Remote Managed Care Jobs
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Software Development 17838B2B Sales & Account Management 10968CRM & Direct Marketing 10917Product 9303Back-End Development 9223Management and Leadership 8423Data and Analytics 8147finance 8094IT & Engineering 6553Enterprise Sales 6500Project & Program Management 5958Customer Support & Service 5958Sustainability & CSR 5474Sales Leadership & Strategy 5011DevOps & Infrastructure 4737Growth & Performance 3338Front-End Development 2857
405 jobs
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Quality Performance Specialist Non Clinical (Ohio resident)
Quality Performance Specialist Non Clinical (Ohio resident)
2 day ago
AmeriHealth Caritas
- Remote: Ohio (USA)
- Full time
HEDIS (Healthcare Effectiveness Data And Information Set)Quality AssessmentHealth Care IndustryProject ManagementRun ChartManaged Care
RN Appeals Analyst
RN Appeals Analyst
1 day ago
BlueCross BlueShield of South Carolina
- Remote: Tennessee (USA)
- Full time
Clinical Data AnalysisUtilization ManagementManaged CareMedical NecessityHome Health CareOnline Communication
Concurrent Review Care Coordinator - EviCore - Work at Home
Concurrent Review Care Coordinator - EviCore - Work at Home
Today
The Cigna Group
- Remote: United States
- Full time
Care CoordinationUtilization ManagementNurse Licensure CompactClinical AssessmentsEmpowermentHome Health Care
RVP of Health Plan Sales - West 
RVP of Health Plan Sales - West
Today
RadiantGraph
- Remote: United States
- Full time
Medical SalesConsultative SellingManaged CareSales StrategyBusiness DevelopmentAI Testing
Career Opportunities: Pharmacy Benefit Specialist II (24915)
Career Opportunities: Pharmacy Benefit Specialist II (24915)
1 day ago
CareOregon
- Remote: Arizona (USA), Idaho (USA), Montana (USA), Nevada (USA), Texas (USA), Utah (USA), Washington (USA), Wisconsin (USA)
- Full time
Pharmacy Benefit ManagementPrior AuthorizationClaims And Litigation ManagementData EntryManaged CareMedical Abbreviations
Medical Director
Medical Director
1 day ago
Highmark Health
- Remote: Alabama (USA), Alaska (USA), Arizona (USA), Arkansas (USA), California (USA), Colorado (USA), Connecticut (USA), Delaware (USA), District of Columbia (USA), Florida (USA), Georgia (USA), Hawaii (USA), Idaho (USA), Illinois (USA), Indiana (USA)
- Full time
Utilization ManagementMedical ManagementCare ManagementClinical ConsultingOnline CommunicationMedical Software
Excess Risk Managed Care Clinician
Excess Risk Managed Care Clinician
1 day ago
Highmark Health
- Remote: Alaska (USA), Arkansas (USA), California (USA), Hawaii (USA), Idaho (USA), Illinois (USA), Indiana (USA), Iowa (USA), Kansas (USA), Kentucky (USA), Louisiana (USA), Michigan (USA), Minnesota (USA), Mississippi (USA), Missouri (USA)
- Full time
Clinical Data AnalysisCare ManagementCost ContainmentClaims And Litigation ManagementHealth Care IndustryProject Management
Integrated Case Manager - Registered Nurse
Integrated Case Manager - Registered Nurse
1 day ago
Sentara Healthcare
- Remote: Virginia (USA)
- Full time
Care CoordinationCare ManagementNurse Licensure CompactPublic HealthHealth And Human ServicesHolistic Health
JX22004061424 - Licensed Practical Nurse - Remote
JX22004061424 - Licensed Practical Nurse - Remote
1 day ago
Sonya M. Recruiting
- Remote: Rhode Island (USA)
- Full time
Clinical NursingPrior AuthorizationCall Center ExperienceCare ManagementLine ChartManaged Care
Government Affairs Associate
Government Affairs Associate
1 day ago
Imagine Pediatrics
- Remote: United States
- Full time
Public AffairsHealth PoliciesLegislationProject ManagementPolicy DevelopmentManaged Care
Member Outreach and Engagement Consultant, DentaQuest (Los Angeles and Sacramento)
