Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Actalent. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Clinical Review Nurse – Prior Authorization (Remote) **Schedule**

*   Training: Monday–Friday, 8 a.m.–5 p.m.
*   Post‑Training:
*   Tuesday–Saturday, 10 a.m.–7 p.m., or Sunday–Thursday, 10 a.m.–7 p.m.

**About The Role** We are seeking two Clinical Review Nurses (Prior Authorization). In this role, you will analyze prior authorization requests to determine medical necessity and appropriate levels of care in alignment with national standards, contractual requirements, and member benefit coverage. You will provide recommendations to the medical team to support quality, compliance, and cost‑effective care. Key Responsibilities

*   Review and process prior authorization requests for Texas Ambetter.
*   Ensure compliance with turnaround times and regulatory requirements.
*   Apply clinical judgment and national guidelines (e.g., InterQual) to determine medical necessity.
*   Maintain accuracy and efficiency while navigating multiple systems and applications.
*   Monitor and meet performance expectations and productivity metrics.
*   Collaborate with internal teams to support quality and compliance initiatives.
*   Maintain adherence to state board and regulatory standards.

**Required Qualifications**

*   Graduate of an accredited School of Nursing or Bachelor’s degree in Nursing.
*   Active RN license (required).
*   2–4 years of prior authorization experience on the insurance/payer side.
*   Strong computer proficiency and ability to navigate multiple systems.
*   Ability to work accurately and efficiently in a fast‑paced environment.
*   Strong teamwork, adaptability, and communication skills.

**Preferred Qualifications**

*   BSN preferred (ADN accepted).
*   Experience with TruCare and/or InterQual (IQ).

Disqualifiers

*   Lack of prior authorization experience on the insurance/payer side.
*   No active RN license.

Job Type & Location This is a Contract position based out of San Antonio, TX. Pay and Benefits The pay range for this position is $33.00 - $38.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

*   Medical, dental & vision
*   Critical Illness, Accident, and Hospital
*   401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
*   Life Insurance (Voluntary Life & AD&D for the employee and dependents)
*   Short and long-term disability
*   Health Spending Account (HSA)
*   Transportation benefits
*   Employee Assistance Program
*   Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Feb 27, 2026. **About Actalent** Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options. If you have questions about this posting, please contact support@lensa.com

Remote Clinical Review Nurse

**JOB PURPOSE:** Develop strategies to improve engagement and manage programs designed to foster team culture. This role partners with the Transition Services (TS) recruitment team on onboarding and works with leadership staff on retention, recognition, culture, wellness, and other activities aimed at creating a positive and inclusive workplace environment for on-site, hybrid, and fully remote employees across the United States. **QualificationsESSENTIAL JOB RESPONSIBILITIES:Employee Engagement Strategy & Culture**

*   Lead the strategy, design, and execution of employee engagement programs and foster the company’s culture ensuring all initiatives/activities are promoted and delivered for staff located across multiple time zones (in 50 states and Puerto Rico)
*   Develop and manage the Employee Engagement program budget in partnership with the Talent Acquisition Manager and National Director for Administration.
*   Align engagement initiatives with organizational policies, division workforce strategies, and employee experience priorities.
*   Create and refine initiatives that strengthen employee experience, belonging, and retention in partnership with TS leadership, HR, and key enterprise partners.
*   Support culture-building initiatives, program/project launches and sunsets, and special engagement projects in coordination with cross-functional teams.

**Measurement, Insights & Reporting**

*   Design and administer engagement surveys and focus groups in collaboration with Enterprise HR to gather quantitative and qualitative feedback.
*   Analyze engagement, satisfaction, and stay and exit interview data to improve branding, the employee life cycle, industry intelligence, retention, and referrals.
*   Develop metrics and dashboards and prepare monthly and annual reports to monitor and track participation, assess effectiveness, and implement changes and inform TS and enterprise leadership.
*   Maintain accurate engagement and program records and contribute data to enterprise reporting and workforce planning efforts.

**Communications, Recognition & Events**

*   Develop and manage an internal communications plan and cadence to share initiatives, and key updates and ensure information is communicated regularly and effectively to staff.
*   Draft and coordinate communications related to team-building, events, announcements, and engagement initiatives in alignment with enterprise branding and messaging standards.
*   Develop and oversee rewards and recognition programs.
*   Organize engagement events, team-building activities, and TS in-person and local programs across for TS staff.

