Remote Senior RN - QOC Investigator (AZ Medicaid/Medicare)
Anacalifornia
- 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
- ...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 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
$71.25k - $89.25k
...Senior Investigator Salary Range $71,250.00 - $89,250.00 Salary/year Level Senior Education Level 4 Year Degree Overview Index... ...of health insurance cost sharing requirements for Medicare, Medicaid, and private insurance and/or the ability to quickly learn...Remote workSeniorWork experience placementFlexible hours- ...Medical School seeks a Fraud Investigator II in Healthcare to combat fraud and abuse within the Medicaid program. This role involves data... ...and collaboration with senior investigators to develop detection... ...are essential. The position is remote, allowing for flexible work arrangements...Remote workSeniorWork at officeFlexible hours
- 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
$46.99k - $112.2k
...community at a time. Position Summary The Senior Investigator, Aetna Special Investigations Unit,... ...of aberrant claims submitted to the Medicaid lines of business for payment... ...fraud and abuse matters ~ Medicaid/Medicare investigation experience; knowledge of...Remote workSeniorHourly payFull timeTemporary workWork at officeLocal area$72.8k - $130k
...together. Job Description - Senior Clinical Quality of Care RN - Arizona (2380922)... ...conducting quality of care (QOC) investigation, review and management... ...are specific to Arizona Medicaid and Medicare members. This position is an Arizona based remote position with the option...Remote workSeniorMinimum wageFull timeFor contractorsWork experience placementWork at officeLocal areaMonday to Friday- ...Registered Nurse Case Manager to support Medicare/Medicaid members in Illinois. You will assess... ...baseline. This full-time role requires an IL RN license, 3+ years of clinical experience... ...to travel up to 50%, and a home-based/remote-friendly setup. Documentation and collaboration...Remote workFull timeWork from home
$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 time- UnitedHealthcare is seeking a Senior Clinical Administrative Nurse in Phoenix, AZ. This role emphasizes outbound phone outreach to engage members, assess needs, and introduce available clinical services to support engagement goals. The position partners with members, caregivers...Remote jobSeniorWeekday work
$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 start$107.7k - $199.3k
...Corporation in New York seeks a highly skilled individual to lead and manage complex internal investigations. This role requires exceptional judgment and the ability to guide senior management while ensuring compliance with federal and state regulations. The ideal...Remote jobSenior- 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 jobSenior
- BCG Attorney Search seeks a Litigation Attorney in Scottsdale, AZ with extensive experience in insurance defense. The successful candidate will handle diverse defense matters, supervise cases with autonomy, and participate in court appearances, hearings, and depositions...Remote jobSenior
- Centene Corporation is seeking a skilled Investigator to lead complex internal investigations and ensure compliance with laws and regulations. This role involves evaluating allegations, conducting interviews, and managing investigation strategies. The ideal candidate will...Remote jobSeniorFlexible hours
$39.2 - $51.84 per hour
Job Description Job Title: Senior Investigator Pay rate: $39.2 - $51.84/hr. Location: Atlanta, GA (Remote) Zip Code: 30313 Duration: 4 Months Start Date: Right Away Keywords: #AtlantaJobs; #SeniorInvestigator; #INDSUB We provide a competitive pay and benefits package...Remote workSeniorContract workTemporary workWork experience placementWork at officeImmediate startWorldwideNight shiftWeekend work$2,267 per week
...Registered Nurse (RN) | Progressive Care Unit Location: Casa Grande, AZ Agency: Atlas MedStaff Pay: $2,267 per week Shift Information: Days... ...not either since a lot of our team has been working remote since the pandemic), but you are part of the Atlas...Remote workHourly payFull timeContract workWork at officeShift workWeekend work- Peraton is seeking an Experienced Background Investigator to support a national BI program, conducting interviews, records checks, and reporting... ...experience with T5 adjudication, and related qualifications. Remote work is unlikely; travel to designated locations and TDY may...Remote jobSeniorFull time
- Centene Corporation seeks an experienced investigator to lead complex internal investigations. The role involves ensuring compliance with regulations and providing strategic advice to senior leadership. Applicants should have a Bachelor's Degree in a relevant field, substantial...Remote jobSeniorFlexible hours
- ...Reddit is seeking a Senior Data Scientist to lead ads fraud detection and scaled enforcement within Safety. You will partner with... ...Policy and Legal to identify emerging fraud signals and translate investigations into durable rules and enforcement pipelines. Own the full...Remote workSenior
- Centene Corporation seeks a seasoned Compliance Investigations leader to guide an enterprise-wide program for investigations across business units, health plans, and corporate functions. You will oversee investigations, prepare reports, and collaborate with Legal, People...Remote jobSenior
- 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
- Centene Corporation in Kentucky is looking for a skilled professional to lead complex internal investigations. The ideal candidate needs 7+ years of experience in investigations, proficiency in regulatory compliance, and a bachelor’s degree in a related field. Knowledge...Remote jobSeniorFlexible hours
$60.2k - $107.4k
...you reside in Tennessee, 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 area$115.44k - $173.16k
TD Bank recherche un Senior Lead Insider Threat Investigator à Mount Laurel, NJ. Ce poste implique la direction d’enquêtes complexes sur les menaces internes et la collaboration avec plusieurs départements. Le candidat idéal aura au moins 10 ans d’expérience dans des enqu...Remote jobSenior$60.2k - $107.4k
...anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Gather all relevant facts to drive investigations (30%) Utilize appropriate systems to monitor and document status of investigation (30%) Collaborate with clinical coding...Remote workSeniorMinimum wageFull timeWork experience placementLocal area$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 area- Centene Corporation is seeking a skilled Medicaid proposal writer to develop responses to high-scoring RFP sections and support growth goals. The role collaborates with internal SMEs to translate policies into compelling narratives and ensures all responses align with...Remote jobSenior
- Kramer Workplace Investigations is seeking a full-time Senior Attorney Investigator in California. The role conducts impartial workplace investigations for... ...) and 3+ years conducting impartial investigations. Remote work from home with occasional travel within California...Remote jobSeniorFull timeWork from home
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