Specialty Claims Adjudication Jobs

This entry-level or specialty pharmaceutical sales role involves leading product launches and serving as the primary sales agent within an assigned territory. The position requires reporting to a National Sales Manager while delivering comprehensive product knowledge to primary care and specialty physicians. Key responsibilities include meeting territory sales goals, identifying market opportunities through business analysis, and building relationships with local opinion leaders. The role appeals to driven individuals seeking a collaborative culture that values integrity and adaptability. It offers the chance to work in an ambiguous environment where strong communication and clinical selling skills are essential for growth. The position is based in the field with a focus on developing new business and sharing market intelligence with corporate teams.

This full-time Registered Nurse Clinical Lead role operates within the Operating Room department at Ascension Franklin in Franklin, Wisconsin. The position focuses on leading daily shift operations by strategically assigning patient care tasks, optimizing unit resources, and ensuring seamless workflows. Key responsibilities include mentoring nursing staff to foster clinical excellence, acting as a primary advocate for complex patient care challenges, and contributing to hiring and performance evaluations. The role appeals to professionals seeking a supportive environment grounded in service and connection within a leading nonprofit health system. The position offers significant opportunities for career growth through paid tuition and professional development, alongside a comprehensive benefits package and a collaborative culture recognized as a top place to work.

The Director of Nursing Specialty Medicine & Surgery leads the Ambulatory Women's Health and Surgical Services department at Rochester Regional Health. This role involves overseeing nurse managers and clinical support staff while collaborating with operational and provider leadership to ensure high-quality, cost-effective patient care. Key responsibilities include developing clinical standards and staffing models, driving quality improvement initiatives, managing regulatory compliance, and fostering professional development across the team. The position offers the opportunity to shape a collaborative culture in a vibrant metropolitan setting, supporting the advancement of nursing science and patient outcomes within a mission-driven healthcare organization.

This full-time Registered Nurse role is based on the night shift at the Specialty Care Unit within Novant Health Brunswick Medical Center, a 19-bed facility combining Intensive Care and Progressive Care services. The position involves collaborating with physicians to assess, plan, and evaluate individualized care plans while utilizing evidence-based practices to support patients in critical and step-down conditions. Key responsibilities include managing patient care with specific nurse-to-patient ratios of 1:2 in ICU and 1:4 in PCU, ensuring a safe environment, and fostering a culture of teamwork and diversity. The role is appealing due to the organization's recognition as a top employer for healthcare excellence, its commitment to innovation and research, and the availability of a Clinical Ladder Program to support professional advancement.

This full-time Nurse Navigator role at Mercy provides leadership and mentorship to direct patient care teams within a specialty department. The position involves coordinating comprehensive care plans by assessing patient needs, managing length of stay, and facilitating discharge planning for both inpatient and outpatient populations. Key responsibilities include conducting pre-operative education, performing daily patient rounding, and ensuring adherence to regulatory guidelines and professional standards. The role appeals to those seeking a collaborative environment where compassion and advocacy drive the mission. It offers opportunities for professional growth through tuition reimbursement and matched retirement plans, with a focus on integrating innovative care models to improve patient outcomes.

This field-based sales role serves as a Chronic Care Specialty Sales Representative for the Fayetteville, Arkansas territory, focusing on the cardiovascular and specialty healthcare sectors. The position involves developing and executing territory business plans while building relationships with cardiologists, pharmacists, and integrated delivery systems leaders. Key responsibilities include conducting compliant product discussions, analyzing market data to drive strategic sales initiatives, and collaborating with internal teams to deliver patient-focused solutions. The role offers the appeal of meaningful patient impact through scientific expertise and a collaborative culture that values diverse perspectives and ethical standards. While the position is primarily field-based with approximately 25% travel required for client meetings, it provides the flexibility of a hybrid work model for non-field days and opportunities for professional growth within a mission-driven organization.

This full-time Registered Nurse role operates within a pediatric specialty clinic at Avera in Sioux Falls, focusing on delivering compassionate care to children and their families. Key responsibilities include administering medications and treatments, assisting providers during procedures, conducting patient assessments, and educating families on health maintenance and wellness. The position also involves coordinating clinic workflows, managing appointment scheduling, and maintaining exam room supplies. The role is appealing due to the organization's commitment to a multidisciplinary team culture centered on compassion and the mission to move health forward. It offers immediate paid time off, retirement matching, and structured career development through mentorship and hands-on training.

