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HCSC jobs in Albuquerque, NM - 58 jobs

  • Lead Business Consultant - Medicare Part D Pharmacy

    HCSC 4.5company rating

    HCSC job in Albuquerque, NM

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This position is responsible for driving delivery, contingency planning, business results, and strategic planning for Medicare Part D Pharmacy consisting of multiple programs, complex projects, and initiatives in support of assigned line of business strategy and multi-year plan. Oversees the day-to-day activities of project delivery and contingency execution strategy, vendors relationship management, and business partner engagement while managing various enterprise-wide projects or initiatives. Ensures integration between partner teams and serves as a functional business liaison in the development and implementation of program scope, timing, and budgets as needed, based on the needs of the business. Providing a blend of technical and business acumen to drive the design, development and implementation of strategic IT projects. Building a sufficient level of knowledge of IT products and LOB to enable targeted probing of delivery feasibility and conflicts with other projects. Setting and managing customer expectations; managing and escalating issues and changes. Responsible for tracking key program milestones and recommending adjustments to program leadership and team. It takes innovation, imagination, and a passion for solving problems in new and better ways. Required Job Qualifications: * Bachelor's degree and 7 years of experience OR 11 years of experience in project management, business analysis, process improvement, strategic planning, product administration or other relevant healthcare function * 4 years of experience leading with large and complex multi-million-dollar projects. * Demonstrated experience leading, coaching, and mentoring teams and more junior resources * Experience communicating with senior management and executive leadership from multiple divisions. * Experience developing and delivering presentations to an executive audience. * Problem resolution experience and skills. * Knowledge of strategic planning techniques and industry trends * Experience interpreting business and financial information * Verbal and written communications skills including establishing working relationships across departments, preparing presentations to senior management, and establishing team environment. * Experience managing and delegating assignments across multiple complex projects successfully in a matrixed environment. * Advanced MS Office products. * Organizational skills. * Problem resolution experience and skills. * Negotiations skills. * Analytical skills. * Detail oriented. Preferred Job Qualifications: * Ability to influence (direct / indirect reports, project stakeholders and leaders), and manage in a matrix organization * Analytical/critical thinking and problem-solving skills; agility and flexibility to adapt to constantly changing priorities * Experience in negotiation, managing conflict, and organizational / political savvy * Structured, organized and methodical in execution, takes ownership and accountability for outcomes, drives for results and drives certainty in delivery; able to manage multiple parallel efforts ad deliver quality deliverables on schedule * Healthcare acumen, Managed Care Organization, Pharmacy Benefit Manager, Medicare experience * Advanced analytical skills, databases medical/pharmacy data * Experience driving personalization efforts at a large organization. * Monitoring and tracking initiative impacts against the personalization maturity curve and connecting them to key enterprise outcomes. * Health insurance or healthcare industry experience. * Proven strategic thinking and execution. * Ability to drive decisions, create optionality and determine impacts of options. * Ability to clearly articulate and prepare presentations for all levels to share data, options and recommendations. This is a Flex (Hybrid) role: 3 days in office; 2 days remote. #LI-PD1 #LI-Hybrid INJLF Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************** The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Base Pay Range $90,900.00 - $164,200.00 Exact compensation may vary based on skills, experience, and location.
    $90.9k-164.2k yearly Auto-Apply 32d ago
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  • Assistant General Counsel - Contracting

    HCSC 4.5company rating

    HCSC job in Albuquerque, NM

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This is an opportunity for a motivated lawyer to provide counsel relating to complex contracting, including vendor, provider network, producer/customer, and strategic sourcing contracting. In a highly complex and evolving legal and technology environment, the ideal candidate will provide sound, actionable legal advice on regulatory, business, and operational matters. A successful candidate will serve as a partner to our business leaders in developing adaptive strategies to support HCSC's established business and to further its growth while continually advancing HCSC's mission. HCSC is the largest customer-owned health insurer in the United States, operating Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. In addition to its core health insurance offerings, HCSC is proud to serve millions of people through a diverse portfolio of businesses that provide adjacent products and services. These companies help advance HCSC's goal of expanding access to quality, cost-effective health care to help people live healthier. The position can be based in Chicago, Illinois; Richardson, Texas; Tulsa, Oklahoma; Albuquerque, New Mexico; Helena, Montana, or Nashville, Tennessee. Please note this role is a hybrid role. This requires in-office hours 3 days a week at the respective office location. Sponsorship is not available for this position. JOB REQUIREMENTS: * Juris Doctor Degree and a license to practice law in the state where the legal department is located. * 5 years' experience as a practicing attorney after receiving a law degree. * Clear and concise verbal and written communication skills. PREFERRED JOB REQUIREMENTS: * Knowledge or understanding of the health care, health insurance, or claim administration field. * 3+ years' experience advising providers, insurers, or other health care entities. #LI-AZ1 #LI-Hybrid Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************** The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Base Pay Range $118,800.00 - $220,800.00 Exact compensation may vary based on skills, experience, and location.
    $118.8k-220.8k yearly Auto-Apply 60d+ ago
  • Director Relationship Manager - Luminare Health

