Remote Medical Necessity 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
185 jobs
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Medical Management Clinician Associate
Medical Management Clinician Associate
Today
Elevance Health
- From: New York (USA) (Full Remote)
- Full time
- Junior (1-2 years)
Utilization ManagementMedical NecessityMedical Licensing (Health Law)Clinical Assessments
Physical Health RN Clinical Care Reviewer II
Physical Health RN Clinical Care Reviewer II
Today
CareSource
- From: Nevada (USA) (Full Remote)
- Full time
- Mid-level (2-5 years)
Clinical Data AnalysisUtilization ManagementNurse Registry
Revenue Cycle Specialist
Revenue Cycle Specialist
Today
Baptist Health System KY & IN
- From: Kentucky (USA) (Full Remote)
- Full time
- Entry-level / graduate
Debt ComplianceRevenue ManagementMedical Necessity
Board Certified Internal Medicine/Pain Management Physician Advisor,
Board Certified Internal Medicine/Pain Management Physician Advisor,
1 day ago
Dane Street, LLC
- From: California (USA) (Full Remote)
- Freelance
Pain ManagementMedical NecessityInternal MedicineClinical Documentation
Utilization Review Nurse
Utilization Review Nurse
1 day ago
Sidecar Health
- From: Florida (USA), Georgia (USA), Kentucky (USA), Ohio (USA) (Full Remote)
- Full time
- Senior (5-10 years)
Utilization ManagementMilliman Care Guidelines (MCG)Clinical InformaticsMedical Necessity
Concurrent Review Nurse, LVN/LPN (Work from Home)
Concurrent Review Nurse, LVN/LPN (Work from Home)
1 day ago
NeueHealth
- From: California (USA) (Full Remote)
- Full time
- Mid-level (2-5 years)
Care CoordinationUtilization ManagementCompliance ManagementClinical Assessments
Concurrent Review Nurse, LVNLPN (Work from Home)
Concurrent Review Nurse, LVNLPN (Work from Home)
1 day ago
Bright Health
- From: California (USA) (Full Remote)
- Full time
- Mid-level (2-5 years)
Care CoordinationUtilization ManagementCompliance ManagementClinical Assessments
Behavioral Health RN Clinical Care Reviewer II
Behavioral Health RN Clinical Care Reviewer II
Today
CareSource
- From: Nevada (USA) (Full Remote)
- Full time
- Mid-level (2-5 years)
Clinical Data AnalysisUtilization ManagementNursing
Concurrent Review Nurse, LVNLPN (Work from Home)
Concurrent Review Nurse, LVNLPN (Work from Home)
1 day ago
NeueHealth
- From: California (USA) (Full Remote)
- Full time
- Mid-level (2-5 years)
Care CoordinationMedical GuidelineUtilization ManagementMedical Necessity
Physician Reviewer - Orthopedic Surgery (Utilization Review) TX
Physician Reviewer - Orthopedic Surgery (Utilization Review) TX
1 day ago
Dane Street, LLC
- From: Texas (USA) (Full Remote)
- Fixed term
Medical Licensing (Health Law)Orthopedics
Remote Medical Case & Peer Reviewers (RNs & Certified Healthcare Professionals – 1099)
Remote Medical Case & Peer Reviewers (RNs & Certified Healthcare Professionals – 1099)
1 day ago
LivantaLLC
- From: United States (Full Remote)
- Freelance
- Senior (5-10 years)
Clinical Data AnalysisNurse Licensure CompactEvidence Analysis
UM Prior Authorization Nurse, RN (Work from Home)
UM Prior Authorization Nurse, RN (Work from Home)
1 day ago
NeueHealth
- From: North America (Full Remote)
- Full time
Utilization ManagementPrior AuthorizationMedical NecessityClinical Consulting
UM Prior Authorization Nurse, RN (Work from Home)
UM Prior Authorization Nurse, RN (Work from Home)
1 day ago
NeueHealth
- From: North America (Full Remote)
- Full time
Utilization ManagementPrior AuthorizationMedical NecessityClinical Consulting
Clinical Review Nurse Prior Authorization
Clinical Review Nurse Prior Authorization
1 day ago
Centene Corporation
- From: United States (Full Remote)
- Full time
- Entry-level / graduate
Clinical Data AnalysisUtilization ManagementMedical NecessityRegulatory Compliance
Licensed Reviewers - Board Certified Behavioral Analyst
Licensed Reviewers - Board Certified Behavioral Analyst
1 day ago
Dane Street, LLC
- From: United States (Full Remote)
- Freelance
CQE Manager IRehab ServicesPhysical Therapy (Remote)
CQE Manager IRehab ServicesPhysical Therapy (Remote)
1 day ago
EmergeCore Networks
- From: United States (Full Remote)
- Full time
- Senior (5-10 years)
Evidence-Based PracticeClinical InformaticsMedical NecessityPhysical Therapy
Utilization Review Nurse
Utilization Review Nurse
1 day ago
