Manager of Utilization Management, Integrated Care Team - Remote
Phoenix, AZ
Manages and evaluates direct reports of UM Prior Authorization Nurses, Inpatient Care Managers, Clinical Coordinators, and other team associates Manages the compliance for UM to meet est...

Neonatal Intensive Care Unit NICU Social Worker - Remote
Houston, TX
Communicate directly with families of babies currently admitted or recently discharges from the NICU, physicians, and community/governmental agencies Collaborate with NICU nurses and/or...

OB Home Care Nurse - Field - Part Time
LaGrange, GA
Provide skilled nursing care for expectant mothers in the home care environment Travel to provide in home patient care and continuous education to patients and family members Continually...

OB Home Care Nurse - Field - Per Diem
Marietta, GA
Provide skilled nursing care for expectant mothers in the home care environment Travel to provide in home patient care and continuous education to patients and family members Continually...

Field Based Bilingual (English / Spanish) Community Health Worker - El Paso, TX
El Paso, TX
Manage assigned member caseload telephonically Complete home engagement visits, when telephonic outreach attempts (3), are unsuccessful. Create a positive experience and relationship wit...

Clinical Coordinator - Remote Mountain Time Zone
Grand Junction, CO
Provide consultation to providers and/or consumers on a variety of issues including benefit information, safety issues, confirmation of prior authorizations and approvals, procedures for...

Transplant Nurse Case Manager RN - Remote
Downers Grove, IL
Making outbound calls to assess members' current health status Identifying gaps or barriers in treatment plans Providing patient education to assist with self management Interacting with...

Clinical Quality Consultant - Remote
Eden Prairie, MN
Responsible for developing and preparing documentation for NCQA and other accreditation survey submissions Works closely with regional quality staff, health plan staff, and internal busi...

Sr. Business Process Analyst - Remote
Eden Prairie, MN
Facilitate, oversee and monitor on going business processes to support HEDIS data reporting Monitor compliance against relevant process requirements (e.g., turnaround time, accuracy) Eva...

QOI Project Analyst - Remote
Eden Prairie, MN
Demonstrate understanding of relevant organizations' operations, products, applications, strategies and processes to effectively support Quality Reporting Operations using relevant tools...

Senior Pharmacy Technician - Telecommute in Phoenix
Phoenix, AZ
Perform telephonic customer outreach to improve health quality outcomes in collaboration with clinical pharmacists Provide additional telephonic engagement with providers and pharmacies...

Per Diem OB Home Care Nurse RN - Remote in Ohio
Dublin, OH
Home health administrator responsibilities as assigned Special project management as assigned Additional responsibilities as assigned Primary Responsibilities Positively represent the Co...

Utilization Management RN Remote
Everett, WA
Consistently exhibits behavior and communication skills that demonstrate Optum's commitment to superior customer service, including quality, care and concern with each and every internal...

Preservice Review Nurse RN - Remote
Phoenix, AZ
Perform initial and ongoing reviews pertaining to primary role (PA, ICM, DCM, PACM), appropriately applying clinical criteria (InterQual, policies, National and Local Coverage Determinat...

Field Based Community Health Worker - Baton Rouge, LA
Baton Rouge, LA
Locate and engage members within a 60 mile radius of a designated region Assess SDOH needs using a standardized screening tool and coordinate with ICT to identify and connect members to...