    Health Care Service Corporation 4.1company rating

    Albuquerque, NM job

    At Luminare Health , our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** Working collaboratively with the Executive Director, HCSC Vertical Lead, this role is responsible for guiding a team of dedicated resources to drive high customer retention, a best-in-class customer experience and satisfaction, and strong account consultation consistent with both Luminare Health, HCSC and client strategic, operational and financial goals. Partnering with Operations and HCSC leadership and staff to bring solutions to clients, problem solving and effective project delivery to major and large accounts. The Director, Relationship Manager will also have direct responsibility for building strong client relationships, fostering collaboration across Luminare Health and HCSC teams, understanding and articulating operational performance and collaborating with key vendors. **Key Accountabilities - HCSC Client Management** + Partners with Executive Director, HCSC Vertical Lead to guide, lead and direct team of resources focused on supporting the ongoing business and operational needs Luminare Health and HCSC major and large clients. Responsible for day-to-day support of client management team and their assigned major and large clients, including: + Leadership level personal contact with clients, and brokers - phone calls, meetings, visits, etc. + Assistance with problem solving and issue resolution + Participation in various presentations including monthly/quarterly performance results, initiative updates, renewal, and action plans + Partnering with HCSC to recommend appropriate upsales + Oversight of completion and execution of Client Action Plans as appropriate + Providing leadership, support, and consultation in the development, implementation and successful execution of project plans and strategies that improve retention, client satisfaction, expense management and profitable growth of the client + Guides all client management communication with client, Luminare Health and HCSC leadership/departments, and vendors regarding new products, strategic initiatives + Ensure the client management team provides high level of customer service to all internal and external constituents by working proactively across department to meet client deliverables as well as providing timely and equitable issue resolution. + Responsible for collaborating with HCSC for Luminare Health revenue growth, identifying critical business opportunities, to be a referral source for more profitable business solutions, and building strong consultative selling initiatives and competencies. This includes initiatives designed to promote co-sell and cross-selling with HCSC and key client. + Ensuring execution follow through and operational accountability. + Other duties as needed/assigned. **Required Job Qualifications - HCSC Client Management:** + Bachelor's degree + 7+ years of insurance industry experience + 5+ years Client Management or related experience + Possess keen understanding of Health Benefits business strategy + Project Management: prioritizes process, establishes and meet deadlines, leads diverse group of individuals to meet time critical deadlines and complete tasks + Communication Skills: demonstrates effectiveness in both written and verbal communication skills, and is able to effectively persuade, shares information in concise manner + Interpersonal Skills: relates well to all kinds of people, inside and outside of the organization; builds appropriate rapport; uses diplomacy and tact; can diffuse high tension situation comfortably + High degree of accuracy, timeliness, and attention to detail + Cross Functional Team Building: successfully blends people into teams; establishes purpose of team; creates strong morale; shares successes; gains respect of team + Self-motivated: makes things happen; energized by challenge; understands the importance and impact of assignments and tenaciously move toward completion + Decisive, resourceful, reliable, and creative working style + PC literacy/Microsoft office **Preferred Job Qualifications:** + 2+ years of team leadership experience + State insurance license + Consultative selling skills LI-TR1 INJLF **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **EEO Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Pay Transparency Statement:** At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for associates. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **Min to Max Range:** $77,800.00 - $146,100.00 Exact compensation may vary based on skills, experience, and location.
    $77.8k-146.1k yearly 9d ago
  • Provider Network Rep

    Health Care Service Corporation 4.1company rating

    Albuquerque, NM job

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** This position is responsible for provider recruitment and contracting, education of providers, and for ongoing provider service. Ability and willingness to travel within assigned areas of responsibility, including overnight stays. Job Requirements: + Bachelor's degree in business OR 4 years' experience in managed care environment. + 2 years' experience in a position that demonstrates leadership abilities and sound decision-making. + Knowledge of contracts, applications and products; claims processing systems. + Demonstrated proficiency in provider reimbursement methods. + Demonstrated ability to meet deadlines and work well under pressure. + Verbal and written communication skills; organizational and planning skills; ability to take initiative and work independently. + PC proficiency to include Microsoft Office + Ability and willingness to travel within assigned areas of responsibility, including overnight stays Preferred Qualifications: + Knowledge of contracting and Single Case Agreements + Negotiation skills + Strong documentation skills **This is a Flex (Hybrid) role: 3 days in office; 2 days remote.** \#LI-MW2 \#LI-Hybrid **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **HCSC Employment Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Base Pay Range** $55,900.00 - $123,500.00 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.
    $25k-30k yearly est. 3d ago
  • Medicare Sales Field Agent - Albuquerque, NM

