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Who We Are
Imagine Pediatrics is a tech enabled, pediatrician led medical group reimagining care for children with special health care needs. We deliver 24/7 virtual first and in home medical, behavioral, and social care, working alongside families, providers, and health plans to break down barriers to quality care. We do not replace existing care teams; we enhance them, providing an extra laye...

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
MUST RESIDE IN THE WEST CALIFORNIA AREA
Registered Nurse Strongly Preferred
Position Purpose: Perform...

Company :
Highmark Health
Job Description :
JOB SUMMARY
This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization, identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. Monitors...

Company :
Highmark Health
Job Description :
JOB SUMMARY
This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization, identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. Monitors...

Company :
Highmark Health
Job Description :
JOB SUMMARY
This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization, identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. Monit...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
* Assess the member's current health status, resource utilization, past and present treatment plan and services,...

PURPOSE AND SCOPE:
The Manager, Kidney Care Specialist provides strategic leadership and operational oversight for a team of Kidney Care Specialist who support individuals living with Chronic Kidney Disease (CKD) and End Stage Renal Disease (ESRD) across both field-based and virtual settings. This leader ensures high-quality patient engagement, consistent execution of education and navigation w...

Bachelor's degree in Health Care Administration, Business, Finance, Management, or a related field.
• Eight plus years of Project Management experience.
• Project Management Professional (PMP) certification.
• Experience in medium to complex enterprise-wide project management.
• Experience implementing General Healthcare technology projects and/or ERP systems with additional focus on third-...

Overview
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
The MJHS...

Sr. Engineering Manager, Care Navigation
Remote / Engineering – Software Engineering / Full-time / Remote Apply for this job Join the team reinventing Healthcare!
The Role: Are you ready to lead the team who will build the next standard for healthcare? We’re looking for a senior engineering manager with a passion for building user centric products to lead one of our rapidly growing Prod...

Join our mission to help transform healthcare delivery from reactive, episodic care to proactively managed patient care that prevents live-changing problems before they happen for patients with two or more chronic conditions. We believe every patient with chronic disease deserves consistent check-ins, follow-up, and support.
The position of the Nurse Chronic Care Coordinator, Remote will perfo...

About Pair Team
At Pair Team, we're an innovative, mission-driven company reimagining how Medicaid and Medicare serve the most underserved populations. As a tech-enabled medical group, we deliver whole-person care-clinical, behavioral, and social-by partnering with organizations deeply connected to the communities we serve.
We're building a powerful care management service and platform that lev...

Job Summary:
The Manager, Customer Care & Sales Enablement is responsible for translating SCANA Energy's business strategy, sales and customer experience goals, and operational priorities into practical learning, quality, knowledge management, and readiness initiatives that improve frontline performance. The role serves as the senior leader for both the Training and Quality organizations, ensur...

Company :
Highmark Health
Job Description :
JOB SUMMARY
This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization, identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. Monit...

Finance Manager / Managed Care Financial Analyst
The purpose of the Finance Manager / Managed Care Financial Analyst is to support the financial operations of the IPA/MSO by managing capitation reconciliations, IBNR analysis, claims payment oversight, utilization financial reporting, and risk-based healthcare financial operations. This position is responsible for monitoring financial performanc...

Job Summary
Project Manager , Specialty Care Program Support
Artemis seeks an experienced Project Manager to support the Department of Veterans Affairs (VA) Veterans Health Administration (VHA) Specialty Care Program Office (SCPO). SCPO provides national leadership, governance, and oversight for specialty care programs, Centers of Excellence, and clinical service lines across VHA, as well as en...

Gritter Francona is looking for a Project Manager that will provide comprehensive project management and implementation support for the design, launch, management, evaluation, and preparation for scaling an Elevated Risk Care Management (ERCM) Pilot focused on improving the coordination, effectiveness, and continuity of suicide prevention-related care for Veterans at elevated risk.
The Project ...

Salary : $80,496.00 - $108,228.00 Annually
Location : Thurston County - Olympia, WA
Job Type: Project (limited duration)
Remote Employment: Remote Optional
Job Number: 2026-06867
Department: Health Care Authority
Division: OTA
Opening Date: 08/17/2026
Closing Date: 8/31/2026 11:59 PM Pacific
Salary Information: The high end of the salary range, Step M is typically a longevity step
Description
...

This is a remote position supporting Louisiana. Candidates must be licensed and reside in Louisiana.
Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings. Collects and analyzes utilization data. Assists with discharge plannin...

Job Summary
Under general supervision, manage the relationship with existing accounts. Responsible for managing a book of business for existing accounts and generating revenue on assigned accounts. Serve as the primary interface for all products and services and create demand for the organization's products and services. Build and maintain effective long-term relationships with a defined custom...