Remote Clinical Review jobs
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CLAIMS SYSTEM CONFIGURATION QUALITY REVIEW SENIOR ANALYST - EVICORE - REMOTE
Resolve non-routine issues escalated from leadership, business, clients and junior team members and act as a subject matter expert (SME) to business and IT for eviCore claims product setups/processes Collaborate with internal and...
| Company | The Cigna Group |
|---|---|
| Address | Franklin, TN |
| Category | Information Technology |
| Job type | Full-time |
| Date Posted | 23 hours ago See detail |
Claims System Configuration Quality Review Senior Analyst - eviCore - Remote New
The Cigna Group
Franklin, TN
Resolve non-routine issues escalated from leadership, business, clients and junior team members and act as a subject matter expert (SME) to business and IT for eviCore claims product setups/processes Collaborate with internal and...
23 hours ago seen See more...
- View all - jobs in Franklin, TN
Auditor, Clinical Services - UM (Remote in TX) - Now Hiring
Molina Healthcare
Houston, TX
$23.76 - $51.49 per hour
Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member Assessment Team (MAT), Health Management (HM), and/or Disease Management (DM). Monitors key cl...
2 days ago seen See more...
- View all - jobs in Houston, TX
Senior Clinical Trial Manager (Remote) - 24-108
Elevar Therapeutics, Inc
United States
$165,000 - $185,000 a year
Collaborate with the operational project team members and Finance stakeholders to oversee clinical study vendor(s) to ensure compliance with the contracted study specifications (i.e., timelines, deliverables) Lead the Clinical Ope...
2 days ago seen
MHPAEA Clinical Reviewer
Willis Towers Watson
Olin, NC
Prepare NQTL carrier data requests on behalf of each client. Coordinate with Project Manager regarding sending requests, timing, status, and follow-up. Attend internal and client kick off meeting with QTL/NQTL team. Monitor carri...
5 days ago seen See more...
- View all - jobs in Olin, NC
RN Pre-Service Clinical Review
Kaiser Permanente
Renton, WA
Conducts Clinical Review of coverage request based on the application of medical necessity criteria, understanding of individual coverage contracts and ability to meet Kaiser Foundation Health Plan of Washington, coding rules and...
2 weeks ago seen See more...
- View all - jobs in Renton, WA
Clinical Nurse Navigator-Days (Not Remote)
University Hospitals
Ohio, United States
DescriptionProvides virtual clinical care to patients within the recognized scope of practice for the profession and professional licensure requirementsProvides clinical triage and clinical support using established protocols duri...
5 days ago seen See more...
- View all - jobs in Ohio State
Registered Nurse Clinical Denials & Appeals Reviewer
Administrative Regional Training Cntr
Buffalo, NY
$36.19 - $54.29 an hour
Registered Nurse with a current New York State license Bachelor of Science Nursing degree Holds, or will obtain within one (1) year of hire, one of the following (or similar) credentials: Certified Documentation Specialist, Certif...
7 days ago seen See more...
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Product Surveillance Clinical MDR Specialist II (Remote)
Arthrex
Naples, FL
Responsible for evaluation of complaints with respect to United States and International adverse event reporting regulations. Performs submission of adverse event reports to United States and International regulatory agencies Meet...
7 days ago seen See more...
- View all - jobs in Naples, FL
Remote Licensed Clinical Social Worker
Grow Therapy
Bridgeport, CT
$72 - $100 an hour
Free, hassle-free credentialing with major insurers: Under the Grow umbrella youll get paneled for free with the major payors in your state so you can also start seeing insurance clients. Referral stream + marketing partnerships...
a week ago seen See more...
- View all - jobs in Bridgeport, CT
Clinical Review Nurse I - Medicare Part B (US)
Elevance Health
Atlanta, GA
Assesses the necessity and reasonableness of the items supplied in a valid claim through the use of medical policy and other materials. . Requires AS in nursing and minimum of 1 year of clinical experience; or any combination of...
2 weeks ago seen See more...
- View all - jobs in Atlanta, GA
Pediatric Speech-Language Pathologist (remote position for Hawaii clinic)
Sprouts Therapy
Hawaii, United States
$45 - $47 an hour
Pediatric Speech Therapist (Remote). Pediatric Feeding Occupational Therapist (Remote). Full-Time Schedule Coordinator (pre-builds caseload for new hires, fills cancellations when able, communicates directly with clients regarding...
2 weeks ago seen See more...
- View all - jobs in Hawaii State
Clinical Research Associate Manager - Central Region (Remote)
Merck
Rahway, NJ
Work allocation, staff development and performance appraisal.. Provides input for capacity planning, including reporting of current manpower and forecasting of CRA capacity and needs, to provide efficient use of resources.. Work w...
2 weeks ago seen See more...
- View all - jobs in Rahway, NJ
RN Clinical Reviewer
Rio Grande Regional Hospital
McAllen, TX
Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transporta...
3 weeks ago seen See more...
- View all - jobs in McAllen, TX
Clinical Nurse Review - II
Progressive Technology Solutions
Owings Mills, MD
$35 - $39 an hour
8 hour shift. Owings Mills, MD 21117: Relocate before starting work (Required)....
2 weeks ago seen See more...
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Outpatient Licensed Clinical Social Worker (fully remote)
Lifebulb
Hampton, VA
Up to $100,000 a year
Provide direct in-session care for your clients. Complete session documentation. Reschedule clients as you see fit & maintain your caseload. High client demand, Quick caseload growth. Guaranteed pay per session (no guess work or w...