    Humana 4.8company rating

    Albuquerque, NM job

    Become a part of our caring community and help us put health first With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live in the designated territory to effectively serve their local community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll help bring Humana's strategy to life: Deliver on the fundamentals, differentiate through exceptional service, and grow by expanding our reach and impact. What You'll Do in This FIELD Based Role: Deliver: Build trust and educate individuals on Humana's Medicare Advantage plans and additional offerings like Life, Dental, Vision, and Prescription coverage. Differentiate: Create meaningful, face-to-face connections through grassroots marketing, community events, and in-home visits-providing a personalized experience that sets Humana apart. Grow: Drive self-generated sales, meet performance goals, and expand Humana's presence in the market by becoming a valued resource in your community. You'll engage with customers in the FIELD through a mix of in-person, virtual, and phone interactions. Face-to-face visits in prospective members' homes are a key part of this role. Why Join Humana? People-first culture that supports your personal and professional growth. Inclusive and diverse environment that values multilingual talent and cultural understanding. Autonomy and flexibility to manage your schedule and success. Purpose-driven mission to help people achieve their best health-and transform healthcare along the way. Benefits include: Medical, Dental, Vision, and a variety of other supplemental insurances Paid Time Off (PTO) and Paid Holidays 401(k) retirement savings plan with a competitive match Tuition reimbursement and/or scholarships for qualifying dependent children And much more! Use your skills to make an impact Required Qualifications Active Health Insurance License or ability to obtain. Must reside in the designated local territory to effectively serve the community. Comfortable with daily face-to-face interactions in prospective members' homes and engaging with the community through service, organizations, volunteer work, or local events. Valid state driver's license and proof of personal vehicle liability insurance meeting at least 25/25/10 coverage limits (or higher, based on state requirements). Preferred Qualifications Active Life and Variable Annuity Insurance License. Prior experience selling Medicare products. Experience in public speaking or delivering presentations to groups. Associate's or Bachelor's degree. Experience using Microsoft Office tools such as Teams, Excel, Word, and PowerPoint. Bilingual in English and Spanish, with the ability to speak, read, and write fluently in both languages. Additional Information This position is in scope of Humana's Driving Safety and Vehicle Management Program and therefore subject to driver license validation and MVR review. Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. Schedule: Meeting with members requires appointments and/or event times that may vary on nights and weekends. Flexibility is essential to your success. Training: The first five weeks of employment and attendance is mandatory. Interview Format: As part of our hiring process for this opportunity, we are using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward in the process, you will receive a text message inviting you to participate in a HireVue prescreen. In this prescreen, you will receive a set of questions via text and given the opportunity to respond to each question. You should anticipate this prescreen taking about 15 minutes. Your responses will be reviewed and if selected to move forward, you will be contacted with additional details involving the next step in the process. Pay Range The range below reflects a good faith estimate of total compensation for full time (40 hours per week) employment at the time of posting. This compensation package includes both base pay and commission with guarantee. The pay range may be higher or lower based on geographic location. Actual earnings will vary based on individual performance, with the base salary and commission structure aligned to company policies and applicable pay transparency requirements. $80,000 - $125,000 per year #medicaresalesrep Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $26k-33k yearly est. Auto-Apply 60d+ ago
  • Physical Therapist Assistant, Home Health

    Humana Inc. 4.8company rating

    Albuquerque, NM job

    Become a part of our caring community and help us put health first As a therapist at CenterWell Home Health, you'll play a vital role in helping patients regain strength, mobility and independence-all from the comfort of their homes. By delivering personalized care that focuses on rehabilitation and functional improvement, you'll empower individuals to overcome physical limitations, perform everyday activities with confidence and enjoy a better quality of life. As a Home Health Physical Therapist Assistant, you will: * Administer the physical therapy treatment plan as developed by the Physical Therapist. * Administer non-complex active and passive manual therapeutic exercises, therapeutic massage, traction heat, light, cold, water, and electrical modalities to patients. * Accurately documents daily, weekly, or monthly records of clients'. Submits clinical paperwork to the office on time each week. * Attend educational meetings and coordinates and contributes to department in-services. * Notify physical therapist or Executive Director of any equipment failures, lack of supplies, staff or client changes, and any other departmental * Schedule clients and performs varied office tasks. * Apply concepts of infection control and universal precautions in performing patient care activities. * Accept clinical assignments that are consistent with education and competence to care for patients. * Promote compliance with all fiscal intermediaries and/or other third-party payors, through education, coaching, and other assistance as necessary. Use your skills to make an impact Required Experience/Skills: * Performs other related duties as assigned. * Associate degree in Physical Therapy from an American Physical Therapy Association. * Current state license to practice Physical Therapy. * Valid driver's license, auto insurance and reliable transportation. * Proof of current CPR certification. * Minimum two years experience as a Physical Therapy Assistant, * Comprehensive knowledge of the physical, emotional, social, and biological changes that occur in the geriatric population. * Self-directed, enthusiastic, and accepts constructive feedback. * Demonstrates good verbal and written communication and organization skills. * Communicates and demonstrates a professional image/attitude for patients, families, clients, coworkers, and others. * Meets mandatory continuing education requirements of CenterWell Home Health and licensing board. Maintains clinical competency in Physical Therapy practice and theory. * Ability to work a flexible schedule and travel locally. * Able to maintain confidentiality. * Maintains current licensure certifications and meets mandatory continuing education requirements. * Must read, write, and speak fluent English. * Must have good and regular attendance. Pay Range * $37.00 - $52.00 - pay per visit/unit * $58,400 - $80,000 per year base pay Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $64,000 - $87,500 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $64k-87.5k yearly 2d ago
  • Medical Director (Appeals)

    Health Care Service Corporation 4.1company rating

    Albuquerque, NM job

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** This Position Is Responsible For Assigned Aspects Of Medical Policies And Programs. Performs Medical Appeal Reviews And Interacts With The Provider Communities For Assigned Areas. **JOB REQUIREMENTS:.** + Physician (M.D. or D.O) with a current and unrestricted physician license in a state or territory of the United States + Maintain Board Certification by a specialty board approved by the American Board of Medical Specialties, National Board of Physicians and Surgeons, or the Advisory Board of Osteopathic Specialists + 5 years of clinical experience + Analytical and communication skills + Strategic thinking skills + Proficiency in computer skills (including software applications such as Microsoft Office Product and Lotus Notes) needed for electronic documentation of case reviews **PREFERRED REQUIREMENTS** : + Board Certifification in Oncology, Physical Medicine and Rehabilitation, Surgical, Plastic Surgeon, or + 3 years Managed Care experience This is a Telecommute (Remote) role: Must reside withing 250 miles of the office or anywhere within the posted state. INAK \#LI-AK1 **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **HCSC Employment Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Base Pay Range** $187,700.00 - $348,600.00 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.
    $187.7k-348.6k yearly 36d ago
  • Executive Director, Client Management Hospitals and Health Systems- Luminare Health

