Milliman Care Guidelines Jobs

This remote Utilization Management Nurse role supports Alignment Health's mission to serve seniors and chronically ill patients by reviewing pre-service authorization requests for medical necessity. The position requires an active California RN or LVN license and involves applying CMS and Milliman Care Guidelines to determine coverage for inpatient and outpatient services. Key responsibilities include collaborating with providers and medical directors, verifying eligibility and coding accuracy, and managing turnaround times for referrals. The role appeals to nurses seeking a fast-paced, production-driven environment with opportunities for professional growth within a mission-driven company. The schedule is Monday through Friday with occasional weekend rotations, operating within Pacific, Mountain, or Central time zones.

This senior sales role within the epocrates division of athenahealth focuses on driving advertising solutions for pharmaceutical and life sciences clients. The position involves managing the full sales cycle, from prospecting and contract negotiation to post-sales engagement and campaign optimization. Key responsibilities include developing strategic account plans, guiding clients on integrated media strategies, and leveraging data insights to maximize ROI while ensuring regulatory compliance. The role appeals to professionals seeking to impact healthcare accessibility through a mission-driven culture that values inclusiveness and innovation. It offers a hybrid work arrangement with remote flexibility and up to forty percent travel, supported by a collaborative environment that encourages work-life balance and professional growth.

This senior sales role within the epocrates division of athenahealth focuses on driving advertising solutions for pharmaceutical and life sciences clients. The Market Leader manages the full sales cycle, from prospecting and contract negotiation to post-sales engagement, while developing strategic account plans and optimizing campaign performance through data-driven insights. Key responsibilities include leading the RFP process, guiding clients on integrated media strategies, and maintaining strong relationships with brand leaders and media agencies. The position appeals to professionals seeking to impact healthcare accessibility through a mission-driven culture that values inclusiveness and innovation. The role offers a hybrid work arrangement with remote flexibility and requires up to forty percent travel within the assigned territory.

This senior sales role within the epocrates division of athenahealth focuses on driving advertising solutions for pharmaceutical and life sciences clients. The Market Leader manages the full sales cycle, from prospecting and RFP coordination to contract negotiation and post-sales campaign optimization. Key responsibilities include developing strategic account plans, guiding clients on integrated media mixes involving programmatic and direct placements, and leveraging data insights to maximize ROI. The position appeals to professionals seeking to impact healthcare accessibility while working with a mission-driven culture that values inclusivity and innovation. The role offers a hybrid work arrangement with remote flexibility and up to forty percent travel within the assigned territory.

This full-time Registered Nurse role serves as a Quality Assurance Coordinator within the BJC HealthCare system at Parkland Health Center in Farmington, Missouri. The position focuses on managing regulatory reporting for critical conditions like STEMI, stroke, and sepsis to ensure state accreditation compliance. Key responsibilities include coordinating patient care for select populations, evaluating clinical outcomes, and utilizing Excel for data analysis. The role is appealing due to the organization's deep local roots, comprehensive benefits package including tuition assistance, and the opportunity to support high-quality care in a rural community setting. The schedule is Monday through Friday with flexibility for occasional evening coordination.

This Dental Hygienist role involves providing comprehensive patient care within a collaborative dental team at an Aspen Dental practice. Key responsibilities include developing patient care plans alongside dentists using AAP guidelines, managing schedules for thorough treatment and education, and utilizing advanced digital technology like 3D scanners. The position is appealing due to flexible scheduling options for full-time, part-time, or PRN work, along with a supportive culture that prioritizes professional growth through free continuing education and mentorship. The role offers access to state-of-the-art equipment and opportunities for career advancement within a mission-driven organization dedicated to making dental care accessible.

This Radiologic Technologist role supports patient care within a CareNow urgent care clinic, part of the larger HCA Healthcare network. The position involves performing diagnostic x-rays and in-house laboratory tests such as drug screens and urinalysis while maintaining strict compliance with safety and documentation standards. Key responsibilities include operating and calibrating imaging equipment, managing patient check-in and records, and collaborating with medical staff to ensure efficient clinic operations. The role appeals to candidates seeking a supportive environment with extensive professional development opportunities, including education assistance and a comprehensive benefits package. The position offers potential for career growth within a large, ethical organization and may require flexibility with shifts or floating between locations.

This Radiologic Technologist role is based at a CareNow urgent care clinic within HCA Healthcare, focusing on delivering high-quality, patient-centered care. The position combines clinical duties with front desk responsibilities, including performing X-rays and various laboratory tests such as drug screens and urinalysis while maintaining equipment and managing patient records. Key responsibilities also involve coordinating with clinic staff to ensure smooth operations and adhering to strict infection control and safety protocols. The role appeals to candidates seeking a collaborative environment with a strong mission to serve the community, offering access to extensive professional growth opportunities, comprehensive benefits, and a supportive team culture. The position may require alternate shifts and occasional travel to other clinic locations.