2 weeks ago seen See more...
- View all - jobs in Hampton, VA
Nurse Practitioner (NP) Director of Clinical Quality (REMOTE)
Vesta Healthcare
Remote
$145,000 - $165,000 a year
Develop, design, revise, and execute our comprehensive Clinical Quality program and educate the team on continuous quality improvements. Collaborate extensively with Nurse Practitioners, collaborating physicians, nursing staff, ot...
3 weeks ago seen
per diem Clinical Care Manager RN -mostly remote
Vns Health
New York, United States
$49.55 - $61.96 per hour
Attractive sign-on bonus and referral bonus opportunities . Generous paid time off (PTO), starting at30 days of paid time offand 9 company holidays . Health insurance plan for you and your loved ones, Medical, Dental, Vision...
3 weeks ago seen See more...
- View all - jobs in New York State
Clinical Research Medical Director, Endocrinology - US, Remote
Biospace
Washington, DC
Provide clinical/scientific knowledge into the development, design, delivery and communcation of the global evidence generation plan for the maridebart cafraglutide (AMG 133) phase 3 program. Support cross-functional and global co...
3 weeks ago seen See more...
- View all - jobs in Washington, DC
Clinical Research Medical Director, Endocrinology - US, Remote
Amgen
Washington, DC
Provide clinical/scientific knowledge into the development, design, delivery and communcation of the global evidence generation plan for the maridebart cafraglutide (AMG 133) phase 3 program.. Support cross-functional and global c...
3 weeks ago seen See more...
- View all - jobs in Washington, DC
Clinical Business Operations Representative 3 - Hybrid/Remote
University Of Miami
Miami, FL
$34.6K - $43.8K a year
Assists the department in managing expectations surrounding pre and post patient care. Obtains or reviews all patient demographic information, insurance information and referral numbers. Reviews clinical records for completeness i...
3 weeks ago seen See more...
- View all - jobs in Miami, FL
Registered Nurse- Risk Manager Clinical Reviewer
Department Of Veterans Affairs
Martinsburg, WV
Competitive
Demonstrates knowledge in the interpretation and application of accrediting body standards and other agency requirements. Assists with monitoring of various aspects of care provided to Veterans and the analysis and interpretation...
4 weeks ago seen See more...
- View all - jobs in Martinsburg, WV
Remote- Clinical Pharmacology, Modeling & Simulation- Senior Principal Scientist
Biospace
Thousand Oaks, CA
Plans all necessary non-compartmental analyses to support project team decisions, publications, and reporting. Designs Clinical Pharmacology components of drug development project clinical plans and provides Clinical Pharmacology...
a month ago seen See more...
- View all Biospace jobs - jobs in Thousand Oaks, CA
Supervisor - Clinical Review (Full-time - Salaried/Exempt) Washington State
Kaiser Permanente
Spokane, WA
Monitors and acts on daily operations of the Clinical Review, Case Management, and Code Review nursing staff using daily management systems. Manages and monitors daily work product of the Clinical Review, Case Management and Code...
a month ago seen See more...
- View all Kaiser Permanente jobs - jobs in Spokane, WA
Remote Clinical Supervisor Board Certified Behavior Analyst (LBA, BCBA)
Highlights Healthcare
Mooresville, NC
Monday through Friday schedule No weekends. Competitive compensation starting at $75 per billable hour, commensurate with experience. Professional development opportunities. Company laptop. Train and supervise a team of Student An...
a month ago seen See more...
Full-time Remote Clinical Supervisor Community Based (LPC LCSW)
Ems Of Virginia
Richmond, VA
Responsible for following through with referrals and completing assessments (initial, reassessments, comprehensive assessments). Responsible for case assignment and maintenance of client care. Ensures that billable hours are achie...
2 months ago seen See more...
- View all - jobs in Richmond, VA
Clinical Review Nurse - Prior Authorization
Bcforward
Indianapolis, IN
Clinical Review Nurse - Prior AuthorizationBC Forward is looking for Clinical Review Nurse - Prior Authorization (Remote Work) Position Title: Clinical Review Nurse - Prior Authorization (Remote Work) Locations: Remote IN (Local t...
2 months ago seen See more...
- View all Bcforward jobs - jobs in Indianapolis, IN
Registered Nurse Clinical Reviewer PRN
Corpus Christi Medical Center Bay Area
Corpus Christi, TX
Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transporta...
2 months ago seen See more...
Associate Director Global Clinical Program Management, Obesity - US, Remote
Biospace
Washington, DC
Line Management of Global Trial Managers (GTM)s. Supports Clinical Program Operations (CPO) Director/Snr Director in the following activities (leads activities in the absence of a director level e.g., on smaller programs):. Overal...
4 weeks ago seen See more...
- View all - jobs in Washington, DC
Associate Manager, Clinical Health Services (Remote)
Cvs Health
Tallahassee, FL
Fundamental Components Implements clinical policies & procedures in accordance with applicable regulatory and accreditation standards (e.g., NCQA, URAC, state and federal standards and mandates as applicable) Serve as a conte...
4 weeks ago seen See more...
- View all - jobs in Tallahassee, FL
Patient Coordinator (Remote/Non-clinical) AccessNurse in null (Remote) at TeamHealth
Teamhealth
Remote
Are you seeking a remote position? And are you able to provide a HIPAA-compliant workspace? Are you looking to start a new career with a reputable health care company? Week 1: July 1-5, M-F 9a-5p Eastern (No Class On July 4th). We...
4 weeks ago seen
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