The purpose of this position is to provide care coordination services to Providence Health Plans(PHP) members. Care coordination services include: disease management programs, including educating, motivating and empowering members to manage their disease. Case management including: triage and referral, transition of care planning, end of life care planning, other acute and catastrophic case management. These services are offered to members and their families who have acute and complex health care needs; members with chronic conditions at risk for poor health outcomes and members who are terminal and nearing end of life. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence Health Plan welcomes 100% remote work for applicants who reside in the following states: - Washington - Oregon Required Qualifications: - Current unencumbered Registered Nurse License in state of residency upon hire. - 5 years Clinical nursing experience. - Experience working with physicians in the collaboration and management of patient care. Preferred Qualifications: - Bachelor's Degree in Nursing or Health Education. - Current nursing experience in the following areas: cardiology, endocrinology, pediatrics, obstetrics, oncology, respiratory, health education. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons. At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise. Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

This is a remote position. Virtual Rockstar is hiring a full-time Medical Virtual Assistant (Front Desk & Patient Coordination Specialist) on behalf of a physical therapy practice to support scheduling, patient communication, intake, and administrative operations. This role is ideal for someone who is highly organized, personable, and detail-oriented, with strong communication skills and the ability to manage patient interactions, scheduling, and day-to-day administrative workflows in a fast-paced healthcare environment. You will play a key role in ensuring a smooth and welcoming patient experience while supporting the internal team with operational and administrative tasks. ​ About Our Client This physical therapy practice is dedicated to helping individuals optimize their physical, mental, and emotional well-being through a holistic and patient-centered approach. The team values strong relationships—with patients, families, and the community—and fosters a culture rooted in compassion, gratitude, collaboration, and overall wellness. Their philosophy is centered on lifestyle medicine, empowering patients to achieve meaningful and lasting results Key Responsibilities Patient Scheduling & Front Desk Support - Manage patient scheduling, including creating, reviewing, and adjusting appointments - Confirm appointments and manage rescheduling requests - Maintain and optimize appointment calendars - Support check-in and check-out processes virtually - Coordinate schedules with therapists and clinical staff - Maintain waitlists and ensure schedule efficiency Patient Communication & Support - Answer and manage incoming phone calls and call overflow - Respond to patient inquiries via phone, email, and messaging platforms - Provide accurate information regarding services, policies, and procedures - Deliver a warm, professional, and welcoming patient experience - Follow up with patients and support ongoing communication Intake & Patient Records Management - Collect and input patient intake information accurately - Maintain and update patient records in EMR systems - Ensure all documentation is complete, accurate, and up to date - Coordinate with other medical offices to obtain referrals and additional patient information Administrative & Operational Support - Process patient payments and maintain accurate financial records - Assist with reporting and tracking practice growth metrics - Manage Lifestyle Medicine program analytics and outstanding balances - Support SOP creation and process improvements - Attend team meetings and contribute to workflow optimization - Perform backup billing support as needed Tools & Systems - PROMPT (EMR) - Weave (VOIP) - Momence (Gym/Program Management Platform) - Email and internal communication tools - (Experience with these tools is preferred but not required.) ​ Requirements - Experience as a Medical Virtual Assistant, Front Desk Coordinator, or similar healthcare administrative role - Strong experience in scheduling, patient coordination, and phone support - Excellent English communication skills with a clear and confident speaking voice - Strong attention to detail and organizational skills - Comfortable handling patient-facing interactions in a professional and empathetic manner - Ability to multitask and manage a high volume of tasks - Proactive, dependable, and able to work independently Non-Negotiables - Exceptionally strong English communication skills and clear speaking voice - Warm, welcoming, and patient-focused personality - Highly organized, dependable, and detail-oriented Benefits - Competitive salary commensurate with experience - Opportunities for professional development and growth - Work in a dynamic and supportive team environment - Make a meaningful impact by helping to build and strengthen families across the globe

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Senior Clinical Administrative Nurse is an outreach‑intensive role in which the nurse spends approximately 90%25 of the workday on the phone attempting engagement with membership. Using clinical expertise, the nurse conducts structured outreach to engage members, assess needs, and introduce available clinical services in support of organizational engagement goals. In addition to outbound outreach, the role supports members and their covered families with health care system navigation and care coordination. Acting as a clinical liaison, the nurse collaborates with members, caregivers, medical providers, and internal and external clinical teams to facilitate coordinated, efficient care using a clinically informed and operationally driven approach. Success in this role requires comfort spending most of the workday on the phone, sustained outbound calling, efficiency in member engagement, and the ability to balance clinical assessment with operational productivity expectations. Candidate must be willing to work weekdays 11:00 am – 8:00 PM CST, including Saturdays 8:00 am – 5:00 PM CST. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Provide members with tools and educational support to navigate the health care system and manage health concerns effectively and cost efficiently - Assist members with adverse determinations, including support through the appeals process - Educate members on the use of UMR internet based wellness tools and resources - Educate and guide members regarding behavioral health and substance use disorder (BHSUD) services - Provide ER steerage and education on appropriate emergency department utilization and alternative levels of care - Conduct outreach to members to provide pre admission counseling - Conduct outreach to members and caregivers to support discharge planning - Track all activities and maintain complete documentation to support customer reporting - Accept referrals through designated processes; collaborate in evaluating available services and coordinate required medical care and community referrals - Comply with all policies, procedures, and documentation standards across applicable systems, tracking mechanisms, and databases - Contribute to treatment plan discussions - Perform other duties as assigned You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - Current and unrestricted RN compact license - Ability to obtain additional state licensure as needed - 2+ years of acute nursing experience - 2+ years of behavioral health nursing experience - 2+ years of case management experience - Basic computer proficiency (i.e. MS Word, Outlook) - Proven ability to function independently and responsibly with minimal supervision Preferred Qualifications: - Bachelor’s degree in nursing - CCM - 2+ years managed care experience - Critical care, pediatric, med-surg and/or telemetry experience - Utilization management experience - Adverse Determination experience - Telecommute experience Soft Skills: - Demonstrated excellent verbal and written communication skills - Excellent customer service orientation - Proven team player and team building skills - Ability and flexibility to assume responsibilities and tasks in a constantly changing work environment *All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #uhcpj

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Clinical Staff Pharmacist RemoteJob Description The Clinical Staff Pharmacist is responsible for the processing and documenting of Utilization Management requests (e.g. formulary exceptions, prior authorization, step therapy, quantity limit exceptions) for delegated products and services. Responsibilities - Process the clinical evaluation for coverage determination requests for prior authorization (PA) or other utilization management (UM) programs, including quantity limits, step therapy, formulary exception and tier exception; this includes consideration of the denial language and appropriateness of the decision as it pertains to the clinical content of the case and the intent of the individual client’s pre-approved criteria - Consult directly with healthcare providers to address non-formulary and clinical product coverage issues - Collaborate with team members to ensure consistent decision-making across the pharmacist team - Respond to medication-related inquiries via phone, providing accurate information to patients, providers, and clinics regarding medications, formulary options, and coverage questions - Other duties as assigned Minimum Qualifications - Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree - 1 years of work experience in clinical, retail, hospital, or managed care - Current pharmacist license in good standing with the State Board of Pharmacy Must be eligible to work in the United States without the need for work visa or residency sponsorship Additional Qualifications - Strong verbal and written communication skills - Ability to work efficiently with computers and digital tools ​ Preferred Qualifications - Managed care experience Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job Potential pay for this position ranges from $51.92 - $88.46 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits). Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.   We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer. Positions will be posted for a minimum of five consecutive workdays.