Sidecar Health
- From: North America (Full Remote)
- Full time
- Senior (5-10 years)
Utilization ManagementMilliman Care Guidelines (MCG)Clinical InformaticsMedical Necessity
RN Nurse Reviewer I CA
RN Nurse Reviewer I CA
1 day ago
Elevance Health
- From: United States (Full Remote)
- Full time
- Entry-level / graduate
Utilization ManagementMedical GuidelineNurse Licensure CompactMedical Necessity
RN - Senior Clinical Documentation Specialist - Utilization Management
RN - Senior Clinical Documentation Specialist - Utilization Management
1 day ago
Sanford Health
- From: United States, Bemidji (Full Remote)
- Full time
- Senior (5-10 years)
Clinical Documentation
Board Certified Gastroenterology, Dual board Internal Medicine Physician Advisor
Board Certified Gastroenterology, Dual board Internal Medicine Physician Advisor
1 day ago
Dane Street, LLC
- From: United States (Full Remote)
- Freelance
Patient EvaluationClinical AssessmentsInternal MedicineGastroenterology
Board Certified Forensic Pathology Physician Advisor, Disability Peer Review
Board Certified Forensic Pathology Physician Advisor, Disability Peer Review
1 day ago
Dane Street, LLC
- From: United States (Full Remote)
- Freelance
Forensic PathologyMedical GuidelineClinical Assessments
RCM Specialist - Prior Authorization (Behavioral Health/Psychiatry)
RCM Specialist - Prior Authorization (Behavioral Health/Psychiatry)
1 day ago
Xponentiate
- From: United States (Full Remote)
- Full time
- Senior (5-10 years)
Behavioral HealthClinical DocumentationPrior AuthorizationEmergency Psychiatry
Physician Advisor (Administrative Role)
Physician Advisor (Administrative Role)
1 day ago
MASC Medical Recruitment Firm
- From: United States, Boynton Beach (Full Remote)
- Full time
- Mid-level (2-5 years)
Utilization ManagementRegulatory ComplianceGood Documentation PracticesClinical Consulting
Behavioral Health Medical Director
Behavioral Health Medical Director
1 day ago
Empower Healthcare Solutions
- From: United States, Little Rock (Full Remote)
- Part time
- Senior (5-10 years)
Utilization ManagementBehavioral HealthPolicy DevelopmentClinical Auditing
Board Certified Endocrinologist Physician Advisor, Disability Peer Review
Board Certified Endocrinologist Physician Advisor, Disability Peer Review
1 day ago
Dane Street, LLC
- From: United States (Full Remote)
- Freelance
Clinical Data AnalysisMedical Necessity
Utilization Review Health Care Professional (PT, LVN, LPN) - REMOTE
Utilization Review Health Care Professional (PT, LVN, LPN) - REMOTE
1 day ago
EK Health Services Inc.
- From: United States (Full Remote)
- Full time
- Entry-level / graduate
Utilization ManagementHealth AssessmentMedical Necessity
Utilization Review Nurse
Utilization Review Nurse
1 day ago
Sidecar Health
- From: United States (Full Remote)
- Full time
- Senior (5-10 years)
Utilization ManagementMilliman Care Guidelines (MCG)Clinical InformaticsMedical Necessity
CQE Manager I-Rehab Services-Physical Therapy (Remote)
CQE Manager I-Rehab Services-Physical Therapy (Remote)
1 day ago
EmergeCore Networks
- From: United States (Full Remote)
- Full time
- Senior (5-10 years)
Physical TherapyClinical InformaticsMedical NecessityQuality Assessment
CQE Manager IRehab ServicesOccupational Therapy (Remote)
CQE Manager IRehab ServicesOccupational Therapy (Remote)
1 day ago
EmergeCore Networks
- From: United States (Full Remote)
- Full time
- Senior (5-10 years)
Medical NecessityOccupational Therapy
Board Certified Neurologist Physician Advisor, Disability Peer Review
Board Certified Neurologist Physician Advisor, Disability Peer Review
1 day ago
Dane Street, LLC
- From: United States (Full Remote)
- Fixed term
Medical Record ManagementClinical Consulting
CQE Manager I-Rehab Services-Physical Therapy (Remote)
CQE Manager I-Rehab Services-Physical Therapy (Remote)
1 day ago
American Specialty Health
- From: United States (Full Remote)
- Full time
- Senior (5-10 years)
Physical TherapyClinical InformaticsEvidence-Based PracticeMedical Necessity
CQE Manager IRehab ServicesOccupational Therapy (Remote)
CQE Manager IRehab ServicesOccupational Therapy (Remote)
1 day ago
American Specialty Health
- From: United States (Full Remote)
- Full time
- Senior (5-10 years)
Medical NecessityOccupational Therapy
Examiner I (Remote, $15/hour)
Examiner I (Remote, $15/hour)
1 day ago
