Elevance Health jobs
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...
Sales Director, Real-world Data Products
A proud member of the Elevance Health family of companies, Carelon Research, formerly HealthCore, Inc., works with life sciences companies, payers and providers, and government and academic organizations to provide real-world evidence in support of a wide variety of healthcare decisions.
Carelon Research is looking to hire a Sales Director to spearhead sales strategies for our Real-world Data Products. In this role, you'll drive growth with life sciences companies by cra...
Wound Care UM RN
Location: Must reside within 50 miles / 1 hour commute of an Elevance Health Pulse Point.
Shift: Monday - 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 det...
Insurance Customer Care Representative- Bilingual (Korean)
Insurance Customer Care Representative- Bilingual (Korean)
Location: On-site 2789 W OLYMPIC BLVD
The Insurance Customer Care Representative - Bilingual (Korean) is responsible for handling all walk-in customers by responding to inquiries for all lines of business.
Sign-on Bonus: $500.00
How you will make an impact:
- Receives and verifies premium payments.
- Assists customers with informatio...
Strategic Sourcing Manager-Technology
Location: 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 Strategic Sourcing Manager (Technology) plays a critical role by leading the execution and implementation of high-value, complex Technology Sourcing and contracting initiatives. This role demands a deep understanding of IT infrastructure, private and public cloud environments, various I...
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...
Behavioral Health Case Manager II
Schedule: First shift PST daytime hours
Behavioral Health Case Manager II
The Behavioral Health Case Manager II 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: ...
Behavioral Health Case Manager 1
Location: This is a virtual role. The preferred candidate will live within 50 miles of one of our listed California Elevance Health PulsePoint locations.
The Behavioral Health Case Manager 1 is responsible for performing telephonic case management within the scope of licensure for members with behavioral health and physical health needs.
How you will make an impact:
- Uses appropriate screening criteria, knowledge, and cl...
Behavioral Health Case Manager 1
Location: This is a virtual role. The preferred candidate will live within 50 miles of one of our listed California Elevance Health PulsePoint locations.
The Behavioral Health Case Manager 1 is responsible for performing telephonic case management within the scope of licensure for members with behavioral health and physical health needs.
How you will make an impact:
- Uses appropriate screening criteria, knowledge, and cl...
Diagnosis Related Group Clinical Validation Auditor-Registered Nurse
Diagnosis Related Group Clinical Validation Auditor-Registered Nurse
Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.
The Diagnosis Related Group Clinical Validation Auditor is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in re...