The Pharmacy Manager role leads pharmacy operations within a Walgreens store, focusing on delivering empathetic clinical services and managing a high-volume workflow. Key responsibilities include supervising staff performance and development, ensuring accurate medication dispensing and regulatory compliance, and providing patient consultations on drug interactions and wellness services like immunizations. The position appeals to candidates seeking a leadership opportunity that blends clinical expertise with business management in a collaborative environment. The role emphasizes professional growth through mentorship and training while offering the chance to transform patient care from transactional to interpersonal within a large, established healthcare network.

The Central Sterile Processing Technician role at UHealth-University of Miami supports patient care by managing the cleaning, sterilization, and distribution of medical instruments and supplies. Key responsibilities include decontaminating equipment, assembling surgical trays, maintaining sterile storage, and ensuring timely delivery of supplies to various hospital departments. This position offers the opportunity to work within a leading academic medical center known for groundbreaking research and high-quality patient care. The role requires specific vocational training and certification, with a focus on adhering to strict infection control standards and safety protocols.

The Pharmacy Manager role leads pharmacy operations within a Walgreens retail location, focusing on delivering empathetic clinical services and managing a high-volume workflow. Key responsibilities include overseeing medication compounding, verification, and dispensing while ensuring strict regulatory compliance. The manager also drives patient engagement by providing drug interaction counseling, administering immunizations, and performing diagnostic testing. Additionally, the position involves managing staff performance, scheduling, and professional development to foster a collaborative team environment. This role appeals to candidates seeking a position that blends clinical expertise with leadership opportunities in a mission-driven healthcare setting. The position offers a dynamic work arrangement within a retail store environment, emphasizing community health and operational efficiency.

The Pharmacy Manager role leads pharmacy operations within a Walgreens retail location, focusing on delivering empathetic clinical services and managing a high-volume workflow. Key responsibilities include supervising staff performance and development, ensuring accurate medication dispensing and regulatory compliance, and driving patient engagement through immunizations, drug therapy reviews, and health consultations. The position appeals to candidates seeking a leadership opportunity that blends clinical expertise with business management in a collaborative environment. The role emphasizes professional growth, community health impact, and the transition of pharmacy services from transactional to interpersonal care, operating within a structured retail setting.

This full-time Radiologic Technologist role is based at a CareNow urgent care clinic within HCA Healthcare, focusing on delivering high-quality, patient-centered care. The position involves performing X-ray procedures and in-house laboratory tests such as drug screens and urinalysis while maintaining and calibrating medical equipment. Key responsibilities also include managing front desk duties like patient check-in and records release, ensuring strict adherence to infection control and safety protocols. The role appeals to candidates seeking a collaborative environment with a strong mission to serve the community, offering opportunities for professional growth within a large healthcare network. The position may require working alternate shifts and floating between clinic locations.

This full-time Radiologic Technologist role is based at a CareNow urgent care clinic within HCA Healthcare. The position combines clinical radiology duties with front desk responsibilities to ensure seamless patient care. Key responsibilities include performing X-ray procedures and in-house laboratory tests such as drug screens, maintaining and calibrating medical equipment, and managing patient check-in and records. The role appeals to candidates seeking a collaborative environment with a strong focus on patient experience and community support. Opportunities for professional growth are available within a large healthcare network that offers comprehensive benefits, including education assistance and retirement matching. The position may require flexible scheduling and occasional travel between clinic locations.

This part-time Nuclear Medicine Technologist role supports the imaging and PET programs at HCA Florida Mercy Hospital, serving primarily adult and geriatric patients. The position involves performing diagnostic nuclear medicine procedures while strictly adhering to safety guidelines to minimize radiation exposure for staff and visitors. The role appeals to professionals seeking a mission-driven environment within a Catholic hospital dedicated to comprehensive care, including stroke and cancer treatment. Candidates benefit from a robust support system featuring extensive health coverage, retirement matching, and significant educational assistance. The position offers flexible PRN scheduling within a collaborative team culture recognized for ethical standards and community investment.

This full-time Radiologic Technologist role is based at a CareNow urgent care clinic within HCA Healthcare. The position involves performing X-ray procedures and conducting in-house laboratory tests such as drug screens and urinalysis while maintaining equipment and ensuring compliance with safety protocols. The role also includes front desk responsibilities like patient check-in and records management to support smooth clinic operations. The position is appealing due to the opportunity to work within a large, collaborative healthcare network that emphasizes patient-centered care and offers extensive professional growth. The role provides access to a comprehensive benefits package including education assistance and retirement matching, with potential flexibility to float between clinic locations.