    Health Care Service Corporation 4.1company rating

    Albuquerque, NM job

    At Luminare Health , our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** The role of the Client Management Health Systems Lead is to retain and grow existing Luminare Health Hospital and Health Systems accounts. This role is responsible for developing the overall strategy for Health Systems business and ensuring the retention, upsell and profitability goals are met or exceeded. In addition, this leader will define the strategy, product / service offering and go-to-market strategy while strengthening and growing distribution channel (brokers, consultants, etc.) relationships that accelerate growth and opportunities. This individual will lead and mentor a team of client managers, providing guidance, support, and performance management that supports the hospital segment of the business. This leader will have responsibility for being the executive sponsor for large health system clients, which includes providing strategic consultation, market insights, knowledge of hospital challenges, problem solving and executive escalations from the clients. **Job Responsibilities:** + Develop and execute the Luminare Health Hospital strategy and product roadmap in partnership with the Executive Director of Strategic Partnerships, the VP of Client Management and the Chief Growth Officer. + Serve as the Executive Sponsor to large, complex Hospital System clients. Engage with the clients at a strategic level helping them execute on their strategic priorities. + Work closely with Client Managers and Relationship managers on day-to-day client/broker issues as well as high priority issue resolution. Address and resolve complex client issues with a sense of urgency by assisting with escalations, ensuring client satisfaction and loyalty. + Lead and mentor the client management team, ensuring effective guidance, performance oversight, and adequate staffing. Collaborate with training and compliance to support onboarding and continuous education, including industry updates, regulations, and product trends. Monitor KPIs to drive client satisfaction, retention, revenue, and service excellence. + Provide high level of customer service to all internal and external constituents by working proactively across department to meet client deliverables as well as providing timely and equitable issue resolution. Represent the client's perspective within the organization, ensuring their needs are understood and addressed by various departments. + Collaborate cross-functionally with sales, marketing, and product teams to deliver a seamless client experience. Partner with sales to understand prospect needs, tailor solutions, and support finalist presentations and RFP responses. + Lead market-based planning for the client engagement team, evaluate RFP performance, and gather market insights to inform product, process, and technology enhancements. Establish a framework to capture and act on feedback related to offerings, pricing, and contracts. + Build and nurture strong relationships with key clients and brokers, acting as a trusted advisor and advocate for their needs within Luminare Health. Identify and pursue new business opportunities within existing client relationships and through new client acquisition. + Other duties as needed/assigned. **Job Requirements:** + Bachelor's degree in a related field. + Minimum of 12 years of leadership experience in client management, ideally within a complex or regulated environment, preferably in healthcare. + Direct experience working within a hospital or health system. + In-depth knowledge of the hospital and health system industry, including market trends and strategic challenges. + Exceptional interpersonal skills with the ability to facilitate meetings, resolve conflicts, build consensus, and collaborate across departments and organizational levels. + Proven ability to build and lead cross-functional teams, foster team morale, and drive shared success. + Strong strategic thinking and problem-solving skills, with a track record of analyzing complex situations and delivering innovative, sound solutions. + Solid financial acumen, including experience with self-funded markets, health system business models, budget management, and revenue growth strategies. + Willingness and ability to travel up to 25%. + Demonstrated consultative selling skills + Advanced degree in related field + Deep experience working with broker and consultant community specifically in health system business *Candidate must reside in the following states to be considered: IL, MT, NM, OK, TX, IN, MO, WI, IA, KS, NC, PA \#LI-TR1 INJLF **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **EEO Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Pay Transparency Statement:** At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for associates. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **Min to Max Range:** $133,400.00 - $250,500.00 Exact compensation may vary based on skills, experience, and location.
    $133.4k-250.5k yearly 36d ago
  • Social Worker-PRN

    Unitedhealth Group Inc. 4.6company rating

    Albuquerque, NM job

    Explore opportunities with At Home Healthcare, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Medical Social Worker, provides medical social services under the direction of a physician and Interdisciplinary Group to assist in the understanding of significant social and emotional factors related to the patient's health status and in development of coping mechanisms. Primary Responsibilities: * Assists the patient, significant others, physician and health care team staff to understand significant personal, emotional, environmental and social factors related to the patient's health status on an as needed basis * Contributes as a health care team member to the development of a comprehensive, integrated Plan of Care for patients on a daily basis * Instructs health care team members on community resources available to assist patients on a as needed basis * Able to function as Bereavement Coordinator and supervise the provision of bereavement services reflective of patient / family if needed. Establishes a Plan of care that addresses bereavement needs with clear delineation of services to be provided 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: * Master's Degree from a school of Social Work accredited by the Council of Social Work * Current CPR certification * Licensed Social Worker in the state of New Mexico * Current Driver's License, vehicle insurance, and access to a dependable vehicle or public transportation * 1+ years of social work experience in a health care setting Preferred Qualifications: * Bereavement Coordination experience * Experience with establishing a plan of care for bereavement needs 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 $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. 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.
    $58.8k-105k yearly 15d ago
  • Pharmacy Technician - Per Diem