**Talent, Leadership & Employee Support**

*   Partner with TS Talent Acquisition, TS Training, and Enterprise HR to support onboarding, retention, and the full employee lifecycle.
*   Provide coaching, training, and resources to ensure the integration of staff feedback and trends into supervisory norms in collaboration with TS Recruitment and TS Training.
*   Manage special projects and cross-functional initiatives with TS Leadership, Enterprise HR and Marketing & Communications in support of the organization’s mission and culture.
*   Manage the internship and mentorship programs, when applicable, to create meaningful experiences.
*   Other duties as assigned.

**General**

*   Communicate verbally and in writing with diverse groups of individuals at different levels using tact and diplomacy.
*   Demonstrate Exceptional customer service, in Everything you do, by placing the child, family, Veteran or client first to support our mission to "Empower people to build better lives for themselves, their families, and their communities."

**Essential QualificationsEDUCATION AND EXPERIENCE:** Bachelor's degree from an accredited college or university in Human Resources, Sociology, Organization Leadership, Psychology, or related field and at least two years of related experience and/or training; or equivalent combination of education and experience. Employee Engagement experience required. **Proficiency In Spanish/English (written And Spoken Language Skills), Required.ATTENDANCE:** Must maintain regular and acceptable attendance at such level as is determined in the employer’s sole discretion. **LICENSES:** Driver’s License with clear record. **VEHICLE:** Must have daily use of a vehicle without prior notice. **WORK LOCATION:** Remote - Must be able to work from home in a private space. Travel for in-person events periodically, as well as travel for division and corporate events or all staff meetings. **OTHER:** Must be available and willing to travel to various locations and with such frequency as the business need dictates. _EXCEPTIONS TO THESE CRITERIA MUST BE APPROVED BY THE DEPARTMENT HEAD._

Employee Engagement Specialist

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Actalent. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Urgent Hiring for "Remote Clinical Review Nurses" **Job Description**

*   Review approximately 20 cases a day for medical necessity.
*   Advocate for and protect members from unnecessary hospital admissions.
*   Follow established procedures and processes to complete authorizations.
*   Collaborate with a team of nurses to assist each other and complete cases.

**Qualifications**

*   3+ years of utilization management, concurrent review, prior authorization, utilization review, case management, and discharge planning is must
*   Active RN Compact License is Must

If you are Interested , Kindly give a call : (726) 216-6069 Job Type & Location This is a Contract position based out of San Antonio, TX. Pay and Benefits The pay range for this position is $35.00 - $40.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Feb 14, 2026. **About Actalent** Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options. If you have questions about this posting, please contact support@lensa.com

Clinical Review Nurse - RN (Remote)

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Sedgwick. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Client Service Representative (REMOTE) Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

*   Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
*   Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.
*   Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
*   Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.
*   Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
*   Enjoy flexibility and autonomy in your daily work, your location, and your career path.
*   Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

**ARE YOU AN IDEAL CANDIDATE?** We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion. **PRIMARY PURPOSE:** To manage accounts of locally assigned programs including monitoring procedures and processes that impact customer satisfaction; and to ensure consistency in service delivery **ESSENTIAL FUNCTIONS And RESPONSIBILITIES**

*   Knowledge of client workers' compensation processes and procedures
*   Excellent oral and written communication, including presentation skills
*   Advanced level Microsoft Office products (especially excel)
*   Strong organizational skills with attention to detail
*   Excellent interpersonal skills
*   Ability to work in a team environment
*   Ability to meet or exceed Performance Competencies

**ADDITIONAL FUNCTIONS And RESPONSIBILITIES**

*   Performs other duties as assigned.
*   Supports the organization's quality program(s).
*   Travels as required.

**QualificationsEducation & Licensing** Bachelor's degree from an accredited college or university preferred. **Experience** Two (2) years of related experience to include one (1) year as an Account Coordinator, analyst, associate or three (3) years adjuster experience. **TAKING CARE OF YOU**

*   Flexible work schedule.
*   Referral incentive program.
*   Career development and promotional growth opportunities.
*   A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles. Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see **sedgwick.com** If you have questions about this posting, please contact support@lensa.com

Client Service Representative (REMOTE)

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for TEKsystems. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Customer Care & Insurance Support Specialist Location: REMOTE - Alabama, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, North Carolina, North Dakota, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Utah, and West Virginia Experience Level: Entry Level Are you passionate about helping people and making a difference every day? Join our team as a Customer Care & Insurance Support Specialist, where you’ll play a vital role in ensuring patients receive the care and support they need. This is more than just answering calls—it’s about creating positive experiences and guiding customers through important healthcare processes. What You’ll Do

*   Be the friendly voice and helpful resource for customers by answering calls and emails promptly.
*   Provide clear, accurate information about products, services, and general inquiries.
*   Process orders and route calls to the right team members, ensuring smooth and efficient service.
*   Review and verify documentation for accuracy and compliance.
*   Complete insurance verification to confirm patient eligibility, coverage, and benefits.
*   Obtain pre-authorizations and submit physician orders to insurance carriers when needed.
*   Navigate multiple EMR systems to update and maintain accurate records.
*   Communicate trends and insights to Customer Service and Management to improve processes.
*   Contact patients when documentation needs updates, offering solutions to keep things moving.

