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
88 jobs
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Supervisor, Behavioral Health Utilization Management
Supervisor, Behavioral Health Utilization Management
Today
Centene Corporation
- From: Florida (USA) (Full Remote)
- Full time
Utilization ManagementBehavioral HealthManaged Care
Observation Clinical Analyst - RN
Observation Clinical Analyst - RN
Today
Sentara Healthcare
- From: Virginia (USA) (Full Remote)
- Full time
Care CoordinationUtilization ManagementNursingMedical Necessity
Expert Demo Specialist - Hospital Financials & Clinicals / Remote
Expert Demo Specialist - Hospital Financials & Clinicals / Remote
4 day ago
Altera Digital Health
- From: Illinois (USA) (Full Remote)
- Full time
Revenue ManagementClinical Data ManagementMedicareExperimental Software Engineering
Board Certified - New Mexico Licensed Physician Reviewers - Endocrinology
Board Certified - New Mexico Licensed Physician Reviewers - Endocrinology
7 day ago
Dane Street, LLC
- From: New Mexico (USA) (Full Remote)
- Freelance
Endocrine Diseases And Disorders
Clinical Review Clinician - Appeals
Clinical Review Clinician - Appeals
8 day ago
Centene Corporation
- From: New York (USA) (Full Remote)
- Full time
Clinical Data AnalysisUtilization ManagementMedical Necessity
RC Appellate Clinician - Remote $10K Sign on Bonus
RC Appellate Clinician - Remote $10K Sign on Bonus
15 day ago
Conifer Health Solutions
- From: Texas (USA) (Full Remote)
- Full time
InterQual CriteriaMedical Necessity
Clinical Appeals Specialist RN
Clinical Appeals Specialist RN
12 day ago
EvergreenHealth
- From: Washington (USA) (Full Remote)
- Full time
AppealsInsurance ReviewsMedical NecessityClinical Consulting
RN Clinical Review Nurse - Prior Authorization
RN Clinical Review Nurse - Prior Authorization
14 day ago
Centene Corporation
- From: New York (USA) (Full Remote)
- Full time
Clinical Data AnalysisUtilization ManagementNurse Licensure CompactMedical Necessity
Utilization Review Nurse
Utilization Review Nurse
30+ days ago
Sidecar Health
- From: Florida (USA), Georgia (USA), Kentucky (USA), Ohio (USA) (Full Remote)
- Full time
Utilization ManagementMedical GuidelineNursingMedical Necessity
Healthcare Appeals Clinician RN - Remote $10K sign on bonus
Healthcare Appeals Clinician RN - Remote $10K sign on bonus
30+ days ago
Conifer Health Solutions
- From: Texas (USA) (Full Remote)
- Full time
AppealsInterQual CriteriaMedical Necessity
Peer Reviewer (Contract Remote)
Peer Reviewer (Contract Remote)
9 day ago
Mountain Pacific
- From: Montana (USA) (Full Remote)
- Freelance
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
Peer Reviewer - Physical Medicine & Rehabilitation (Contract Remote)
Peer Reviewer - Physical Medicine & Rehabilitation (Contract Remote)
30+ days ago
Mountain Pacific
- From: Montana (USA) (Full Remote)
- Freelance
Evaluation Of CareHealthcare QualityMedical Necessity
Peer Reviewer - Interventional Cardiology (Contract Remote)
Peer Reviewer - Interventional Cardiology (Contract Remote)
30+ days ago
Mountain Pacific
- From: Montana (USA) (Full Remote)
- Freelance
Cardiology
Revenue Cycle Specialist
Revenue Cycle Specialist
24 day ago
Baptist Health System KY & IN
- From: Indiana (USA) (Full Remote)
- Full time
Debt ComplianceRevenue ManagementMedical Necessity
Quality Improvement Coordinator - Behavioral Health
Quality Improvement Coordinator - Behavioral Health
30+ days ago
Centene Corporation
- From: Washington (USA) (Full Remote)
- Full time
Behavioral HealthClinical NursingQuality AssessmentTotal Quality Management
Career Opportunities: Utilization Review Nurse (Remote- Maine RN Only) (30353)
Career Opportunities: Utilization Review Nurse (Remote- Maine RN Only) (30353)
30+ days ago
Gainwell Technologies LLC
- From: Maine (USA) (Full Remote)
- Full time
Utilization ManagementInterQual CriteriaMedical NecessityClinical Documentation
UM Prior Authorization Nurse, LVN/LPN
UM Prior Authorization Nurse, LVN/LPN
20 day ago
Bright Health