    Unitedhealth Group Inc. 4.6company rating

    Albuquerque, NM job

    Explore opportunities with CPS, part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind Caring. Connecting. Growing together. As a per diem, nonexempt Pharmacy Technician, you will assist in various pharmacy activities under the supervision of a licensed pharmacist. Your responsibilities will include preparing, delivering, and restocking medications; performing order entry; procuring drugs; billing. You will carry out your job duties according to written procedures and guidelines based on pharmacy standards and regulatory requirements. You will 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. Haven Behavioral Hospital of Albuquerque is a licensed, acute care behavioral hospital that provides a safe, nurturing environment for the treatment of complex mental health and substance abuse issues. Offerings include innovative and customized treatments in both inpatient and outpatient programs. Care is customized based on individual needs and preferences to help individuals move past illness or addiction and take back control of their lives. This centralized pharmacy utilizes Pyxis/Wellsky with most medications automatically distributed after review by the Director. Pharmacy hours are 8:00am-4:00pm, Monday through Friday. Pharmacy coverage is provided by a remote services provider outside of pharmacy hours. Schedule: This per diem, nonexempt position will provide coverage for PTO and as needed up to 19 hours/week Monday-Friday between the hours of 8:30am-3:00pm. Primary Responsibilities: * Fill medications and restocking Pyxis machines * Intake of patient medications to ensure all are documented appropriately * Monthly outdates and inventory reconciliation * Inventory ordering and maintenance 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: * High school diploma or equivalent * Current New Mexico Pharmacy Technician license in good standing * Experience as a Pharmacy Technician, ideally in a hospital setting * Proficiency with pharmacy software Preferred Qualifications: * PTCB/CPhT 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 hourly pay for this role will range from $17.74 to $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 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.
    $17.7-31.6 hourly 25d ago
  • BH Government Programs Care Manager III

    Health Care Service Corporation 4.1company rating

    Albuquerque, NM job

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** This position is responsible to provide care coordination to members via telephonic and/or field based care management to inform and educate them on health care programs to address their personal health needs, engage the member in adherence to personal health goals, respond to inquiries from members, and support the clinical operations department with their provider and member activities. This position will be required to complete member telephone and/or field based health screenings, comprehensive health assessments and care planning duties which may require visits to members' home and/or facilities to support complex and specialty populations. **JOB REQUIREMENTS** **:** + Registered Nurse (RN) with 2 years direct clinical care to the consumer in a clinical setting or , unrestricted Licensed Professional Counselor (LPC, TX), or Licensed Master Social Worker (LMSW, TX, NM), Licensed Clinical Professional Counselor (LCPC, IL) or Licensed Clinical Social Worker (LCSW, IL & NM) Licensed Marriage and Family Therapist **(LMFT, IL** & **NM),** Licensed Professional Clinical Counselor (LPCC, NM), Licensed Independent Social Worker (LISW, NM), or Licensed Mental Health Counselor {LMHC, NM) with 2 years of clinical practice experience. Current, valid, unrestricted license in the state of operations (or reciprocity). For compact licensee changing permanent residence to state of operations, you must obtain active, unrestricted RN licensure in the state of operations within 90 days of hire. + Plus 3years wellness or managed care experience presenting clinical issues with members/physicians. + Experience handling medical management programs and health educations programs in an independent manner. + Knowledge of the health and wellness marketplace and employer trends. + Verbal and written communication skills including discussing medical needs with members and interfacing with internal staff/management and external vendors and community resources. + Analytical experience including medical data analysis. + PC proficiency to include Word, Excel, and PowerPoint, database experience and Web based applications. + Ability and willingness to travel within assigned territory. **PREFERRED JOB REQUIREMENTS** **:** + 3 years clinical experience. + Patient education experience. + Behavioral Health experience preferred + Access to consistent internet + Condition Management experience. + Bilingual in English, Spanish, and Navajo. + Experience in managing complex or catastrophic cases. + Certification in Case Management, Training, Project Management or nationally recognized health care certification. + Government Programs experience + Population Management **This position requires onsite visits to members** **This is a Telecommute (Remote) role: Must reside within 250 miles of the office or anywhere within the posted state.** \#LI-AC1 \#LI-Remote \#CA **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **HCSC Employment Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Base Pay Range** $26.90 - $59.35 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.
    $26.9-59.4 hourly 60d+ ago
  • Contract Specialist

    HCSC 4.5company rating

    HCSC job in Albuquerque, NM

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This Position Is Responsible For Drafting Account-Specific Documents. Training Less Experienced Staff On Production Procedures; And Participating In The Peer Review Process. JOB REQUIREMENTS: Bachelor degree or 4 years work experience in a position involving independent judgment and initiative. Experience and skills in drafting standard or customized group health contracts or booklet documents with minimal guidance of up to 10 paragraphs. Knowledge of insurance contracts such as health, life, disability, supplemental health and/or self-funded Knowledge of insurance products such as health, dental, life, disability and/or supplemental Knowledge of group health state and federal regulations on contract administration. PC experience including Microsoft Office. Experience in deadline driven environment and completing tasks on time. Judgment and problem resolution skills. Verbal and written communication skills to interface with staff from other departments, draft document language and handle issue resolution. PREFERRED JOB REQUIREMENTS: Referral preference given to applicants able to take and meet testing criteria. Experience working on corporate projects. Skills in project management/project planning. This position is expected to adhere to HCSC's hybrid FLEX policy of 3 days/week on-site at an approved location. Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************** The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Base Pay Range $41,700.00 - $92,800.00 Exact compensation may vary based on skills, experience, and location.
    $41.7k-92.8k yearly Auto-Apply 8d ago
  • Medical Reviewer LPN

