Full-Time LPN jobs in the Insurance industry

Physicians Plus Insurance Corporation has a full-time Case Manager- Lead position available within our Health Services Department. Reporting to the Director of Health Services, the Case Manager - Lead assists with daily workflows of the Case Management Team, functions as a subject matter expert, and provides guidance, education and support to the staff including handling escalated issues. In addit...
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WellPoint is one of the nation's leading health benefits companies and a Fortune 50 company. The Clinical Fraud Investigator II is responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse through the review of submitted medical record claims. Primary duties may include, but are not limited to: Conducts data mining activities using available to...
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WellPoint is one of the nation's leading health benefits companies and a Fortune 50 company. The Clinical Account Management Director is responsible for clinical account management of an assigned group of clients (80% 1-5k, 20% 5K+ segment). Primary duties may include, but are not limited to: Provides consultative subject matter expert information on 360 Health programs. Presents prepared reports ...
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POSITION SUMMARY: Manages submission, intervention and resolution of appeals, grievances, and/or complaints from Molina members and related outside agencies as a part of the integrated Healthcare Services Team. Conducts pertinent research, evaluates, responds and completes appeals and other inquiries accurately, timely and in accordance with all established regulatory guidelines. Prepares appeal s...
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Location: Irving, TX This is a non-remote position Job Summary Responsible for overseeing the Integrated Case Management staff focused on assisting Molina Healthcare members with their health care needs to achieve optimal clinical, financial and quality of life outcomes. Monitors information daily as appropriate including member metrics and staff productivity. Evaluates the services provided and o...
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HealthPlus of Michigan has an excellent opportunity for an individual to join our leading health insurance organization. The Navigator provides member guidance, support, education, referrals, coordination of care, and other assistance to the member as they move through the case management process. The Navigator makes outbound calls and coordinates in-home visits to provide advocacy for member’s ps...
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We're currently seeking a Healthcare Consultant for a contract opportunity in Troy, IN with our partner, one of the nation's leading providers of health care, dental, pharmacy, group life, and disability insurance, and employee benefits. Responsibilities · Coordinate and manage the wellness program at any employer site as assigned by arranging for yearly health fair, seeing employees on a regular ...
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Case Management Consultant CLAIM YOUR FUTURE AS A GREAT PERFORMER! Providing both satisfying and challenging work along with a highly professional and friendly work atmosphere, Sedgwick has a strong commitment to its colleagues and its clients. If you are seeking place where you can do great things for those whose lives you touch while maximizing your own career possibilities, Sedgwick is the plac...
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MOLINA HEALTHCARE - Care Review Clinician II - RN JOB SUMMARY Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalizatio...
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Job Fair (Full-Time/Part-Time/Entry Level/Manager) Job Description We are looking for job seekers from all types of backgrounds and industries to participate in our Job Fair! Whether you are currently seeking employment or are currently employed and looking to take the next step in your career, we have opportunities for every type of job seeker at our Job Fairs. Our mission is to connect the best ...
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Job Fair (Full-Time/Part-Time/Entry Level/Manager) Job Description We are looking for job seekers from all types of backgrounds and industries to participate in our Job Fair! Whether you are currently seeking employment or are currently employed and looking to take the next step in your career, we have opportunities for every type of job seeker at our Job Fairs. Our mission is to connect the best ...
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Job Fair (Full-Time/Part-Time/Entry Level/Manager) Job Description We are looking for job seekers from all types of backgrounds and industries to participate in our Job Fair! Whether you are currently seeking employment or are currently employed and looking to take the next step in your career, we have opportunities for every type of job seeker at our Job Fairs. Our mission is to connect the best ...
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Job Fair (Full-Time/Part-Time/Entry Level/Manager) Job Description We are looking for job seekers from all types of backgrounds and industries to participate in our Job Fair! Whether you are currently seeking employment or are currently employed and looking to take the next step in your career, we have opportunities for every type of job seeker at our Job Fairs. Our mission is to connect the best ...
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Job Fair (Full-Time/Part-Time/Entry Level/Manager) Job Description We are looking for job seekers from all types of backgrounds and industries to participate in our Job Fair! Whether you are currently seeking employment or are currently employed and looking to take the next step in your career, we have opportunities for every type of job seeker at our Job Fairs. Our mission is to connect the best ...
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Job Fair (Full-Time/Part-Time/Entry Level/Manager) Job Description We are looking for job seekers from all types of backgrounds and industries to participate in our Job Fair! Whether you are currently seeking employment or are currently employed and looking to take the next step in your career, we have opportunities for every type of job seeker at our Job Fairs. Our mission is to connect the best ...
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Consolidated Services Group, Inc. is always looking for outstanding candidates to work for us. Here's a list of just some of the positions that we're always hiring for: Pre-Certification Coordinator: Provide clerical support services under the direction of nurse case managers in processing Workers’ Compensation claims. Includes: phone reception, appointment scheduling, contact with injured workers...
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MOLINA HEALTHCARE - Care Review Clinician II - RN JOB SUMMARY Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalizatio...
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Affinity Health Plan, an independent, growing, not-for-profit managed care company designed specifically to serve the needs of low-income New Yorkers, needs a Program Manager- Medicare Quality Improvement. In this position, you will effectively manage the development and implementation of the Medicare Quality Improvement Project within the Quality Management Department and throughout Affinity Heal...
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Mutual Assurance Administrators Inc. / BMI-HealthPlans Division has a full-time opportunity for a Utilization Review Nurse. This position is primarily responsible for accurately and efficiently taking clinical information and determining medical necessity by using appropriate national criteria. The UR Nurse is also responsible for handling all correspondence and assisting with customer calls while...
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Mutual Assurance Administrators Inc. / BMI-HealthPlans Division has a full-time opportunity for a Utilization Review Nurse. This position is primarily responsible for accurately and efficiently taking clinical information and determining medical necessity by using appropriate national criteria. The UR Nurse is also responsible for handling all correspondence and assisting with customer calls while...
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Mutual Assurance Administrators Inc. / BMI-HealthPlans Divisionhas a full-time opportunity for a Utilization Review Nurse. This position is primarily responsible for accurately and efficiently taking clinical information and determining medical necessity by using appropriate national criteria. The UR Nurse is also responsible for handling all correspondence and assisting with customer calls while ...
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Solid reputation, passionate people and endless opportunities. That's Travelers. Our superior financial strength and consistent record of strong operating returns mean security for our customers - and opportunities for our employees. You will find Travelers to be full of energy and a workplace in which you truly can make a difference. In-house telephonic utilization review for prospective, concurr...
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Job Fair (Full-Time/Part-Time/Entry Level/Manager) Job Description We are looking for job seekers from all types of backgrounds and industries to participate in our Job Fair! Whether you are currently seeking employment or are currently employed and looking to take the next step in your career, we have opportunities for every type of job seeker at our Job Fairs. Our mission is to connect the best ...
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Job Fair (Full-Time/Part-Time/Entry Level/Manager) Job Description We are looking for job seekers from all types of backgrounds and industries to participate in our Job Fair! Whether you are currently seeking employment or are currently employed and looking to take the next step in your career, we have opportunities for every type of job seeker at our Job Fairs. Our mission is to connect the best ...
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Job Summary Responsible for developing, organizing, collecting, coordinating, preparing and presenting results of quality improvement studies and projects activities to monitor, evaluate and continuously improve the quality of healthcare services provided to Molina member. Essential Functions • Collaborates with the Quality Improvement department staff in the development of quality improvement stu...
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