and system navigation of behavioral health services and social services and supports Build partnerships with individuals, families, youth, and key stakeholders to promot...