This full-time Registered Nurse role is based at the Avera Pediatric Specialists clinic in Sioux Falls, focusing on pediatric gastrointestinal care within a multidisciplinary team. The position involves administering medications, assisting providers during procedures, and conducting patient assessments including vital signs and health history. Key responsibilities also include coordinating appointment schedules, educating families on treatment plans, and maintaining exam room supplies and lab protocols. The role appeals to candidates seeking a compassionate work environment aligned with the organization's mission to move health forward. It offers immediate paid time off, retirement matching, and structured career development through mentorship and hands-on training.

The Regional Sales Manager, Specialty West role provides leadership for a sales team within the pharmaceutical industry, focusing on the Western United States. The position involves driving regional revenue growth, managing sales representatives through coaching and performance development, and collaborating with marketing to execute strategic programs. Key duties include analyzing market trends to increase share, securing high-level customer relationships, and ensuring effective use of CRM systems. This opportunity appeals to candidates seeking to contribute to a global biotherapeutics leader dedicated to saving lives through innovative treatments. The role offers a dynamic environment with a strong emphasis on inclusion, professional growth, and a work arrangement requiring significant field presence to support the team.

This full-time in-office role at Inaba Foods in Scottsdale, Arizona, focuses on managing strategic relationships within the Pet Specialty channel for a leading premium pet food manufacturer. The Senior Key Account Manager drives growth by expanding distribution, negotiating with national retailers and distributors, and executing promotional strategies to increase sales volume. Key responsibilities include analyzing sales data to forecast demand, leading business reviews, and collaborating cross-functionally with internal teams to align production and pricing. The position appeals to candidates seeking stability within a family-owned global company with a strong brand reputation, offering the opportunity to influence growth strategy in a rapidly expanding U.S. market while working in a collaborative professional environment.

This Assistant Vice President role within East West Bank's Structured Finance division focuses on underwriting, credit monitoring, and managing a portfolio of loans backed by diverse asset classes. Key responsibilities include assessing credit risk, analyzing complex financial statements and loan structures, preparing credit memoranda, and ensuring compliance with regulatory and internal policies. The position offers the opportunity to work with a multicultural team in a top-performing commercial bank known for its integrity and global reach. The role supports career advancement within industries such as real estate, entertainment, and technology, providing a stable environment for professional growth in a collaborative setting.

This senior underwriting role focuses on managing Medical Professional Liability coverage for physicians, surgeons, and various healthcare facilities. The position involves setting production goals, directing underwriting activities for the company-wide portfolio, and supporting distribution partner promotions. Key responsibilities include mentoring underwriting staff and managing team performance, hiring, and development. The role offers remote work flexibility and is based in Elgin, Illinois. It is appealing due to the opportunity to lead a specialized team within a highly rated company that provides comprehensive benefits, including family medical coverage, paid vacation, tuition reimbursement, and a pension plan with company matching.

This Cloud Solutions Architect role at Opti9 focuses on designing and delivering scalable, secure cloud architectures for diverse business clients. The position involves leading customer migrations to the public cloud, creating cost-optimized technical designs, and collaborating with sales and engineering teams to build proposals and ensure successful deployments. Key responsibilities include conducting architectural workshops, mentoring junior staff, and advocating for cloud adoption through complex technical discussions. The role appeals to professionals seeking a hybrid work arrangement with unlimited PTO and a supportive, casual culture that prioritizes innovation and continuous learning. Opportunities for professional growth include access to training and certification support within a collaborative team environment.

This part-time Endodontist role is based at the URBN Dental Uptown location and focuses on delivering high-quality root canal treatments within a supportive, team-oriented environment. The position involves providing precise clinical care, building strong patient relationships, and collaborating with general dentists and support staff to maintain efficient workflows. Key responsibilities include utilizing modern digital technology, ensuring a luxury patient experience, and contributing to the growth of patient volume. The role is appealing due to its flexible one-day-per-week schedule, which supports work-life balance, and the opportunity to work in a facility equipped with advanced imaging and laser technology. The position emphasizes a culture of kindness and professional growth for licensed specialists with private practice experience.

This full-time Registered Nurse role is based in the Medical Surgical Intensive Care Unit at Good Samaritan Hospital in Cincinnati, focusing on high-acuity care for complex surgical and medical patients. The position involves managing ventilators, hemodynamic monitoring, and dialysis while performing comprehensive patient assessments, developing individualized care plans, and collaborating with physicians to ensure timely interventions. The role offers a supportive environment with a strong orientation program, opportunities for specialty certification, and a collaborative culture that prioritizes professional growth and continuous learning. The schedule is full-time on days, requiring on-site presence in a fast-paced 24-bed unit.

