Martin’s Point Health Care
Remote Jobs
Martin's Point Health Care is an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.
3 Jobs
Utilization Review and Appeals Nurse - Remote
Martin’s Point Health CareMartin's Point Health Care is an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.
The Utilization Appeals Review Nurse is responsible for the clinical review and resolution of member and provider appeals and claims disputes by applying medical policies and regulatory standards. This role involves coordinating clinical resolution, ensuring compliance with various contractual and regulatory standards, and participating in quality improvement initiatives.
Health Plan Data and Medical Policy Clinician
Martin’s Point Health CareMartin's Point Health Care is an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.
The Health Plan Data and Medical Policy Clinician analyzes data, as well as coverage, payment, and coding policies, reviews findings, and informs, supports, and makes recommendations to Utilization Management leadership as well as other Clinical Programs at Martin’s Point Healt...
Special Investigations Unit (SIU) Director
Martin’s Point Health CareMartin's Point Health Care is an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.
The Director, Special Investigations Unit (SIU), reports to the General Counsel and Chief Legal Officer and leads the Martin’s Point’s Audit & Recovery team. Responsible for developing and implementing a fraud, waste, and abuse program encompassing a wide range of investigati...