What Makes You a Great Fit

*   Must Have:
*   1+ year of healthcare call center experience
*   Proficiency with Microsoft Office

Why You’ll Love Working Here

*   Impact: Help patients access the care they need by guiding them through insurance and documentation processes.
*   Growth: Learn valuable skills in healthcare, insurance, and customer service.
*   Team Culture: Join a supportive, collaborative environment where your contributions matter.

Ready to make a difference? Apply today and start your journey with us! Job Type & Location This is a Contract to Hire position based out of San Antonio, TX. Pay and Benefits The pay range for this position is $16.00 - $16.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

*   Medical, dental & vision
*   Critical Illness, Accident, and Hospital
*   401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
*   Life Insurance (Voluntary Life & AD&D for the employee and dependents)
*   Short and long-term disability
*   Health Spending Account (HSA)
*   Transportation benefits
*   Employee Assistance Program
*   Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Dec 22, 2025. h4>About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. **About TEKsystems And TEKsystems Global Services** We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you have questions about this posting, please contact support@lensa.com

Healthcare Customer Service Representative (Remote)

Description Campaign Overview: We’re excited to share an opportunity to join the Centene Ambetter campaign—a seasonal, licensed sales program helping individuals under 65 enroll in affordable health insurance through the Affordable Care Act (ACA) Marketplace. You’ll support a diverse range of customers, many of whom qualify due to income, unemployment, or disability, and often need family coverage. Ambetter serves 29 states, and don’t worry if you’re not currently licensed in all of them—ResultsCX will purchase any additional reciprocal licenses you need, allowing you to support more customers and maximize your earnings throughout the season. What sets this campaign apart is the diversity of customers you’ll support and the importance of adapting your tone, pace, and approach to meet each caller’s needs. Some members may be tech-savvy and direct, while others may be navigating language barriers, disabilities, or low-income situations. Your ability to listen actively, explain options clearly, and match the customer’s pace will directly impact both their experience and your success. This is a sales-first environment, but it’s rooted in service and compliance. You’ll complete enrollments, explain plan options, overcome objections, and meet daily conversion goals—all while adhering to state and federal guidelines. In addition to inbound sales, you may follow up on marketing leads, support renewals, or assist with returning members through voice or chat channels. If you’re a strong communicator with sales confidence, a heart for service, and a desire to help people access essential care, this is a high-impact seasonal opportunity—with potential to convert to long-term employment based on performance and business need. To Work Virtual In Your Home, You Will Need ResultsCX will provide equipment for all – however, they must have high speed internet, with the ability to direct ethernet connect (no satellite or WiFi acceptable). High Speed Internet – minimum download speed of 10 Mbps and a minimum upload speed of 6 Mbps Ability to connect directly to the internet service provider modem with an Ethernet cable, (WIFI is not acceptable) 2 dedicated computer monitors minimum 13 inches or larger A VoIP USB Headset with microphone and a Web Cam for Training Dedicated workspace in your home that is free of background noise and distractions Additional equipment specifications will be tested during the interview process Skills Customer support, health insurance, inside sale Additional Skills & Qualifications Education: High school diploma or GED required License: The accounts that we are getting agency support on require both life and health resident license. Sales Skills: We are looking for people who are ready to sell and close the deal – charismatic and persuasive individuals who excel at building relationships and connecting with others. Technical Proficiency: This position requires you to toggle back and forth between multiple systems while communicating with the customer. You will need to have intermediate/advanced technical proficiency Availability: Hours of Operation:

*   7 days a week 8:00 AM – 11:00 PM EST Oct 15- Feb 1
*   5 days a week 8:00 AM – 9:00 PM EST Feb 2 - October 15

Pay Expectation: Our seasonal pay rates move from base pay to $20-$21/hr on the first day of the selling season and return to base rates after the selling season. Experience Level Entry Level Pay And Benefits The pay range for this position is $30.00 - $30.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits Available For This Temporary Role May Include The Following

*   Medical, dental & vision
*   Critical Illness, Accident, and Hospital
*   401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
*   Life Insurance (Voluntary Life & AD&D for the employee and dependents)
*   Short and long-term disability
*   Health Spending Account (HSA)
*   Transportation benefits
*   Employee Assistance Program
*   Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Sep 11, 2025. h4>About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About TEKsystems And TEKsystems Global Services We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

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