Elevance Health jobs
Nurse/CPC – Clinical Fraud Investigator Senior
Nurse/CPC - Clinical Fraud Investigator Senior - SIU Fraud & Abuse
Location: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.
The Clinical Fraud Investigator Senior is responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse.
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LTSS Service Coordinator – RN Clinician
LTSS Service Coordinator - RN Clinician
Location: Candidate should reside in California and be within 50 miles of one of our PulsePoint locations (Cerritos, Costa Mesa, LA, Palo Alto, Rancho Cordova, Sacramento, Walnut Creek, or Woodland Hills). This is a hybrid position, candidate will need to go into the office at least one day a week.
The LTSS Service Coordinator - RN Clinician is responsible for overall management of member's case within the...
Engineer Senior
Engineer Senior
Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of the following Pulsepoint location. 12900 Park Plaza Drive, Cerritos, California 90703
Hours: Monday to Friday, 8:00am to 5:00pm
The Engineer Senior collaborates with product managers and business stakeholders for system requirements, designs, architects, performs cost estimation and delivery timeli...
Nurse Reviewer I
Location: This is a Virtual role , Must be located within 50 miles of a Pulse Point
Schedule: 9:30am-6:00pm , Rotating weekend shifts.
Responsible for conducting preauthorization, out of network and appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines.
- Collaborates with healthcar...
Nurse Appeals (RN) CA
Nurse Appeals – Licensed RN Nurse
Location: This position will work in a hybrid model (remote and office). Ideal candidates will live in the state of California within 50 miles of one of our PulsePoint locations.
Shift: Monday to Friday from 8:00am-5:00pm PST
The Nurse Appeals is responsible for investigating and processing medical necessity appeals requests from members and providers.
Nurse Reviewer I
Location: This is a Virtual role , Must be located within 50 miles of a Pulse Point
Schedule: 9:30am-6:00pm , Rotating weekend shifts.
Responsible for conducting preauthorization, out of network and appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines.
- Collaborates with healthcar...
LTSS Service Coordinator
LTSS Service Coordinator
Location: Candidate should reside in California and be within 50 miles of one of our PulsePoint locations (Cerritos, Costa Mesa, LA, Palo Alto, Rancho Cordova, Sacramento, Walnut Creek, or Woodland Hills). This is a hybrid position, candidate will need to work in office at least one day a week.
The LTSS Service Coordinator is responsible for conducting service coordination functions for a defined caseload of individuals ...
LTSS Service Coordinator – RN Clinician
LTSS Service Coordinator - RN Clinician
Location: Candidate should reside in California and be within 50 miles of one of our PulsePoint locations (Cerritos, Costa Mesa, LA, Palo Alto, Rancho Cordova, Sacramento, Walnut Creek, or Woodland Hills). This is a hybrid position, candidate will need to go into the office at least one day a week.
The LTSS Service Coordinator - RN Clinician is responsible for overall management of member's case wit...
LTSS Service Coordinator – RN Clinician
LTSS Service Coordinator - RN Clinician
Location: Candidate should reside in California and be within 50 miles of one of our PulsePoint locations (Cerritos, Costa Mesa, LA, Palo Alto, Rancho Cordova, Sacramento, Walnut Creek, or Woodland Hills). This is a hybrid position, candidate will need to go into the office at least one day a week.
The LTSS Service Coordinator - RN Clinician is responsible for overall management of member's case within the...
LTSS Service Coordinator
LTSS Service Coordinator
Location: Candidate should reside in California and be within 50 miles of one of our PulsePoint locations (Cerritos, Costa Mesa, LA, Palo Alto, Rancho Cordova, Sacramento, Walnut Creek, or Woodland Hills). This is a hybrid position, candidate will need to work in office at least one day a week.
The LTSS Service Coordinator is responsible for conducting service coordination functions for a defined caseload of individuals ...