Remote QOC Nurse Investigator - Medicaid/Medicare (AZ)
Unitedhealth Group
- Remote job
UnitedHealth Group is seeking an experienced Senior Clinical Quality of Care RN in Arizona. The role conducts QOC investigations, reviews regulatory IAD portals, and prepares reports for internal and external customers, ensuring compliance with State and Federal requirements. The position supports Medicaid/Medicare QOC reviews, collaborates with Medical Directors, and may require up to 25% travel with some in-office time at the Phoenix office. Remote work options may apply. #J-18808-Ljbffr UnitedHealth Group
- 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...Remote jobWork at office
- ...in Arizona to conduct quality of care investigations for Medicaid/Medicare members. This hybrid role requires 5+... ...years of RN experience, unrestricted AZ license, and ability to travel up to... ...the state. The position may involve remote work with up to 40% in-office time at...Remote jobWork 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...Remote workWork at office
- ...with expert review to surface fraud, waste, and abuse across Medicare, Medicaid, Commercial, and FEP lines of business, returning... ...and customer success, but you will not manage anyone. Strong investigators here come from healthcare payer/vendor backgrounds or from...Remote work
$77.1k - $92.52k
...Status: Regular Full-Time Office: Remote Salary: $77,099.34 - $92,5... .... Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding... ...: The SIU Fraud Investigator is responsible for identifying, investigating...Remote workFull timePart timeWork at officeFlexible hours$36 - $41 per hour
...appropriate interventions to the patients and families by utilizing the nursing process, the VITAS Palliative Care Guide, and Telecare Protocols... ...License(s) (with no current/pending restrictions) required.AZ multi-state licenseTelecare RNs that reside in a Nurse Licensure...Remote workContract workFlexible hoursNight shiftWeekend workDay shiftAfternoon shiftWeekday work- UnitedHealthcare is seeking a Senior Clinical Quality of Care RN to conduct QOC investigations, review IAD portal cases, and prepare reports for internal... ...State, Federal, and regulatory standards. This Arizona-based remote role allows up to 40% in‑office with up to 25% travel. Key...Remote jobWork at office
$53k - $55k
...Healthcare Investigator - State of Ohio (Multiple Openings) Work Location: Remote – Must be a licensed LSW, RN, or LPC in the State... ...investigating incidents involving Medicaid recipients and/or providers to... ...Required) Licensed Registered Nurse (RN) – Ohio Licensed Social...Remote workWork from homeFlexible hours$1,291 per week
Travel Nurse RN - Medical-Surgical - $1,291 per week in Glendale, AZ Glendale , AZ Last day to apply Full Time Registered Nurse (RN) | Medical-Surgical Location:... ...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 officeImmediate startShift workNight shiftWeekend work- ...Healthcare in Arizona is seeking a registered nurse to serve as a Care Manager for Medicaid members recently admitted to hospital. The role... ..., address barriers, and travel locally 25-40%. Remote work is possible within AZ, with shifts 7:00 AM-6:00 PM. #J-18808-Ljbffr...Remote 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
$68k - $71.12k
...Medicaid Registered Nurse Albany, NY (Hybrid: 50% Onsite / 50% Remote) Salary Range: $68,000 - $71,116.50 The Bureau of Specialized Services for Children (BSSC) within the Division of Program Development and Management (DPDM) is seeking a dedicated Registered Nurse...Remote workWork at officeFlexible hours- Job Overview Registered Nurse - BMT Clinic - RN Job at Mayo Clinic, Phoenix, AZ. City: Phoenix. State: AZ. Remote: No. Department: Nursing. Why Mayo Clinic Mayo Clinic is top‑ranked in more specialties than any other care provider according to U.S. News & World Report....Remote workFull timeMonday to FridayFlexible hoursNight shiftAfternoon shift
$130k - $170k
...Nurse Practitioner (NP) Remote Care Model If you're a Nurse Practitioner who prefers autonomy, enjoys... ...healthcare team focused on managing complex Medicaid populations through a telehealth-... ...: Nurse Practitioner license (AZ) Master's degree or higher Strong...Remote job- Molina Healthcare is seeking an RN Care Manager to support AZ Medicaid members transitioning from hospital to home or post-acute care. The role blends phone outreach with in-person interactions, requiring strong EMR and HIPAA competence and meticulous note-taking. The position...Remote jobNight shiftWeekday work
- Registered Nurse - Pain Clinic - RN job at Mayo Clinic. Phoenix, AZ. City Phoenix State AZ Remote NO Department Nursing Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together...Remote workFull timeFlexible hoursShift workNight shiftWeekend workAfternoon shift
