UNKNOWN

FEED

The Enterprise Architect for ServiceNow and Nuvolo will play a key role in designing and implementing architectural solutions that leverage ServiceNow and Nuvolo platforms to streamline operations and enhance service delivery. Bachelor’s degree in information systems, Computer Science, Healthcare IT, Biomedical Engineering, or related field (Master’s degree preferred but not required) .

Greenberg-Larraby, Inc. (GLI)

Enterprise Architect, ServiceNow, Nuvolo, Remote, Contingent

ea_via_bold

The ServiceNow Integration Engineer focused on Healthcare Systems/CDW will be responsible for designing and implementing integration solutions that connect ServiceNow with various healthcare systems and applications. 5+ years of experience with ServiceNow integrations and data interfaces Strong experience with SQL, ETL processes, data mapping, and data validation .

ServiceNow Integration Engineer - Healthcare Systems / CDW (Remote)

The ideal candidate will drive the overall architectural strategy and lead the technical execution of our data platform, with a strong focus on the integration, optimization, and best practices implementation of Microsoft Fabric. Tiger Analytics is a global leader in AI and advanced analytics consulting, empowering Fortune 1000 companies to solve their toughest business challenges.

Tiger Analytics Inc.

Microsoft Fabric Solutions Architect

CONTRACTOR

Experience or detailed knowledge of the Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavior Health Services, Trauma-informed Care, ACEs, Crisis Intervention services, and evidence-based practices applicable to the Kentucky SKY populations, is required. The Care Management Associate supports comprehensive coordination of medical services including Care Team intake, screening and supporting the implementation of care plans to promote effective utilization of healthcare services.

Apidel Technologies

Healthcare Consultant II

partner Conrep

The candidate should have 5%2B years experience with the following: Experience with AI/ML deployment, Agent deployment, LLM integration,Retrieval-Augmented Generation (RAG) patterns, cloud architecture, API integration, observability, and production readiness. While scheduling is the primary focus, the team also supports additional patient experience and care navigation use cases, including AI-powered tools that help answer patient questions before and after medical procedures.

AI Software Engineer

Complete Clinical Reviews and provide a determination of Medicare-Medicaid Coverage Determination/Redetermination, Medical Review, Global Exception et cetera, by following established clinical process. 4. Assists Member Services and other internal customers in responding to and resolving pharmacy-related inquiries from members (NCQA Requirement).

Pharmacist - Clinical Pharmacist

Working knowledge and experience may be required with the usage of hand held scanners, iPods, flash drives and laptops (as applicable) in order to collect, save, rename, and transfer confidential information.\'. This position interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS and CMS performance measures.

HEDIS Reviewer III

The position is a high-volume outbound calling role focused on obtaining prescription refill authorizations from physician offices after prior outreach attempts (fax, electronic messaging, etc.) have not received a response. Location: Remote, Texas-focused sourcing candidates located in the Dallas, Austin, San Antonio hubs are preferred; HM is willing to consider strong candidates from other Texas locations.

Pharmacy Tech I - Work At Home

The Staff Accountant will review contracts/SOWs and IT invoices for appropriate coding and accounting guidance treatment. The ideal candidate will have some Planview and Ariba experience, ensuring accuracy and timeliness in processing invoices.

Staff Accountant

Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member\'s needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member\'s benefit plan and available internal and external programs/services. The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.

Nurse Case Manager II - West Virginia

The Rep I, Clinical Services will also assist with other duties as needed to include but not limited to: outbound calls, reviewing and processing Prior Auths received via fax and ePA, monitoring and responding to inquiries via department mailboxes and other duties as assigned by the leadership team. The Representative I, Clinical Services takes in-bound calls from providers, pharmacies, and members etc, providing professional and courteous phone assistance to all callers through the criteria based prior authorization process.

Representative I, Clinical Services

Case Management Coordinators will determine appropriate services and supports due to members health needs; including but not limited to: Prior Authorizations, Coordination with PCP and skilled providers, Condition management information, Medication review, Community resources and supports. - Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.

