Elevance Health jobs
Outreach Care Specialist II
Outreach Care Specialist II
Location : This is a remote role. Ideal candidates will live within 50 miles of an Elevance Health PulsePoint location in California.
A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs f...
Nurse Reviewer
Location: This is a Virtual role , Must be located within 50 miles of a Pulse Point
Schedule: Monday- Friday 9:30am-6:00pm PST, ability to work rotating weekends.
Responsible for conducting preauthorization, out of network and appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines.
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.
Wound Care UM RN
Location: Must reside within 50 miles / 1 hour commute of an Elevance Health Pulse Point.
Shift: Mon - Friday 10am - 7pm CST
Responsible for performing pre-certification certification and/or authorization activities for Home Health Services for members with wound care needs included as contracted services that meet eligibility and benefits coverage. Oversees members who have complex wound needs to determine if ...
Clinical Quality Program Manager
Location: This is a hybrid role that requires you to work from the Woodland Hills, CA office 1 - 2 times each week or minimum 1 day/week. One must reside within 50 miles of 21215 Burbank BLVD Woodland Hills, CA
The Clinical Quality Program Manager is responsible for serving as a liaison with and overseeing the quality improvement activities/projects/programs for one or more states within a major line of business.
How you will make a ...
Managing Associate General Counsel Sr.
Managing Associate General Counsel Senior
Location: This position will work a hybrid model (remote and office). Ideal candidates must live within 50 miles of a PulsePoint location.
The Managing Associate General Counsel Senior will be responsible for providing leadership and strategic oversight for all aspects of the Government Business Legal Team, with a specific focus on Medicaid managed care. Additionally, is responsible for providing...
Outreach Care Specialist II
Outreach Care Specialist II
Location : This is a remote role. Ideal candidates will live within 50 miles of an Elevance Health PulsePoint location in California.
A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs f...
Behavioral Health Case Manager I
Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health PulsePoint location.
Schedule: First shift PST daytime hours
The Behavioral Health Care Manager I is responsible for performing case management telephonically within the scope of licensure for members with behavioral health disorder needs.
How you will make an impact:
- Uses appropriate screening criteria...
Clinical Ops Medical Director
Location: Within 50 miles of any Elevance Health Pulse Point office
Shift: Monday – Friday; 8.5-hour shifts between 7am – 7pm CT (later shift hours preferred)
The Clinical Ops Medical Director opportunity is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to members and providers.
How you will make an impact:
- Ensures timely completion of clinica...
Provider Operations Manager
The Provider Operations Manager is responsible for developing, executing and delivering operational readiness plans for provider experience strategic initiatives. Primary duties may include, but are not limited to:
- Leads the standardization of operational readiness plans for provider experience initiatives and mentors team members.
- Coordinates the development and delivery of required training to support the needs of the project team and operational/productio...