- From: California (USA) (Full Remote)
- Full time
Utilization ManagementPrior AuthorizationMedical NecessityClinical Consulting
UM Prior Authorization Nurse, LVN/LPN
UM Prior Authorization Nurse, LVN/LPN
20 day ago
NeueHealth
- From: California (USA) (Full Remote)
- Full time
Utilization ManagementPrior AuthorizationMedical NecessityClinical Consulting
Emergency Medicine Telecommute Medical Review Stream Physician
Emergency Medicine Telecommute Medical Review Stream Physician
30+ days ago
Concentra
- From: Texas (USA) (Full Remote)
- Full time
Utilization ManagementClinical AssessmentsMedical Licensing (Health Law)
Peer Reviewer - Surgeon (Contract Remote)
Peer Reviewer - Surgeon (Contract Remote)
30+ days ago
Mountain Pacific
- From: Montana (USA) (Full Remote)
- Freelance
Evaluation Of CareGeneral SurgeryHealthcare QualityMedical Necessity
CRT Claims Examiner
CRT Claims Examiner
9 day ago
Integra Partners
- From: Arizona (USA), Colorado (USA), Connecticut (USA), Florida (USA), Georgia (USA), Idaho (USA), Illinois (USA), Kentucky (USA), Massachusetts (USA), Michigan (USA), New Jersey (USA), New York (USA), North Carolina (USA), Ohio (USA), Pennsylvania (USA) (Full Remote)
- Full time
Claims And Litigation Management
Care Coordinator - Behavioral Health RN
Care Coordinator - Behavioral Health RN
12 day ago
Premera Blue Cross
- From: Alaska (USA), Arizona (USA), Arkansas (USA), California (USA), Colorado (USA), Florida (USA), Georgia (USA), Idaho (USA), Iowa (USA), Kansas (USA), Kentucky (USA), Maine (USA), Michigan (USA), Minnesota (USA), Missouri (USA) (Full Remote)
- Full time
Behavioral HealthClinical MedicineMedical Necessity
SAF/IS Regional Program Specialist - Reserve
SAF/IS Regional Program Specialist - Reserve
4 day ago
American Red Cross
- From: Djibouti, Kuwait, Republic of Lithuania, Bulgaria, Poland, Romania (Full Remote)
- Full time
Emergency Communication SystemsVolunteer ManagementDeployment Project
Peer Reviewer - Diagnostic Radiologist (Contract Remote)
Peer Reviewer - Diagnostic Radiologist (Contract Remote)
9 day ago
Mountain Pacific
- From: Montana (USA) (Full Remote)
- Freelance
Radiology
Kentucky Licensed Reviewers - Psychology
Kentucky Licensed Reviewers - Psychology
5 day ago
Dane Street, LLC
- From: Kentucky (USA) (Full Remote)
- Freelance
PsychologyMedical Licensing (Health Law)
Utilization Management Specialist (Home-Based) - Prior Authorization
Utilization Management Specialist (Home-Based) - Prior Authorization
15 day ago
Sanford Health
- From: Minnesota (USA), North Dakota (USA), South Dakota (USA) (Full Remote)
- Part time
Utilization ManagementDiagnosis CodesInterQual CriteriaMedical Necessity
Peer Reviewer - Radiologist (Contract Remote)
Peer Reviewer - Radiologist (Contract Remote)
9 day ago
Mountain Pacific
- From: Montana (USA) (Full Remote)
- Freelance
Radiology
LPN – Utilization Management (Shift Care Team)
LPN – Utilization Management (Shift Care Team)
30+ days ago
The CKHobbie Group
- From: Pennsylvania (USA) (Full Remote)
- Full time
Care CoordinationUtilization ManagementPediatric NursingCompliance Management
Healthcare Appeals Clinician RN - Remote $10K sign on bonus
Healthcare Appeals Clinician RN - Remote $10K sign on bonus
15 day ago
Conifer Health Solutions
- From: Texas (USA) (Full Remote)
- Full time
InterQual CriteriaMedical Necessity
Peer Reviewer - Nephrologist (Contract Remote)
Peer Reviewer - Nephrologist (Contract Remote)
30+ days ago
Mountain Pacific
- From: Montana (USA) (Full Remote)
- Freelance
Nephrology
Physician Reviewer - Orthopedic Spine Surgery (Utilization Review)
Physician Reviewer - Orthopedic Spine Surgery (Utilization Review)
26 day ago
Dane Street, LLC
- From: New York (USA) (Full Remote)
- Fixed term
Utilization ManagementWorkers' Compensation ClaimsMedical NecessityOrthopedics
Board Certified - Washington Licensed Physician Reviewers - Endocrinology
Board Certified - Washington Licensed Physician Reviewers - Endocrinology
9 day ago
Dane Street, LLC
- From: Washington (USA) (Full Remote)
- Freelance