    HCSC 4.5company rating

    HCSC job in Albuquerque, NM

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This position is responsible for pre-authorization reviews in accordance with the medical contract and regulations, medical criteria, utilization review, and quality of care. JOB REQUIREMENTS: * LPN with valid, current, unrestricted clinical license in the state of operations. * 3 years of clinical experience in physician office, hospital, or surgical setting. * Customer service oriented to assist internal/external customers. * Verbal and written communication skills. * Interpersonal skills and ability to be a team player. * Willingness and ability to travel. * Familiar with PC or database systems. * Incumbents with nursing licenses in positions/departments requiring multi-state licenses are required to obtain and maintain additional current, valid, and unrestricted applicable nursing licenses in other states as determined by management. Multi-state license fees will be provided by HCSC. Incumbents with other clinical licenses are not required to obtain multi-state licenses. PREFERRED JOB REQUIREMENTS: * Utilization review or utilization management experience * Insurance Industry experience. Telecommute: This is a Telecommute (Remote) role: Must reside within 250 miles of the office or anywhere within the posted state. #LI-TELECOMMUTE #LI-SG1 Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************** The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Base Pay Range $45,900.00 - $102,100.00 Exact compensation may vary based on skills, experience, and location.
    $45.9k-102.1k yearly Auto-Apply 4d ago
  • Medical Assistant, Endocrinology

    Unitedhealth Group Inc. 4.6company rating

    Albuquerque, NM job

    $4,000 Sign-on Bonus for external Candidates Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Compassion is the essential trait that drives superior health care performance. But it's just a start. At OptumCare innovative thinking is just as important. Our unique team of health care providers are an emerging and important part of Optum and the UnitedHealth Group family of businesses. Our approach is designed to help physicians and other providers deliver the right care at the right time in the right setting. That takes smart ideas and incredible teamwork. And that's where you come in. In this role, you'll support a clinical team that's helping patients in new and better ways while giving them a generous helping of compassion and respect. Positions in this function performs clinical and administrative duties that assist in the delivery of effective patient care within assigned area. Greet patients; escort them to exam room and takes vitals and other MA related duties as assigned. Provide direct customer service and front desk assistance for assigned department to include but not limited to registering, telephones, scheduling and verifying insurance. Handles customer account transactions, provides customer assistance, and performs and/or oversees cashiering operations. Demonstrates knowledge of medical practice and patient care as it relates to the clinical setting and medical specialty. Adheres to policies, procedures and regulations to ensure compliance and patient safety. Participation in Compliance and other important training is a condition of employment. Primary Responsibilities: * Greets patients and escorts them to exam room. Performs hand washing, weighs patients, takes vital signs and patient history, and documents chief complaint. May administer limited injections requested by a physician and supervised by a physician, registered nurse, nurse practitioner or physician assistant in accordance to established regulations, in conjunction with attending and passing Injection class * Responds effectively to incoming patient calls and communicates pertinent information to physician or designee to provide for continuity and optimal care * Appropriately communicates lab results, physician orders, and medication instructions to patients * Provides direct customer service and front desk assistance for assigned department to include but not limited to registering, scheduling and verifying insurance and arriving patients. Electronic eligibility verification, updating patient demographics, ensure required referrals and prior authorization are in place for patient visit. Manage no-show list. Schedule waits list, follow-up, x-ray, referral appointments * Prepares exam room for next patient and assures that supplies are stocked and available in anticipation of the provider's needs. Manages medical supply inventory and cleans equipment * Provides customer assistance. Obtaining "expert" level knowledge of the inter-workings of various insurance plans and staying abreast of insurance plans in the process of being added, deleted or changed. Collection of co-pays, co-insurance, self-pay, fee-for-service, and payment on account * Maintains patients' record/files and participates in the revenue cycle process * Assists patients in scheduling appointments and obtains referral when necessary * May be required to analyze medical records and charge entry information for financial reimbursement within the guidelines and procedures. Work TES charge entry edits * Completing basic Medical Assistant competencies in addition to departmental specific competencies * Adheres to policies, procedures and regulations to ensure patient safety and regulations. May attend departmental meetings and provide constructive recommendations for areas improvement * Coordinates Specialty referrals and appointments for all enrolled patients * Completes prior authorizations (DME, HHC, stat testing, Specialty visits, etc.) * 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: * High school diploma or GED * Completion of a Medical Assistant program or relevant experience (EMT, Medic, CNA ,etc.) * BLS certification or must be able to complete certification within 30 days of hire * Experience utilizing excellent customer service skills * Knowledge and understanding of medical terminology * Demonstrated proficiency in Windows navigation and a variety of MS Office software applications * Demonstrated ability to type and enter data efficiently and accurately Preferred Qualifications: * National Certified Medical Assistant (NCMA) Certification through the National Center for Competency Testing (NCCT) or active Certified Clinical Medical Assistant (CCMA) Certification through National Health career Association (NHA) * 1+ years of related experience * Endocrinology experience * Demonstrated ability to work independently and willingness to learn * Demonstrated ability to communicate effectively * Demonstrated ability to multi-task and work under pressure * Demonstrated attention to detail 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 hourly pay for this role will range from $18.25 to $25.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 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.
    $18.3-25 hourly 43d ago
  • Sr Mgr Pharmacy Underwriting

