- CVS Health (Hartford, CT)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... each and every day. **Position Summary** The Specialty Strategic Account Executive - Payer Relations manages a portfolio of small to mid-size regional health plan… more
- Sharecare (Topeka, KS)
- …visit www.sharecare.com . **Job Summary:** CareLinx is looking for a Care Advisor to assist with CareLinx's Payer Operations line of business. CareLinx is ... hire process. Once a caregiver match is made, the Care Advisor will follow closely to ensure...be the place for you. **Location:** This role is remote , except for candidates located in the Mesa, AZ… more
- Carle Health (Champaign, IL)
- …Health is seeking a **Physician Advisor ** to help oversee the efficiency of care for our Behavioral Health team over the West, Central, and East regions in ... the Case Management Team, the Clinical Denial Management Team, and other health care professionals. + The Behavioral Health Physician Advisor , in accordance with… more
- The Cigna Group (Bloomfield, CT)
- …**EHR Platform-Specific Responsibilities:** + Lead integration and optimization efforts for Epic Payer Platform and other EHR systems. + Collaborate with IT and ... clinical teams to ensure seamless data exchange between payer and provider systems. + Analyze workflows and recommend improvement opportunities across the enterprise… more
- CommonSpirit Health (Englewood, CO)
- **Job Summary and Responsibilities** **Thi** **s is a remote position** The Utilization Management Physician Advisor II (PA) conducts clinical case reviews ... referred by case management staff and/or other health care professionals to meet regulatory requirements and in accordance with the system's objectives for assuring… more
- R1 RCM (Detroit, MI)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our **Physician Advisor ** , you will help our client facilities navigate the path ... documentation was available for the admission status, procedure, and care setting that was requested. You will also advise...basic computer skills is essential for excelling in this remote position. **Here's what you will experience working as… more
- NTT DATA North America (Boston, MA)
- …enterprise transformation, and long-term strategic partnerships** with leading payer organizations. **Role Overview** The Transformational Client Executive Leader ... plan transformation, and executive-level partnerships. This leader serves as a **trusted advisor ** to Health Plan C-suite stakeholders and is responsible for shaping… more
- Nuvance Health (Danbury, CT)
- *Description* *FULL TIME DAY SHIFTS- VARIABLE HOURS / WEEKEND ROTATIONS REQUIRED* * *Hybrid/ Remote * * *Summary:* The purpose of the Denial Prevention Nurse is to ... will require specialized system skills, best practice application of investigating payer practices, successfully challenging payers as they prevent obstacles and… more
- UNC Health Care (Chapel Hill, NC)
- …conditions, patient safety indicators, hierarchical condition categories and complexity of care rendered to all patients. Educates on proper creation of provider ... CPT codes in accordance with the Official Coding Guidelines, and third party payer , state and federal regulations. 10. Identifies cases for CDI Physician Advisor… more
- University of Michigan (Ann Arbor, MI)
- RN CASE MANAGER: University Hospital ( Care Management) Apply Now **Job Summary** The RN Case Manager assesses, develops, implements, coordinates and monitors a ... comprehensive plan of care for each patient/family in collaboration with the physician,...admission; review every 3 days or as requested by payer + Determine patient classification with provider and ensure… more
- Surgery Care Affiliates (Philadelphia, PA)
- Overview At SCA Health, we believe health care is about people - the patients we serve, the physicians we support and the teammates who push us forward. Behind every ... our organization. As part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of… more
- Humana (Tallahassee, FL)
- …Partner with national innovation teams to pilot and scale emerging technologies and care models (eg, remote monitoring, clinical pathways, tech-enabled care ... and cross-functional collaboration. The RVP acts as a key advisor , innovator, and relationship builder, ensuring alignment with Humana's...years clinical practice + 5 + years in managed care industry, either provider or payer . +… more
- Northwell Health (Melville, NY)
- …+ Serves as liaison between the patient and facility/physician and the third party payer . + Prepares and defends level of care and medical necessity for ... assigned case. + Collaborates with physician advisor , payor representative and site case managers to facilitate...Review experience, preferred. + Must have experience with Milliman Care Guidelines and/or InterQual. Hours/Shift + Fully remote… more
- Medexus Pharma (CT)
- Senior Medical Science Liaison remote Remote , NYC, NJ, CT, United States . full-time . December 3, 2025 Description **Company Bio** Medexus Pharma is a leading ... Affairs team. The MSL will serve as a scientific expert and trusted advisor , engaging with Key Opinion Leaders (KOLs), healthcare providers (HCPs), payors, and… more
- Amgen (Thousand Oaks, CA)
- …of multi-channel engagement strategies that elevate scientific understanding and patient care and drive the digital and technology roadmap to enable and ... enabling operational efficiency. + Serve as a thought partner and advisor to Therapeutic Area and regional leadership, guiding insight-driven and impact-oriented… more
- TEKsystems (Annapolis, MD)
- …Strategy, Solutioning & Leadership o Engage with clients as a trusted advisor to understand their business goals, challenges, and strategic priorities and how ... 7 or more years of broad healthcare experience knowledge ( Payer & Provider) . 5 or more years in.... Short and long-term disability . Health & Dependent Care Spending Accounts (HSA & DCFSA) . Transportation benefits… more
- Cardinal Health (Juneau, AK)
- …(TM) Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy ... better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class...ensure all teams deliver on commitments. This is a remote , work from home opportunity that requires travel for… more
- TEKsystems (Chicago, IL)
- …+ Strategy, Solutioning & Leadership + Engage with clients as a trusted advisor to understand their business goals, challenges, and strategic priorities and how they ... 7 or more years of broad healthcare experience knowledge ( Payer & Provider) + 5 or more years in.... Short and long-term disability . Health & Dependent Care Spending Accounts (HSA & DCFSA) . Transportation benefits… more