Member Outreach and Engagement Consultant, DentaQuest (Los Angeles and Sacramento)
3 day ago
DentaQuest
- Remote: California (USA)
- Full time
Civic EngagementCare CoordinationEducational OutreachHealth And Human ServicesManaged CarePatient Education And Counseling
Member Outreach and Engagement Consultant, DentaQuest (Los Angeles and Sacramento)
Member Outreach and Engagement Consultant, DentaQuest (Los Angeles and Sacramento)
3 day ago
Sun Life
- Remote: California (USA)
- Full time
Civic EngagementCare CoordinationSocial MarketingHealth And Human ServicesPatient Education And CounselingAnalytics
Managed Care Coordinator I-Medicaid Case Management
Managed Care Coordinator I-Medicaid Case Management
1 day ago
Horizon Blue Cross Blue Shield of New Jersey
- Remote: United States
- Full time
Online CommunicationMedical AbbreviationsContext AnalysisEnrollment ManagementEmployment ContractsBilling
Encounters Operations Data Reporting Analyst III
Encounters Operations Data Reporting Analyst III
1 day ago
CareSource
- Remote: United States
- Full time
AnalyticsSQL (Programming Language)SAS (Software)Power BIData MappingData Visualization
Epic Digital Products Manager - Member Experience
Epic Digital Products Manager - Member Experience
1 day ago
Cook Children's Health Care System
- Remote: United States
- Full time
Agile Software DevelopmentProject ManagementDigital Product ManagementBusiness AnalysisSoftware UpdaterDigital Advertising
Manager, Grievance and Appeals Service Integration
Manager, Grievance and Appeals Service Integration
1 day ago
CareSource
- Remote: United States
- Full time
Data MiningProject ManagementProcess ImprovementConflict ResolutionTechnical WritingHealthcare Industry Knowledge
Utilization Management Registered Nurse, MI - Remote
Utilization Management Registered Nurse, MI - Remote
3 day ago
McLaren Health Care
- Remote: Michigan (USA)
- Full time
Utilization ManagementNursingManaged CareCare ManagementBehavioral Change TheoriesMedical Management
Process Consultant II (Behavioral Health)
Process Consultant II (Behavioral Health)
3 day ago
Health Care Service Corporation
- Remote: Illinois (USA), Texas (USA)
- Full time
Data MiningProject ManagementBusiness MetricsProcess ImprovementCoding TheoryMeeting Facilitation
Utilization Management Nurse – Behavioral Health Focus (Remote)
Utilization Management Nurse – Behavioral Health Focus (Remote)
3 day ago
Morgan Stephens
- Remote: Arizona (USA), Florida (USA), Georgia (USA), Idaho (USA), Iowa (USA), Kentucky (USA), Michigan (USA), Nebraska (USA), New Mexico (USA), New York (USA), Texas (USA), Utah (USA), Washington (USA), Wisconsin (USA)
- Full time
Utilization ManagementBehavioral HealthNurse Licensure CompactInterQual CriteriaDigital File ManagementManaged Care
Network Client Services Manager
Network Client Services Manager
1 day ago
Prime Therapeutics
- Remote: United States
- Full time
Pharmacy Benefit ManagementRegulatory ComplianceNetwork AdministrationCustomer Relationship ManagementProject ManagementSocial Influences
Community Health Educator Sr (Region 5/6)
Community Health Educator Sr (Region 5/6)
6 day ago
AmeriHealth Caritas
- Remote: Michigan (USA)
- Full time
Health EducationPublic HealthManaged CareCommunity AdvocacyMarketingHealthcare Industry Knowledge
Product/Benefit Administration Specialist (remote)
Product/Benefit Administration Specialist (remote)
1 day ago
Executive Recruiting Agency
- Remote: United States
- Full time
Project ManagementRegulatory ComplianceMedicareBenefits AdministrationCoding TheoryFunctional Design
Care Coordinator
Care Coordinator
7 day ago
Rogers Behavioral Health
- Remote: Wisconsin (USA)
- Full time
Patient Education And CounselingCross-Functional CollaborationMental Health EducationManaged Care