    Health Care Service Corporation 4.1company rating

    Albuquerque, NM job

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** Interpret and describe BCBS products and financial arrangements as well as those provided by competitors. Interact with BCBSA and member plans. **Required Job Qualifications:** * Bachelor Degree and 5 years' experience underwriting small and/or large accounts and dealing directly with key customers, consultants and/or brokers **OR** 6 years of experience underwriting small and/or large accounts and dealing directly with key customers, consultants and brokers. * 3 years of underwriting of higher complexity cases (if responsibility includes one or more of the following segments: large/major/national/and or special accounts (Labor Union, Student Health, IL Hospital, Co-operatives, Private Exchange, etc.) or OR Demonstrated capability to meet required job responsibility. * Successfully demonstrated skills and experience in underwriting and pricing of various funding options and products and making sound decisions. * Operational knowledge of renewal and prospective group health underwriting processes and procedures. * Knowledge of underwriting methodologies including mathematical and financial group health underwriting funding. * Extensive experience applying consortium procedure and pricing (if applicable). * Extensive experience and knowledge of managed care/health care, group insurance products and group health underwriting financial arrangements and knowledge of state and federal legislation to underwriting practices and making sound decisions. * Work management skills in prioritizing and assigning work and project assignments. * Demonstrated highly effective Presentation skills for addressing customers and senior management. * Demonstrate skills for developing presentations, building and maintaining positive relationships internally and externally, interacting with representatives of large and strategic accounts, coordinating initiatives across departments, interacting with senior management, lead staff. * Project management skills and experience, including designing and leading projects. * Verbal and written communication skills, including correct grammar, appropriate word choice, precisions, structure, and appropriate tone and level of detail for audience. * Interact with BCBSA and member plans. * Interpret and describe BCBS products and financial arrangements as well as those provided by competitors. * Successfully demonstrated interpersonal skills in establishing and maintaining positive business relationships. * Independent judgment and problem resolution skills. * Work and project management skills including the ability to multi-task, prioritize, and manage time and workload to meet deadlines. * PC proficiency to include Word and Excel. * Successfully demonstrated skills and experience in presenting to external clients. * Process management and process improvement experience and skills to identify and implement process changes. **Preferred Job Qualifications:** * Pharmacy Underwriting experience * Experience leading pharmacy underwriters Please note that this role is **HYBRID** with an in-office requirement of 3 days a week \#LI-LK1 \#LI-Hybrid \#INJLF **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **HCSC Employment Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Base Pay Range** $100,000.00 - $180,700.00 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.
    $100k-180.7k yearly 28d ago
  • Comprehensive Wellness Center - Advanced Practice Clinician (PA/NP), Optum - Albuquerque, NM

    Unitedhealth Group Inc. 4.6company rating

    Albuquerque, NM job

    Optum NM is seeking an Advanced Practice Clinician to join our team in Albuquerque, NM. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you'll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. Position Highlights & Primary Responsibilities: In this position you will provide patient care for our Medicare Advantage patients that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health with preventative care as the core approach located at our Community Wellness Center. This role will also take you out of the "home" clinic and into a mobile van going to the patient or imbedded with one of our partner clinics for a day. We travel to our patients with important screenings, tests, shots and other care services. Some travel to rural areas for home visits will be involved as well. We run a systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value. What makes an Optum Career different? * As the largest employer of Advanced Practice Clinicians, we have a best-in-class employee experience and enable you to practice at the top of your license * We believe that better care for clinicians equates to better care for patients * We are influencing change collectively on a national scale while still maintaining the culture and community of our local care organizations * We grow talent from within. No matter where you want to go- geographically or professionally- you can do it here Compensation & Benefits Highlights: * Guaranteed, competitive compensation model based on quality, not quantity, with significant earning potential, annual increases, and bonus eligibility * Financial stability and support of a Fortune 5 Company * Robust retirement offerings including employer funded contributions and Employee Stock Purchase Plan (ESPP for UHG Stock) * Comprehensive benefits plan inclusive of medical, dental, vision, STD/LTD, CME and malpractice coverage * Robust clinician learning and development programs Albuquerque: * 300 days a year of sun-drenched and picturesque mountain views * Enjoy all seasons with mild winters * A Top City with the Cleanest Air in America, Thrillist * Top destination for hiking, biking, skiing and running * Top 10 ranking for America's Best Cities for Foodies, Travel + Leisure * Diverse Culture - Art galleries, theater, concerts, shopping, music venues * A Top Big Best Cities for Active Families, Outdoor Magazine * Top 5 ranking for "Secretly Cool Cities", Huffington Post 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: * Board Certified/Eligible Advanced Practice Clinician * Medical Licensure in the State of New Mexico or ability to obtain prior to employment * DEA license or ability to obtain prior to employment The salary range for this role is $104,500 to $156,000 annually based on full-time employment. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
    $104.5k-156k yearly 60d+ ago
  • Speech Therapist-PRN

    Unitedhealth Group Inc. 4.6company rating

    Albuquerque, NM job

    Explore opportunities with At Home Healthcare, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Speech Therapist in Home Health is responsible for the assessment and evaluation of patient care needs related to treating speech and language disorders, and functional training in communication, swallowing, and cognitive impairments. Based on this assessment and evaluation, the Speech Therapist works to help determine a treatment plan, performs interventions aimed at improving and enhancing the patient's well-being, and evaluates the patient's progress. Primary Responsibilities: * Provides services within the scope of practice as defined by the state laws governing the practice of speech therapy, in accordance with the plan of care, and in coordination with other members of the health care team * Evaluates the patient's level of function by applying diagnostic and prognostic functional ability tests. Assists the physician in the development of the therapy plan of care * Treats patients to communicate effectively by expressing thoughts according to the patient's condition using acceptable standards of practice * Observes, records, and reports to the supervising nurse and/or physician the patient's response to treatment and changes in the patient's condition * Instructs the patient, the family and/or caregiver and other members of the health care team in areas of speech therapy in which they can participate 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: * Licensed in Speech Therapy in the state of New Mexico * Current CPR certification * Current driver's license, vehicle insurance, access to a dependable vehicle or public transportation * Available to work a weekend rotation 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 hourly pay for this role will range from $34.23 to $61.15 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 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.
    $34.2-61.2 hourly 15d ago
  • Dir Ent Pharmacy Govt Programs

