Remote Senior RN - QOC Investigator (AZ Medicaid/Medicare)
Anacalifornia
Phoenix, AZ
- Remote job
UnitedHealthcare is seeking a Senior Clinical Quality of Care RN to conduct QOC investigations and manage IAD regulatory needs for Arizona Medicaid/Medicare members. This role is Arizona-based with remote work up to 60% and up to 25% travel. Collaborate with Medical Directors, prepare reports, and ensure investigations meet state and federal requirements. Some in-office presence may be required to support performance metrics. #J-18808-Ljbffr Anacalifornia
Vacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the Remote Senior RN - QOC Investigator (AZ Medicaid/Medicare) in Phoenix, AZ vacancy
- ...is seeking an experienced Senior Clinical Quality of Care RN in Arizona. The role conducts QOC investigations, reviews regulatory IAD portals... .... The position supports Medicaid/Medicare QOC reviews, collaborates... ...at the Phoenix office. Remote work options may apply. #J...Remote jobWork at office
- UnitedHealthcare is seeking a Senior Clinical Quality of Care RN based in Arizona to conduct quality of care investigations for Medicaid/Medicare members. This hybrid... ..., unrestricted AZ license, and ability to... ...The position may involve remote work with up to 40% in-office...Remote jobSeniorWork at office
- UnitedHealthcare seeks a Senior Clinical Quality of Care RN to conduct QOC investigations and manage regulatory IAD processes for Arizona Medicaid/Medicare members. The role is Arizona-based with remote work and up to 40% in-office, plus up to 25% travel, located at 1 East...Remote workSeniorWork at office
- UnitedHealthcare is seeking a Senior Clinical Quality of Care RN to conduct QOC investigations, review IAD portal cases, and prepare reports for internal and external... ..., and regulatory standards. This Arizona-based remote role allows up to 40% in‑office with up to 25%...Remote jobSeniorWork at office
- UnitedHealthcare seeks an experienced Senior Clinical Quality of Care RN in Arizona. The role involves reviewing and managing quality-of-care investigations for Medicaid/Medicare members, communicating findings, and preparing internal and external reports. Travel up to...SeniorWork at office
- UnitedHealthcare is seeking a Senior Clinical Quality of Care RN to conduct quality of care investigations, review regulatory IAD portals, and prepare reports for internal... ...and guidelines. Based in Arizona with a remote arrangement and up to 25% travel, you will partner...Remote jobSenior
$72.8k - $130k
...This Role The Senior Clinical Quality of Care RN will conduct quality of care investigations, manage regulatory... ...for Arizona Medicaid and Medicare members. Highlights... ...: Phoenix, AZ Schedule: Full... ...Arizona based remote position with the... ...in response to QOC occurrences. Interface...Remote workSeniorFull timeFor contractorsWork at officeDay shift- ...tomorrow.Section 1: Position SummaryThe Senior Fraud Investigator is a senior individual contributor... ...relevant experience preferredFor all virtual remote positions, in order to ensure... ...SummaryLocation: Remote, Florida; Phoenix, AZ; Nashville, TN; Houston, TX; Charlotte,...Remote workSeniorFull timeSecond job
Ascensus
Dallas, TX3 days ago - ...leading complex fraud, waste, and abuse investigations, the full-time Senior Fraud Investigator will utilize... ...support corrective actions in a remote work environment. Key... ...healthcare regulations, including Medicaid and Medicare Preferred certifications include...Remote workSeniorFull time
Virtual Vocations Inc
United States14 hours ago $46.99k - $112.2k
...Senior Investigator, Aetna Special Investigations Unit We're building a world of health around... ...of aberrant claims submitted to the Medicaid lines of business for payment Conduct... ...fraud and abuse matters ~ Medicaid/Medicare investigation experience; knowledge of...Remote workSeniorHourly payFull timeTemporary workWork at officeLocal areaCVS Health
United States4 days ago$48.47k - $53.85k
...communities for a better quality of life. SENIOR INVESTIGATOR (Temporary Positions) Office of... ...To learn more about DES please visit des.az.gov or click on the link here to view ‘Our... ...the option of a full-time or part-time remote work schedule, employees enjoy improved...Remote workSeniorFull timeTemporary workPart timeFor contractorsWork at officeLocal areaFlexible hoursArizona Department of Administration
Phoenix, AZ3 days ago- UnitedHealth Group in Phoenix, AZ is seeking a Senior Clinical Quality of Care RN to conduct investigations, review medical records,... ...regulations for Arizona Medicaid and Medicare members. This full-time daytime... ...arrangement: Arizona-based remote with up to 40% in-office,...Remote jobSeniorFull timeWork at office
$72.8k - $130k
...Senior Clinical Quality of Care RN At UnitedHealthcare, we're simplifying the... ...conducting quality of care (QOC) investigation, review and management... ...specific to Arizona Medicaid and Medicare members. This position is an Arizona based remote position with the option...Remote jobSeniorMinimum wageFull timeFor contractorsWork experience placementWork at officeLocal area- ...are seeking a personable yet professional Senior Project Manager to work with one of our... ...position is hybrid, leaning more or the remote side, but the most qualified candidate will... ...Act as the primary liaison between state Medicaid agencies, federal partners (CMS), enterprise...Remote workSeniorContract work
BITHGROUP Technologies