RN Specialist Complex Case Manager
RN Specialist Complex Case Manager
6 day ago
Blue Cross and Blue Shield of Minnesota
- Remote: Minnesota (USA)
- Full time
Care ManagementClinical AssessmentsManaged CareMotivational LeadershipNursingCultural Competency Training
Therapeutic Education Manager, Tzield West
Therapeutic Education Manager, Tzield West
Today
Sanofi
- Remote: Canada
- Full time
Cross-Functional CollaborationMedical DevicesActivities Of Daily Living (ADLs)Continuing Medical EducationDiabetes ManagementReimbursement Regulations
Quality Improvement Specialist
Quality Improvement Specialist
4 day ago
Centene Corporation
- Remote: Illinois (USA)
- Full time
Data MiningCompliance ManagementQuality AssessmentHealth Care IndustryCode Of Federal RegulationsManaged Care
Clinical Integration Liaison - Licensed/Remote in CA
Clinical Integration Liaison - Licensed/Remote in CA
10 day ago
Magellan Health
- Remote: California (USA)
- Full time
Clinical Data ExchangeUtilization ManagementProject ManagementMental Health EducationAddiction CounselingMental Health Counseling
Quality Program Strategist II
Quality Program Strategist II
8 day ago
Centene Corporation
- Remote: New York (USA)
- Full time
AnalyticsStakeholder CommunicationsQuality AssessmentPerformance ManagementHEDIS (Healthcare Effectiveness Data And Information Set)Compliance Management
Utilization Review Clinician (RN, PT, OT) - Oregon
Utilization Review Clinician (RN, PT, OT) - Oregon
6 day ago
WellSky
- Remote: Oregon (USA)
- Full time
Care CoordinationUtilization ManagementMedical GuidelineNursingInterQual CriteriaMedical Software
Pharmacy Operations Specialist I
Pharmacy Operations Specialist I
Today
Centene Corporation
- Remote: Texas (USA)
- Full time
AnalyticsProcess ImprovementUser Acceptance Testing (UAT)Pharmacy OperationsDeveloping Training MaterialsOperational Support And Analysis
Insurance Claims Specialist (Remote)
Insurance Claims Specialist (Remote)
10 day ago
Conifer Health Solutions
- Remote: Texas (USA)
- Full time
Account ManagementMedical Insurance ClaimsBusiness CycleHospital Information SystemsMedicaidCommercial Insurances
Denials Specialist - Remote
Denials Specialist - Remote
3 day ago
Conifer Health Solutions
- Remote: Texas (USA)
- Full time
Coding TheoryMedical AbbreviationsICD Coding (ICD-9/ICD-10)Managed CareCPT CodingMedical Billing
Behavioral Health Care Manager I (LCSW/CSWA/LPC)
Behavioral Health Care Manager I (LCSW/CSWA/LPC)
13 day ago
Samaritan Health Services
- Remote: Arizona (USA), Arkansas (USA), Connecticut (USA), Florida (USA), Georgia (USA), Idaho (USA), Indiana (USA), Iowa (USA), Kansas (USA), Kentucky (USA), Louisiana (USA), Michigan (USA), Mississippi (USA), Missouri (USA), Montana (USA)
- Full time
Clinical Social WorkMental Health CounselingHealthcare Delivery ModelsDigital File ManagementMedicareCare Management
Regional Business Manager
Regional Business Manager
12 day ago
Takeda
- Remote: Ohio (USA)
- Full time
Consultative SellingPharmaceutical SalesGastroenterologyDemand GenerationMarket AnalysisBusiness Partnering
Internal Auditor II (Full-time Remote, North Carolina Based)
Internal Auditor II (Full-time Remote, North Carolina Based)
3 day ago
Alliance Health
- Remote: North Carolina (USA)
- Full time
AuditingCompliance ManagementAuditingRisk ManagementComputer-Aided Audit ToolsInternal Controls
Insurance Strategy Lead
Insurance Strategy Lead
Today
Humana
- Remote: Arizona (USA), California (USA), Colorado (USA), Florida (USA), Georgia (USA), Illinois (USA), Indiana (USA), Kentucky (USA), Maryland (USA), Michigan (USA), Minnesota (USA), Nebraska (USA), Nevada (USA), New Hampshire (USA), New Jersey (USA)
- Full time
Business StrategiesStakeholder CommunicationsHealthcare StrategyMarket AnalysisProject ManagementStrategic Leadership
