Home Health Nursing Jobs

Position Information Schedule: Monday–Friday 8:00am-5:00pm EST About Us American Health Holding, Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care management solutions that…

Position Summary The Lead Director, UM Center of Excellence (UM COE), Policy & Process Governance is a strategic and operational leader responsible for enterprise governance of the content and resources that guide Utilization Management work. This role ensures UM policies,…

Position Summary Responsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate,…

The Reasonable Accommodation Case Manager is responsible for managing and supporting the company’s compliance with the Americans with Disabilities Act (ADA), ADA Amendments Act (ADAAA), and applicable state and local disability laws. This role provides subject matter expertise…

** This role requires Board Certification in a Orthopedic Spine OR Neurosurgery. ** The starting base salary for this role is $300K Position Summary Aetna, a CVS Health Company, a Fortune 6 company, is one of the oldest and largest national insurers. That experience gives us a…

Position Summary Join Aetna's Medicaid Actuarial team for an exciting opportunity to work on strategic projects and other business-critical functions. This position will support Medicaid-wide analyses and reporting as part of the Medicaid Strat team. The role will work with…

Position Summary: Program Start Date: June 7, 2027 The pay range for this role is: $75,000 – $85,000 Please apply to be considered as a candidate if the starting salary is within your desired salary expectation. Who we are: We are America’s leading health solutions company…

Position Summary The Senior Analyst, PPO Network Discount Optimization plays a critical role in enhancing the value and competitiveness of Aetna Dental's provider networks by driving improvements in PPO discount performance across the United States. This position is responsible…

Position Summary The Senior Analyst, Compliance COE will be a key member of the Compliance Monitoring team and will execute assigned compliance monitoring activities. This role applies healthcare compliance, billing, coding, and risk adjustment knowledge to execute assigned…

Job Description Summary Develops and manages a team to address matters regarding complaints and appeals, ensuring compliance with federal and/or state regulations. Leads the development of policies, procedures, and programs to ensure compliance with policies of all applicable…

Role Summary This exciting new role in our Oak Street Health team will provide strategic leadership for Analytics product development by defining roadmaps, prioritizing feature development, coordinating with stakeholders, and ensuring successful product launches. You will work…

Position Summary We are seeking a highly skilled and visionary Staff Engineer to lead the architecture, development, and scaling of our core applications. In this role, you will bridge the gap between complex backend data systems, emerging AI capabilities, and intuitive frontend…

Position Summary Responsible for initial review and triage of claims tasked for review. Determines coverage, verifies eligibility, identifies and redirects misdirects Responsible for prepping the authorization in the system and triage cases to medical staff for review. Organized…

Position Summary Reporting to the Executive Director, Pharma Data Strategy & Solutions Delivery, the Senior Manager, Solutions Delivery manages the day-to-day execution of predefined and ad hoc engagements and analytics solutions for pharmaceutical manufacturer clients. This…

Position Summary CVS Health is seeking a Staff Software Development Engineer to design, develop and implement digital solutions and systems by applying advanced technical expertise to architect and code software applications, conduct system testing and debugging, collaborate…