    Health Care Service Corporation 4.1company rating

    Albuquerque, NM job

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** This position is responsible for directing the Medicaid pharmacy operations team and responsible for analyzing and optimizing the operational metrics, productivity and program requirements. Direct and manage the ongoing assessment and program maintenance updates for the Medicaid pharmacy operations program. In addition, assess, direct and manage to the compliance of the program requirements as required by the applicable state Medicaid or Medicare requirements. Manage the preparation and readiness for on-going audits. Represent the department to internal and external areas including government agencies and audit vendors. Lead enterprise Medicaid operational and clinical programs. **JOB REQUIREMENTS** **:** + Registered Pharmacist with current, valid license in the state of operations. + 4 years of experience in pharmacy. + Strong leadership skills including working through others and training skills. + Analytical skills including translating business needs into technical requirements. + Verbal and written communication skills including interpersonal skills to direct team, work across internal departments and represent the company to external agencies. + Negotiation and problem-solving skills. + Overseeing the annual budget and allocating resources for various projects and operational needs. + Translating needs and initiatives into compelling business cases. + Conducting cost-benefit analyses to justify investments and ensure ROI. **PREFERRED JOB REQUIREMENTS** **:** + Knowledge of Medicaid and/or Medicare health plan and PBM operations. + Additional degrees or credentials outside the pharmacy area (such as an MBA). + 3 years of supervisory or management experience in a Pharmacy environment including managing a budget. **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **HCSC Employment Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Base Pay Range** $118,800.00 - $220,800.00 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.
    $69k-111k yearly est. 60d+ ago
  • Advanced Practice Clinician (Nurse Practitioner/Physician Assistant) - Optum New Mexico

    Unitedhealth Group Inc. 4.6company rating

    Rio Rancho, NM job

    Optum NM is seeking a Advanced Practice Clinician (Nurse Practitioner/Physician Assistant) to join our team in Rio Rancho, NM. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. Position Highlights & Primary Responsibilities: Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration, and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) In this position you will provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. You will enjoy working with our employees who work with professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population. We run a systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value. Albuquerque: * 300 days a year of sun-drenched and picturesque mountain views * Enjoy all seasons with mild winters * A Top City with the Cleanest Air in America, Thrillist * Top destination for hiking, biking, skiing and running * Top 10 ranking for America's Best Cities for Foodies, Travel + Leisure * Diverse Culture - Art galleries, theater, concerts, shopping, music venues * A Top Big Best Cities for Active Families, Outdoor Magazine * Top 5 ranking for "Secretly Cool Cities", Huffington Post Compensation & Benefits Highlights: * Med/Den/Vis, STD, LTD, United Health stock options * Continuing Medical Education allowance with time off * Robust Relocation program * Professional Liability Insurance * Excellent PTO package * Generous retirement program including employer funded contributions (401K) 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: * Board Certified/Eligible Advanced Practice Clinician * Medical Licensure in the State of New Mexico or ability to obtain prior to employment * DEA license or ability to obtain prior to employment The salary range for this role is $104,500 to $156,000 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. OptumCare 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. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
    $24k-34k yearly est. 8d ago
  • Nurse Practitioner or Physician Assistant [NP/PA] - Cardiology - Optum New Mexico

    Unitedhealth Group Inc. 4.6company rating

    Albuquerque, NM job

    Optum NM is seeking a Nurse Practitioner/Physician Assistant to join our team in Albuquerque, NM. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you'll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. We are looking for an Advanced Practice Clinician to join our team of medical professionals. You will work with patients to provide a full range of heart and cardiovascular services and treatments. You will perform various tests, make diagnoses, provide treatment plans and options, and work with other physicians and surgeons to treat patients' heart and/or cardiovascular disorders. We run a value-based care delivery model that demonstrates the ability to effectively call on system resources to provide care that is of optimal value, benefiting patients and the ones who care for them. Primary Responsibilities: * Consulting with patients to understand their symptoms and health concerns * Prescribing tests, treatments, and/or surgery, when necessary * Maintaining detailed notes of appointments with patients, including comments, tests and/or treatments prescribed, and test results * Performing tests, when needed, to check the health of patients' hearts and/or cardiovascular systems * Interpreting test results to determine how effectively the heart and/or cardiovascular system is functioning * Using medical imaging equipment, such as CT and MRI scanners, to diagnose and treat heart and/or cardiovascular conditions * Assisting and/or performing surgery which may include complex surgical interventions that require a team of medical professionals * Prescribing medication to treat heart and/or cardiovascular disease * Providing support and advice to patients receiving long-term care * Training and providing educational support to junior staff, when necessary * Mon- Fri, 100% outpatient with no hospital work Albuquerque: * 300 days a year of sun-drenched and picturesque mountain views * Enjoy all seasons with mild winters * A Top City with the Cleanest Air in America, Thrillist * Top destination for hiking, biking, skiing and running * Top 10 ranking for America's Best Cities for Foodies, Travel + Leisure * Diverse Culture - Art galleries, theater, concerts, shopping, music venues * A Top Big Best Cities for Active Families, Outdoor Magazine * Top 5 ranking for "Secretly Cool Cities", Huffington Post Compensation & Benefits Highlights: * Med/Den/Vis, STD, LTD, United Health stock options * Continuing Medical Education allowance with time off * Robust Relocation program * Professional Liability Insurance * Excellent PTO package * Generous retirement program including employer funded contributions (401K) 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: * Board Certified/Eligible Advanced Practice Clinician * Medical Licensure in the State of New Mexico or ability to obtain prior to employment * DEA license or ability to obtain prior to employment The salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. 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. OptumCare 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. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
    $39k-44k yearly est. 8d ago

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