$46.99k - $112.2k
...Senior Investigator, Aetna Special Investigations Unit We're building a world of health... ...payment of aberrant claims submitted to the Medicaid lines of business for payment... ...healthcare fraud and abuse matters ~ Medicaid/Medicare investigation experience; knowledge of...Remote workHourly payFull timeTemporary workWork at officeLocal area$80.4k - $109.5k
...Role Overview: The Investigator is responsible for conducting comprehensive investigations... ...required. For roles that are 100% remote or hybrid, you must have access to a... ...: Health care industry and/or Medicare/Medicaid/Pharmacy/Behavioral Health/Pharmacy Benefit...Remote workContract workWork experience placementWork at officeLocal areaFlexible hours- ...Section 1: Position SummaryThe Senior Fraud Investigator is a senior individual contributor... ...relevant experience preferredFor all virtual remote positions, in order to ensure associates... ...SummaryLocation: Remote, Florida; Phoenix, AZ; Nashville, TN; Houston, TX; Charlotte,...Remote workFull timeSecond job
$46.7k - $60.7k
...Industry Operations Investigator This position is an entry-level Industry Operations Investigator... ...Mobile, AL Montgomery, AL Phoenix, AZ Show more locations (69) Dublin, CA... ...WA Charleston, WV Milwaukee, WI Remote job Telework eligible: No Travel...Remote workPermanent employmentFull timeTemporary workWork at officeRelocationTrial period$85.94k - $94.56k
...and accountability. POSITION SUMMARY The Investigator 2 is responsible for conducting full-scale... ...-motivate and works independently in a remote environment. Critical thinking skills, ability... ...states eligible for remote work: AL, AZ, CA, CO, CT, DE, FL, GA, IL, IN, KY, MD,...Remote workFull timeTemporary workWork at officeLocal areaFlexible hours$48.47k - $53.85k
...communities for a better quality of life. SENIOR INVESTIGATOR (Temporary Positions) Office of Inspector... ...To learn more about DES please visit des.az.gov or click on the link here to view ‘... ...the option of a full-time or part-time remote work schedule, employees enjoy improved...Remote workFull timeTemporary workPart timeFor contractorsWork at officeLocal areaFlexible hours- ...leading complex fraud, waste, and abuse investigations, the full-time Senior Fraud... ...and support corrective actions in a remote work environment. Key responsibilities... ...state healthcare regulations, including Medicaid and Medicare Preferred certifications include Accredited...Remote workFull time
- ...growth of a healthcare analytics firm, the full-time remote Healthcare Fraud Investigator will identify and qualify improper-payment leads, manage... ...payer or vendor environment Experience across Medicare, Medicaid, Commercial, and FEP lines of business Proficiency with...Remote workFull time
- ...Healthcare Fwa InvestigatorLevels (Investigator, Sr. Investigator, etc) will depend on experience... ...resultsSupport multiple clients with Medicaid, Medicare, Federal Employee and Commercial lines... ...to work independently within a remote team, under minimal supervisionBenefits...Remote work
- ...Job Location : Tempe, AZ (3 days onsite & 2 days remote) Duration: 6-month contract-to-hireSchedule: Monday–FridayWork Arrangement: Onsite training... ...of relevant experience in financial crimes, AML, fraud investigations, compliance, operational risk, law enforcement, or...Remote workContract workWorldwide
$66k - $106k
...(SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and... ...practices regarding healthcare providers. Knowledge of Medicare and/or Medicaid programs and the rules, regulations, policies and...Remote workContract workFor contractorsFlexible hoursShift workNight shift$71.1k - $97.8k
...caring community The Pre-Authorization Nurse reviews prior authorization requests... ...with large carriers Previous Medicare/Medicaid experience Outpatient or home health... ...HIPAA information.Travel: While this is a remote position, occasional travel to Humana's...Remote workFull timeTemporary workApprenticeshipWork from homeHome office$71.1k - $97.8k
...community The Utilization Management Nurse utilizes clinical nursing skills to support... ...Health Plan experience Previous Medicare/Medicaid experience Call center or triage experience Additional Information Remote to work the eastern or central time zone...Remote workFull timeTemporary workApprenticeshipWork at officeWork from homeHome office$95.1k - $237.7k
...this is a fully on site position at the site in Phoenix, AZ. Are you a Nurse Practitioner or Physicians Assistant ready to embark on an... ...to the PI and study coordinator Familiarize with Investigational Products and related documents Effective Communication...Full timePart timeImmediate startWorldwide
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