This hybrid pharmacist role operates across various retail locations in Missouri with one day per week dedicated to remote centralized support. The position involves verifying prescriptions, compounding medications, and conducting drug therapy reviews while ensuring strict regulatory compliance. Key responsibilities include providing patient consultations, administering immunizations, managing inventory, and collaborating with medical providers to optimize patient care and pharmacy operations. The role is appealing for its blend of direct patient interaction and strategic support work, offering opportunities to foster community health through outreach and mentorship. The position supports a collaborative culture focused on continuous improvement and professional growth within a large, established healthcare organization.

This hybrid pharmacist role is based in North Carolina, combining four days of in-store retail duties with one day of remote centralized support. The position involves verifying prescriptions, compounding medications, and providing clinical services such as immunizations and patient consultations. Key responsibilities include managing inventory, optimizing pharmacy workflows, and fostering relationships with local healthcare providers. The role appeals to professionals seeking a blend of direct patient care and operational leadership within a large, established healthcare organization. It offers a flexible work arrangement that balances community engagement with remote administrative tasks, supporting a mission to create healthier futures for patients.

This hybrid pharmacist role is based in North Carolina, combining four days of in-store retail operations with one day of remote centralized support. The position involves verifying prescriptions, compounding medications, and conducting drug therapy reviews while ensuring strict regulatory compliance. Key responsibilities include providing clinical services such as immunizations and patient consultations, managing inventory and financial workflows, and fostering professional development within the pharmacy team. The opportunity appeals to candidates seeking a blend of direct patient care and operational leadership within a large, established healthcare organization. The role offers a flexible work arrangement that balances community engagement with remote administrative duties, supporting a mission to build healthier futures through accessible healthcare services.

This hybrid pharmacist role is based in North Carolina, combining four days of on-site work at retail locations with one day of remote support for centralized services. The position involves verifying prescriptions, managing medication compounding, and providing clinical services such as immunizations and patient consultations. Key responsibilities include optimizing pharmacy workflows, managing inventory, and fostering relationships with local healthcare providers. The role appeals to professionals seeking a blend of direct patient care and operational leadership within a large, established healthcare organization. It offers the opportunity to work in diverse environments while contributing to community health initiatives and supporting team development.

This hybrid retail pharmacist role is based in North Carolina, combining on-site duties at various locations with one day per week of remote centralized support. The position involves verifying prescriptions, compounding medications, and conducting drug therapy reviews while ensuring strict regulatory compliance. Key responsibilities include providing patient consultations, administering immunizations, managing inventory, and collaborating with medical providers to optimize patient care. The role appeals to professionals seeking a blend of clinical practice and operational leadership within a large, established healthcare organization. It offers opportunities for professional growth, community engagement, and the chance to work in a flexible environment that supports both in-store and virtual pharmacy services.

This PRN Radiologic Technologist role at Carroll Hospital supports the Diagnostic Imaging team in producing high-quality radiographs for patients of all ages. Key responsibilities include operating various imaging equipment such as DR, CR, and fluoroscopes, utilizing PACS systems for patient care, and troubleshooting technical issues independently. The position is appealing due to the organization's commitment to professional growth through tuition reimbursement and advanced certification opportunities, alongside a collaborative culture that encourages working at the top of one's license. The role is based in Westminster, Maryland, with flexible hours scheduled on an as-needed basis.

This hybrid pharmacist role operates across various retail locations in Tennessee, combining four days of in-store duties with one day of remote centralized support. The position involves verifying prescriptions, compounding medications, and conducting drug therapy reviews while ensuring strict regulatory compliance. Key responsibilities include providing clinical services such as immunizations and patient consultations, managing inventory and financial workflows, and fostering professional development within the pharmacy team. The opportunity is appealing for its flexible hybrid work arrangement and the chance to contribute to a large, established healthcare organization dedicated to improving community health outcomes through trusted patient relationships.

This full-time Case Manager Social Worker role at Grace Medical Center supports the allied health team by coordinating post-acute care and providing psychosocial support to patients and families. Key responsibilities include conducting comprehensive assessments, developing intervention plans that address social and emotional needs, and leading discharge rounds to ensure efficient resource utilization. The position appeals to professionals seeking a collaborative environment within a purpose-driven health system that values innovation and community-centered care. The role offers significant opportunities for professional growth through tuition reimbursement and advanced certification programs, while operating on a standard day shift schedule in Baltimore.

This senior technology role within the Prospect and Client Management team at LPL Financial focuses on leading the design and development of high-volume, low-latency applications for mission-critical systems. The position involves collaborating with product owners to translate business needs into technical solutions, coordinating with architecture and infrastructure leaders to optimize delivery speed, and coaching teams through the software development lifecycle. The role appeals to candidates seeking a collaborative environment where they can drive innovation while supporting the firm's mission to empower financial advisors. The position offers a hybrid work arrangement and provides opportunities for professional growth within a culture that values integrity, creativity, and continuous improvement.