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Jobs: 1 - 10 of 627

Appeals Nurse Consultant Chat With Our Recruiters Here:

Aetna. Hartford

POSITION SUMMARY Review clinical appeals related to Medicare Advantage Plan members using Center for Medicare and Medicaid Services criteria as well as other criteria Fundamental Components: Review clinical appeals concerning a variety of c...

Country United States
State Connecticut (CT)
Job Category Healthcare
Position Type Full Time

Supvr, Bus Info Mgmt&Anly Chat With Our Recruiters Here:

Aetna. Blue Bell

POSITION SUMMARY To define, develop and provide information, analysis and reporting solutions on Medicare Advantage/Prescription Drug Plan membership to drive the decision-making process and support business operations for internal and exte...

Country United States
State Pennsylvania (PA)
Job Category Healthcare
Position Type Full Time

Sr Informatics Analyst Chat With Our Recruiters Here:

Aetna. Phoenix

POSITION SUMMARY This position will be involved with Finance / Value Based Purchasing and will be responsible for meeting technical requirements for converting medical data into performance informatics. Working on business requirements that...

Country United States
State Arizona (AZ)
Job Category Healthcare
Position Type Full Time

Provider Relations Representative Chat With Our Recruiters Here:

Aetna. Philadelphia

POSITION SUMMARY Responsible for maintaining working relationships with the existing provider network. Assists providers with policy and procedure interpretation. Maintains accurate and current databases relating to provider facilities and ...

Country United States
State Pennsylvania (PA)
Job Category Healthcare
Position Type Full Time

Utilization Management Clinical Consultant (RN)- Registered Nurse Chat With Our Recruiters Here:

Aetna. Baton Rouge

POSITION SUMMARY The Prior Authorization Review Nurse utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Applies critical thinking and knowledge in clinically appropri...

Country United States
State Louisiana (LA)
Job Category Healthcare
Position Type Full Time

Network Account Manager Chat With Our Recruiters Here:

Aetna. Rochester

POSITION SUMMARY Develops strong relationships with network providers and internal business partners leading to the achievement of provider satisfaction, medical cost targets, network growth and/or efficiency targets. Works with internal bu...

Country United States
State New York (NY)
Job Category Healthcare
Position Type Full Time

Provider Relation Representative Chat With Our Recruiters Here:

Aetna. Allentown

POSITION SUMMARY Responsible for maintaining working relationships with the existing provider network. Assists providers with policy and procedure interpretation. Maintains accurate and current databases relating to provider facilities and ...

Country United States
State Pennsylvania (PA)
Job Category Healthcare
Position Type Full Time

Sr Informatics Analyst Chat With Our Recruiters Here:

Aetna. Plantation

POSITION SUMMARY The successful candidate for this position will be a skilled report developer (SQL and Crystal Reports) with the ability to balance multiple priorities. Responsible for executing and completing specific deliverables and act...

Country United States
State Florida (FL)
Job Category Healthcare
Position Type Full Time

Network Account Manager Chat With Our Recruiters Here:

Aetna. New York

POSITION SUMMARY Develops strong relationships with network providers and internal business partners leading to the achievement of provider satisfaction, medical cost targets, network growth and/or efficiency targets. Works with internal bu...

Country United States
State New York (NY)
Job Category Healthcare
Position Type Full Time

Utilization Management (UM) Nurse Associate Chat With Our Recruiters Here:

Aetna. Blue Bell

POSITION SUMMARY AETNA CLINICAL JOB FAIR-FRIDAY, MARCH 24-9-5 AND SATURDAY, MARCH 25-9-2 DoubleTree Suites by Hilton Philadelphia West 640 Fountain Road Plymouth Meeting, PA 19462 In the Utilization Management Nurse Associate role, you will...

Country United States
State Pennsylvania (PA)
Job Category Healthcare
Position Type Full Time
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