Nurse Practitioner Advisor - 20 hours/Remote
Nurse Practitioner Advisor - 20 hours/Remote
7 day ago
UMass Chan Medical School
- Remote: Massachusetts (USA)
- Part time
Medical GuidelineMedical Record ManagementDisability ClaimsManaged CareUser FeedbackCase Assessment
Account Executive, Ultrasound Radiology (Pacific Northwest)
Account Executive, Ultrasound Radiology (Pacific Northwest)
14 day ago
Boston Imaging
- Remote: Washington (USA)
- Full time
Customer Relationship ManagementTherapeutic UltrasoundRadiologyProposal DevelopmentAnalyticsMarket Analysis
Denials Specialist - Remote
Denials Specialist - Remote
10 day ago
Conifer Health Solutions
- Remote: Texas (USA)
- Full time
ICD Coding (ICD-9/ICD-10)CPT CodingBusiness WritingRegulatory ComplianceState LawsManaged Care
Medical Billing Specialist - Remote
Medical Billing Specialist - Remote
8 day ago
Conifer Health Solutions
- Remote: Texas (USA)
- Full time
Medical BillingMedical Insurance ClaimsClaims And Litigation ManagementBusiness CycleManaged CareClinical Auditing
Medical Director - 20 hours/Remote
Medical Director - 20 hours/Remote
7 day ago
UMass Chan Medical School
- Remote: Massachusetts (USA)
- Part time
Clinical GovernanceRegulatory ComplianceDisability ManagementClinical SupervisionPolicy DevelopmentBusiness Development
Stop Loss Registered Nurse
Stop Loss Registered Nurse
10 day ago
BlueCross BlueShield of South Carolina
- Remote: South Carolina (USA)
- Full time
Medical BillingCare ManagementManaged CareNurse Licensure CompactHealthcare Delivery Models
Payment Integrity Nurse
Payment Integrity Nurse
Today
BlueCross BlueShield of South Carolina
- Remote: South Carolina (USA)
- Full time
Managed CareHEDIS (Healthcare Effectiveness Data And Information Set)Quality AssessmentTotal Quality ManagementBehavioral HealthOnline Communication
Behavioral Health Care Management Specialist – Servicing Santa Fe, NM and surroundings
Behavioral Health Care Management Specialist – Servicing Santa Fe, NM and surroundings
10 day ago
Health Care Service Corporation
- Remote: New Mexico (USA)
- Full time
NursingClinical Social WorkFamily TherapyMedical Social WorkCare CoordinationChronic Care
Business Development Manager
Business Development Manager
16 day ago
AmeriHealth Caritas
- Remote: Pennsylvania (USA)
- Full time
Stakeholder CommunicationsProposal DevelopmentHealthcare Industry KnowledgeBusiness DevelopmentBusiness WritingManaged Care
Grievance and Appeals Nurse Specialist
Grievance and Appeals Nurse Specialist
8 day ago
Partnership HealthPlan of California
- Remote: California (USA)
- Full time
Care ManagementGrievance ArbitrationUtilization ManagementClinical AssessmentsDocumentation GenerationNurse Licensure Compact
Employee Benefits Educator
Employee Benefits Educator
21 day ago
Ascensus
- Remote: Oregon (USA)
- Part time
Benefits AdministrationMedicareManaged CareRetirement PlanningMedicareTraining Analysis
Chief Medical Officer - Community Plan of Idaho - Remote
Chief Medical Officer - Community Plan of Idaho - Remote
28 day ago
UnitedHealthcare
- Remote: Idaho (USA)
- Freelance
Clinical GovernanceAnalyticsHealth EquityTotal Quality ManagementMedicaidMedicare
Claims Resolution Specialist- Remote
Claims Resolution Specialist- Remote
8 day ago
Conifer Health Solutions
- Remote: Texas (USA)
- Full time
Medical BillingICD Coding (ICD-9/ICD-10)Claims And Litigation ManagementBusiness WritingRegulatory ComplianceCPT Coding
Manager Medical Policy and Corporate Coding
Manager Medical Policy and Corporate Coding
21 day ago
Capital Blue Cross
- Remote: Pennsylvania (USA)
- Full time
Clinical GovernanceHealth PoliciesRegulatory ComplianceCoding TheoryCross-Functional CollaborationRegulatory Compliance
