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Open positions
Utilization Review LVN/RN
Assesses services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines. Analyzes clinical service requests from members or providers against…
RN Utilization Management Nurse
Salary: Pays up to $39/hr ($2,000 sign on bonus) with great benefits package Shift: Monday to Friday 8:00AM to 5:00PM • Performs review of requested outpatient and elective, prospective inpatient medical services. •…
RN Field Case Manager
Salary : Up to $68,000 plus 6% annual bonus opportunities & Excellent Benefits Package Shift: Monday to Friday 8:00AM to 5:00PM Assess the member's current health status, resource utilization, past and present…
RN Field Case Manager
Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Utilize assessment skills and…
HEDIS Nurse Abstractor
Ideal candidate must be flexible and willing to develop/share strategies to accomplish goals. Will work under the supervision of Anthem internal staff and designated lead in order to achieve goals and keep the project…
Prior Authorization Pharmacy Technician
Candidate will be working in the MagellanRX call center and will be responsible for answering around 30-50 calls per day (majority being inbound). Calls may be from enrollees, doctor offices or pharmacies and topics…
Bilingual Pharmacy Technician
Candidate will be responsible for telephonic outreach by the pharmacy department for the MyMeds Program. Will provide outreach to non-adherent patients to assist in refilling maintenance medication. Will also…
Registered Nurse Supervisor of Case Management
RN Case Management Supervisor Are you an experienced Registered Nurse with Case Management / Care Management experience and Supervisory experience looking for a new opportunity with a prestigious healthcare company? Do…
Registered Nurse Concurrent Review
We are aggressively seeking RN Concurrent Review Nurses and RN Case Managers for a Fortune 500 Healthcare organization. Take advantage of flexible hours, a competitive salary, and be a n RN Concurrent Review Nurse…
Utilization Review RN
These candidates will be working in the continued stay review department. They will be looking at emerging urgent inpatient admissions for medical necessity. Strong computer skills, positive attitude, and ability to…
Registered Nurse Case Manager
Perform true case management functions, interacting with patient and managing their clinical care telephonically Work with patients/members in the foster care program You will be responsible for developing and…
Behavioral Health Case Manager
Perform integrated case management functions with high risk members Help Health Plan members achieve their goals, empowerment and improved quality of life for their behavioral and physical health issues Conduct field…
Behavioral Health Case Manager
Perform integrated case management functions with high risk members Help Health Plan members achieve their goals, empowerment and improved quality of life for their behavioral and physical health issues Work with NCQA…