Healthcare Consultant I - WEST / MID MIAMI AREA

The Tech I will also assist with other duties as needed to include but not limited to: outbound calls, reviewing and processing Prior Auths received via fax and ePA, monitoring and responding to inquiries via department mailboxes and other duties as assigned by the leadership team. The Pharmacy Technician is responsible for placing outbound calls to physician offices to obtain verbal authorization for prescription refill renewals when previous outreach attempts have not received a response.

Pharmacy Tech I - Prior Authorization

This person will serve as a practical link between the PIM team and business data owners: identifying missing or conflicting information, documenting exceptions, routing questions to the right owners, and confirming that approved data is correctly represented in the PIM for the initial data migration. This role will help load, cleanse, validate, audit, and maintain product information within the PIM platform while coordinating closely with business data owners across product, marketing, sales, operations, customer service, and other functional teams.

Data Entry Specialist

In this role, a Inbound Patient Account Services Specialist will provide a high level of customer service, resolve patient billing questions, and report potential trends to Leadership for review. Key Responsibilities of the Inbound Patient Account Services Coordinator: Develop a deep understanding of Specialty processes and learn how customer service impacts a patients journey from order to reimbursement for services.

Billing Specialist I

Orchestrates a strong, robust communications process between leadership, managers and colleagues ensuring the appropriate and timely dissemination of information to seasonal HEDIS colleagues. Are you able to connect the Aetna provided laptop to your home internet modem via an ethernet cable connection (Not thru a WiFi connections).

Project Manager III

Minimum of 3 years' experience in the energy industry with a focus on the appropriate one of the following: billing, ESG-EDI transmissions, credit and collections, business operations and planning, customer service, regulatory and or finance. Responsible for providing expertise, analysis, and solutions to complex supplier coordination (ESG), billing, regulatory processes, and technical problems with a focus on improving operational effectiveness and excellence.

Professional(Other) - Billing Specialist II

HEDIS Reviewer II

Description: If the worker will perform any duties on, over, or adjacent to navigable waters, or in support of marine, waterfront, port, terminal, dock, shipyard, vessel, harbor, or cargo operations, or any work that could potentially be subject to the U.S. Longshore and Harbor Workers Compensation Act (USL&H), indicate Yes. Examples include errands, deliveries, pickups, transporting tools or materials, driving between job sites or other locations, moving vehicles, or using a personal vehicle for work.

Substation Design Engineer III

Provides support for Healthcare Effectiveness Data and Information Set (HEDIS) quality initiatives and regulatory/contractual requirements including outreach to members who are noncompliant in the designated outreach services. Provides support for Healthcare Effectiveness Data and Information Set (HEDIS) quality initiatives and regulatory/contractual requirements including outreach to members who are noncompliant in the designated outreach services.

Work From Home Jobs in Roseburg, OR

Enterprise Architect, ServiceNow, Nuvolo, Remote, Contingent Greenberg-Larraby, Inc. (GLI)

ServiceNow Integration Engineer - Healthcare Systems / CDW (Remote) Greenberg-Larraby, Inc. (GLI)

Microsoft Fabric Solutions Architect Tiger Analytics Inc.

Healthcare Consultant II Apidel Technologies

AI Software Engineer Apidel Technologies

Pharmacist - Clinical Pharmacist Apidel Technologies

HEDIS Reviewer III Apidel Technologies

Pharmacy Tech I - Work At Home Apidel Technologies

Staff Accountant Apidel Technologies

Nurse Case Manager II - West Virginia Apidel Technologies

Representative I, Clinical Services Apidel Technologies

Healthcare Consultant I - WEST / MID MIAMI AREA Apidel Technologies

Pharmacy Tech I - Prior Authorization Apidel Technologies

Data Entry Specialist Apidel Technologies

Billing Specialist I Apidel Technologies

Project Manager III Apidel Technologies

Professional(Other) - Billing Specialist II Apidel Technologies

HEDIS Reviewer II Apidel Technologies

Substation Design Engineer III Apidel Technologies

Coordinator III Apidel Technologies

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