Endocrine Diseases And Disorders
Physician Reviewer - Orthopedic Spine Surgery (Utilization Review)
Physician Reviewer - Orthopedic Spine Surgery (Utilization Review)
30 day ago
Dane Street, LLC
- From: New York (USA) (Full Remote)
- Freelance
Utilization ManagementWorkers' Compensation ClaimsMedical NecessityOrthopedics
Board Certified OB/GYN-Obstetrics and Gynecology Physician Advisor, Disability
Board Certified OB/GYN-Obstetrics and Gynecology Physician Advisor, Disability
30+ days ago
Dane Street, LLC
- From: California (USA) (Full Remote)
- Freelance
Obstetrics And GynaecologyObstetrics And GynaecologyMedical Necessity
Orthopedic Surgery - Spine Surgeon - NV
Orthopedic Surgery - Spine Surgeon - NV
30+ days ago
Dane Street, LLC
- From: Nevada (USA) (Full Remote)
- Fixed term
Medical NecessityClinical Consulting
Clinical Appeal Nurse - Remote $10K Sign on Bonus
Clinical Appeal Nurse - Remote $10K Sign on Bonus
15 day ago
Conifer Health Solutions
- From: Texas (USA) (Full Remote)
- Full time
Clinical Data AnalysisInterQual CriteriaMedical Necessity
Clinical Review Coordinator
Clinical Review Coordinator
30+ days ago
Soleo Health
- From: California (USA) (Full Remote)
- Full time
Clinical Data AnalysisInfusionsPrior AuthorizationMedical Necessity
Spine Telecommute Medical Review Stream
Spine Telecommute Medical Review Stream
30+ days ago
Concentra
- From: California (USA) (Full Remote)
- Full time
Utilization ManagementClinical AssessmentsMedical Licensing (Health Law)
Dentist Telecommute Medical Review Stream
Dentist Telecommute Medical Review Stream
30+ days ago
Concentra
- From: New Jersey (USA) (Full Remote)
- Full time
Utilization ManagementClinical Assessments
Clinical Denial Management Specialist RN - Remote $10K sign on bonus
Clinical Denial Management Specialist RN - Remote $10K sign on bonus
15 day ago
Conifer Health Solutions
- From: Texas (USA) (Full Remote)
- Full time
AppealsInterQual CriteriaMedical Necessity
Physician Reviewer - (Ophthalmology, Otolaryngology, OB/GYN)
Physician Reviewer - (Ophthalmology, Otolaryngology, OB/GYN)
30+ days ago
Dane Street, LLC
- From: North Carolina (USA) (Full Remote)
- Freelance
Insurance ReviewsMedical NecessityClinical Consulting
Medical Director - Cardiology - EviCore
Medical Director - Cardiology - EviCore
15 day ago
Evernorth Health Services
- From: Ohio (USA) (Full Remote)
- Full time
CardiologyClinical Assessments
Clinical Review Registered Nurse
Clinical Review Registered Nurse
15 day ago
Strategic Staffing Solutions
- From: Vermont (USA) (Full Remote)
- Freelance
Evidence-Based PracticeUtilization ManagementMedical NecessityClinical Assessments
Expert Demo Specialist - Hospital Financials & Clinicals / Remote
Expert Demo Specialist - Hospital Financials & Clinicals / Remote
4 day ago
Altera Digital Health
- From: United States (Full Remote)
- Full time
Revenue ManagementClinical Data ManagementPatient Education And CounselingExperimental Software Engineering
PM&R Telecommute Medical Review Stream
PM&R Telecommute Medical Review Stream
30+ days ago
Concentra
- From: Texas (USA) (Full Remote)
- Full time
Utilization ManagementClinical AssessmentsMedical Licensing (Health Law)
Nurse Reviewer - REMOTE
Nurse Reviewer - REMOTE
30+ days ago
UMass Chan Medical School
- From: Massachusetts (USA) (Full Remote)
- Full time
Clinical Data AnalysisCare ManagementPrior AuthorizationMedical Necessity
RN Reviewer 
RN Reviewer
30+ days ago
Cohere Health
- From: United States (Full Remote)
- Mid-level (2-5 years)
- 28 - 28K
Utilization ManagementNursing
Board Certified - Licensed Physician Reviewers-Neurological Surgery
Board Certified - Licensed Physician Reviewers-Neurological Surgery
20 day ago
Dane Street, LLC
- From: United States (Full Remote)
- Freelance
NeurosurgeryMedical Licensing (Health Law)
RN Utilization Management (Relief)
RN Utilization Management (Relief)
6 day ago
St. Charles Health System
- From: United States (Full Remote)
- Part time
Utilization ManagementPatient Progress NotesMedical NecessityProcess Improvement