EmergeCore Networks
- From: United States (Full Remote)
- Full time
Data EntryIntegrated CareMedical Necessity
CQE Manager I-Rehab Services-Occupational Therapy (Remote)
CQE Manager I-Rehab Services-Occupational Therapy (Remote)
1 day ago
EmergeCore Networks
- From: United States (Full Remote)
- Full time
- Senior (5-10 years)
Medical NecessityOccupational Therapy
Utilization Review Nurse
Utilization Review Nurse
1 day ago
Sidecar Health
- From: North America (Full Remote)
- Full time
- Senior (5-10 years)
Utilization ManagementMilliman Care Guidelines (MCG)Clinical InformaticsMedical Necessity
RCM Specialist - Prior Authorization (Behavioral Health/Psychiatry)
RCM Specialist - Prior Authorization (Behavioral Health/Psychiatry)
6 days ago
Xponentiate
- From: India (Full Remote)
- Full time
- Senior (5-10 years)
Behavioral HealthClinical DocumentationPrior AuthorizationEmergency Psychiatry
UM Prior Authorization Nurse, RN (Work from Home)
UM Prior Authorization Nurse, RN (Work from Home)
1 day ago
Bright Health
- From: United States (Full Remote)
- Full time
- Mid-level (2-5 years)
Utilization ManagementClinical MedicinePrior AuthorizationMedical Necessity
CQE Manager I-Rehab Services-Occupational Therapy (Remote)
CQE Manager I-Rehab Services-Occupational Therapy (Remote)
1 day ago
American Specialty Health
- From: United States (Full Remote)
- Full time
- Senior (5-10 years)
Clinical InformaticsQuality AssessmentMedical NecessityOccupational Therapy
CQE Manager IRehab ServicesPhysical Therapy (Remote)
CQE Manager IRehab ServicesPhysical Therapy (Remote)
1 day ago
American Specialty Health
- From: United States (Full Remote)
- Full time
- Senior (5-10 years)
Physical TherapyClinical InformaticsMedical NecessityCredential Manager
Concurrent Review Nurse, LVN/LPN (Work from Home)
Concurrent Review Nurse, LVN/LPN (Work from Home)
1 day ago
Bright Health
- From: United States (Full Remote)
- Full time
- Mid-level (2-5 years)
Medical GuidelineElectronic Health Record ApplicationsUtilization ManagementCare Management
Physician Reviewer - Orthopedic Surgery (Utilization Review) TX
Physician Reviewer - Orthopedic Surgery (Utilization Review) TX
6 days ago
Dane Street, LLC
- From: Texas (USA) (Full Remote)
- Fixed term
Medical Licensing (Health Law)Orthopedics
Medical Director
Medical Director
9 days ago
Impresiv Health
- From: Oregon (USA) (Full Remote)
- Full time
- Senior (5-10 years)
Evidence-Based PracticeUtilization ManagementInpatient CareMedical Necessity
Clinical Reviewer II - Licensed /Remote in NM
Clinical Reviewer II - Licensed /Remote in NM
7 days ago
Magellan Health
- From: New Mexico (USA) (Full Remote)
- Full time
- Mid-level (2-5 years)
Utilization Management
Board-Certified Neurological Surgeon - Independent Medical Reviewer (Remote, Ill
Board-Certified Neurological Surgeon - Independent Medical Reviewer (Remote, Ill
9 days ago
Dane Street, LLC
- From: Illinois (USA) (Full Remote)
- Fixed term
Neurosurgery
Board Certified - Texas Licensed Physician Reviewers- Pediatric Nephrology
Board Certified - Texas Licensed Physician Reviewers- Pediatric Nephrology
30+ days ago
Dane Street, LLC
- From: Texas (USA) (Full Remote)
- Freelance
NephrologyMedical Licensing (Health Law)
Board Certified - Texas Licensed Physician Reviewers- Otolaryngology
Board Certified - Texas Licensed Physician Reviewers- Otolaryngology
30+ days ago
Dane Street, LLC
- From: Texas (USA) (Full Remote)
- Freelance
OtolaryngologyMedical Licensing (Health Law)
Care Advocate
Care Advocate
7 days ago
Rogers Behavioral Health
- From: Wisconsin (USA) (Full Remote)
- Full time
Utilization ManagementInternal DocumentationMedical NecessityPatient Education And Counseling
Surgical Case Reviewer: Certified Coder (F/T) - Remote
Surgical Case Reviewer: Certified Coder (F/T) - Remote
30+ days ago
Optim Health System
- From: Georgia (USA) (Full Remote)
- Full time
Surgical PathologyMedical Necessity
PB Diagnostic Coder (Coding Specialist lll)
PB Diagnostic Coder (Coding Specialist lll)
30+ days ago
Oregon Health & Science University
- From: Oregon (USA) (Full Remote)
- Full time
ICD 503CppunitClinical Documentation
Outpatient Coding Team Lead
Outpatient Coding Team Lead
30+ days ago
University of Maryland Medical System
- From: Maryland (USA) (Full Remote)
- Full time
Outpatient CodingICD 503Cppunit