Baltimore, MD21 days ago - ...Lumen is seeking an experienced Corporate Investigator to join the Ethics & Compliance team. You will lead complex internal investigations... ...skills, with the ability to manage multiple cases in a remote or distributed environment while maintaining discretion and professionalism...Remote workSenior
Lumen Inc
Honolulu, HI1 day ago - A leading background screening company is seeking a highly skilled Background Investigator to conduct detailed, impartial pre-employment investigations for government agencies. This role involves researching candidate qualifications, conducting interviews, and compiling...Remote workSenior
KENTECH Consulting
United States3 days ago - ...Conducting non-field investigations of suspected fraud or illegal activities, the full-time Senior Internal Security Investigator will work remotely, interviewing witnesses, evaluating information credibility, and providing training to support the claims handling process...Remote workSeniorFull time
Virtual Vocations Inc
United States3 days ago $45k
A technology and investigations firm is looking for a Background Investigator to conduct impartial pre-employment investigations for government clients. This remote full-time role requires strong investigative skills, attention to detail, and the ability to handle sensitive...Remote workSeniorFull timeKENTECH Consulting
Doral, FL3 days ago- ...seeking a Family Advocate Support CARE - Senior Clinical Admin Nurse to provide... .... The position requires an active RN license, 2+ years in acute and behavioral health nursing, and Medicaid waiver experience, with flexibility for remote work within #J-18808-Ljbffr Texas...Remote jobSenior
- ...Hybrid Work Model.Job DescriptionProtect. Investigate. Lead.At CHEP, we don’t just protect... ..., we protect trust. We’re looking for a Senior Asset Protection Investigator who thrives... ...employee stock match program, and MORE!Remote TypeFully RemoteSkills to succeed in the...Remote workSeniorFull timeTemporary workLocal areaNight shift
CHEP
Columbus, OH3 days ago - ...Family Advocate Support CARE - Senior Clinical Admin Nurse to provide... ...teams and external partners. This remote role supports members across the... ...and discharge planning. Required: RN license, 2+ years of relevant nursing experience, Medicaid waiver familiarity; preferred:...Remote jobSenior
$120k - $145k
...teammates. ABOUT THE ROLE: We are seeking an experienced BSA/AML Investigator to help detect, prevent, and report financial crimes. As part... ...-time salaried position with a Saturday–Wednesday schedule. Remote work is permitted on Saturdays and Sundays; in-office attendance...Remote workSeniorPermanent employmentFull timeTemporary workWork at officeLocal areaWeekend workSpaceXAI
Palo Alto, CA1 day ago- UnitedHealthcare is seeking a Senior Clinical Quality of Care RN in Arizona to conduct quality of care investigations and manage regulatory IAD... ...professional standards. It is a remote Arizona-based position with... .... You must have an active AZ RN license, 5+ years of RN experience...Remote jobSeniorWork at office
$80 - $110 per hour
...high-impact project with the Centers for Medicare & Medicaid Services (CMS), helping to define and... ...walk is okay! This position is 100% remote . Our entire team is remote across the... ...requirements-gathering process, working with senior government stakeholders to define the...Remote workSeniorHourly payContract workTemporary workFor contractorsWork at officeImmediate startFor People
Arlington, VAa month ago$60.2k - $107.4k
...you reside in Virginia, you will have the flexibility to work remotely as you take on some tough challenges. Primary... ...Gather all relevant facts to articulate behavior through an Investigation Summary and compliance package. Communicate clear rationale for...Remote workSeniorMinimum wageFull timeWork experience placementLocal areaUnitedHealth Group
United States4 days ago- ...Health Plan in Los Angeles, CA, is recruiting a full-time RN for care management to support frail seniors in aging in place through telephonic care... ...will develop and implement plans of care for Medi-Cal/Medicare members with complex needs, aiming to prevent hospitalizations...Remote jobSeniorFull time
$60.2k - $107.4k
...Senior Investigator At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system...Remote workSeniorMinimum wageFull timeTemporary workWork experience placementLocal areaReliant Medical Group
United States2 days ago- ...responsible for preparing and and reviewing the Medicare and Medicaid cost reports for all OhioHealth... ...and financial reporting. The Senior Reimbursement Consultant will be a subject... ...other term or condition of employment Remote Work Disclaimer Positions marked as remote...Remote workSeniorLocal areaShift work
- ...seeking a registered nurse to serve as a Care Manager for Medicaid members recently admitted to hospital. The role combines... ...care, address barriers, and travel locally 25-40%. Remote work is possible within AZ, with shifts 7:00 AM-6:00 PM. #J-18808-Ljbffr Molina HealthcareRemote jobShift work
- Molina Healthcare is seeking a Remote Care Manager RN in Arizona to support AZ Medicaid members transitioning from inpatient care. The role blends phone outreach and in-person meetings with field travel, focusing on coordinating post-discharge care and connecting members...Remote job
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Senior RN - QOC Investigator (AZ Medicaid/Medicare). Be the first to apply!