The Business Banker role within Wells Fargo's Consumer Banking and Lending division focuses on managing and growing relationships with small business clients in branch locations. Key responsibilities include developing tailored financial solutions, analyzing client operations to meet their goals, and actively prospecting to expand the customer base while adhering to compliance standards. The position appeals to professionals seeking a client-centric environment where they can serve as trusted advisors for business accounts, credit, and treasury services. This full-time opportunity is based in Calabasas, California, with potential placement within a ten-mile radius of the assigned branch, offering a supportive culture that emphasizes strong customer relationships and professional growth.

This role is a Registered Nurse position within the Medical Surgical Critical Care Unit in Lebanon, New Hampshire. The position involves working 12-hour rotating shifts, either day or night, and requires a current New Hampshire nursing license along with at least two years of recent PCU experience. Key responsibilities include providing direct patient care, maintaining necessary clinical certifications such as BLS or ACLS, and adhering to strict health and safety protocols. The opportunity is appealing due to its travel-focused nature, offering tax-free housing, license reimbursement, and a supportive culture that prioritizes employee well-being over traditional employment structures.

This role is a Registered Nurse position within the Operating Room at a facility in Lebanon, New Hampshire, covering evening shifts from 3:00 PM to 11:30 PM. The position requires a current New Hampshire nursing license and at least two years of recent experience in the OR. Key responsibilities include providing direct patient care during surgical procedures and maintaining compliance with all clinical safety standards and certifications. The opportunity is appealing due to its travel-focused nature, offering tax-free housing, license reimbursement, and travel pay. The organization emphasizes a supportive culture that prioritizes staff well-being and professional growth through flexible contract arrangements.

The RN Coordinator role within the Ventricular Assist Device and Heart Transplant team at Ochsner Health manages pre-implant, post-implant, and inpatient mechanical circulatory support. Key responsibilities include acting as a patient advocate and educator to promote independence, monitoring patients independently, managing outpatient clinics, and collaborating closely with transplant physicians. The position appeals to dedicated nurses seeking to make a significant impact in a mission-driven environment that values innovation and patient care. The role requires a current RN license, relevant clinical experience, and certifications such as BLS and ACLS. While the position is primarily on-site, it offers opportunities for professional growth, leadership development, and the chance to work with a diverse patient population across all age groups.

This full-time Technical Trainer or Principal Technical Trainer role is based in Tampa, Florida, within Northrop Grumman's Mission Systems division. The position requires an active Top Secret/SCI clearance and involves collaborating with subject matter experts to design and deliver training for complex cyber systems. Key responsibilities include developing instructional materials such as videos and guides, creating assessments to measure learning effectiveness, and utilizing video editing tools to produce high-quality technical content. The role offers the opportunity to work on revolutionary defense technologies in a culture that values intellectual curiosity and innovation. While the position is on-site with approximately 10% travel, it provides a supportive environment for professional growth, comprehensive benefits, and the chance to contribute to national security missions.

This part-time Clinical Pharmacist role serves as a resource float for Sentara's outpatient pharmacies across seven locations in the Hampton Roads area. The position involves managing patient drug therapy, verifying medication orders for safety and appropriateness, and providing specialized drug information and patient counseling. Key responsibilities include precepting pharmacy students, training new employees, and maintaining quality assurance standards while adapting to rotating shifts at various hospital sites. The role appeals to professionals seeking diverse clinical experiences in a collaborative environment that supports continuous learning through tuition assistance and professional development resources. The position offers flexibility with a resource float schedule and includes travel support between facilities.

This 13-week contract role places a Registered Nurse within a home health team in Portland, Oregon, focusing on delivering personalized in-home care to patients. The position involves conducting comprehensive patient assessments, developing and adjusting individualized care plans, and providing direct skilled nursing services alongside patient and family education. Key responsibilities include coordinating with interdisciplinary teams, managing a caseload efficiently, and maintaining accurate documentation of care delivery. The role appeals to nurses seeking autonomy and the opportunity to make a meaningful impact in a community-focused environment that has received awards for quality care. The schedule features day shifts from Monday through Friday, requiring a valid driver's license and reliable transportation to visit patients across the area.