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Clinical Criteria Remote Jobs

24 fresh jobs found

Prior Authorization LPN - LVN
Work At Home-Texas, United States

Digital charting Pharmacy benefits Pharmacist Navigating multiple systems LVN Phone LPN Clinical Criteria Medical Services +28

USD 44K+

Utilization Management Nurse Consultant (Remote)
Work At Home-Ohio, United States

Post-acute care Navigating multiple systems Coverage determination Benefit utilization RN licensure Benefit management Clinical Criteria Keyboarding Acute care +22

USD 52K+

Utilization Management Nurse Consultant
Work At Home-Missouri, United States

Um certification Med Compass CM/UM certification IT platforms Med/surg Coverage determination Benefit utilization Benefit management RN licensure +23

Entry Mid Full Time

USD 52K+

UM Nurse Consultant
Work At Home-Ohio, United States

Um certification Cm certification CM/UM certification Benefit utilization Coverage determination RN licensure Benefit management Clinical Criteria Clinical Judgment +16

USD 52K+

Clinical Pharmacist
Remote-WA, United States

Centene Corporation

Formularies Pharmacy policies Authorization requests Clinical programs Clinical pharmacy Clinical Criteria Medical management Performance Improvement Prior authorization +13

Entry Mid Full Time

USD 105K+

Utilization Management Nurse Consultant (Weekend)
Work At Home-Illinois, United States

Med Compass CM/UM certification IT platforms Med/surg Benefit utilization Coverage determination Benefit management RN licensure Clinical Criteria +23

Entry Mid Full Time

USD 64K+

Prior Authorization Clinician RN
Work At Home-Oklahoma, United States

Precertification Navigating multiple systems Keyboarding Coverage determination Benefit management Benefit utilization Clinical Criteria RN licensure Clinical Judgment +18

USD 52K+

Senior Behaviorial Health Program Manager
Remote-MI, United States

Centene Corporation

Managed care experience Corrective action plans Health management Clinical Criteria Workflow Design Provider education Psychology Health education Clinical Training +29

Senior Full Time

USD 86K+

Utilization Management Nurse Consultant
Work At Home-Michigan, United States

CM/UM certification IT platforms Med/surg Coverage determination Benefit management Benefit utilization Clinical Criteria RN licensure Clinical Judgment +20

Entry Mid Full Time

USD 58K+

Utilization Management Nurse Consultant
Work At Home-Kansas, United States

CM/UM certification IT platforms Med/surg Coverage determination Benefit management Benefit utilization Clinical Criteria RN licensure Clinical Judgment +20

Entry Mid Full Time

USD 52K+

Utilization Management Nurse Consultant
Work At Home-Illinois, United States

Keyboarding Coverage determination Benefit management Benefit utilization Clinical Criteria Computer Systems RN licensure Telephonic Communication Medical necessity +25

USD 64K+

Utilization Management Clinical Consultant - Remote Kentucky
Work At Home-Kentucky, United States

Healthcare services coordination Triage support Crisis support Clinical Practice Guidelines Navigating multiple systems Keyboarding Benefit management Benefit utilization Evidence-Based Care +24

USD 52K+

Utilization Management Nurse Consultant
Work At Home-Florida, United States

Medical Necessity Review Coverage determination Benefit management Benefit utilization Clinical Criteria Telephonic Communication Medical necessity Acute care Clinical Judgment +21

USD 52K+

Utilization Management Nurse Consultant
Work At Home-New York, United States

Healthcare services coordination Keyboarding Coverage determination Benefit management Benefit utilization Clinical Criteria Computer Systems RN licensure Telephonic Communication +25

USD 64K+

Utilization Review Nurse Consultant - Oncology and Transplant
Work At Home-Arizona, United States

Evidence-based criteria Transplant Clinical call center Concurrent review Clinical Practice Guidelines Telephone Communication Navigating multiple systems Clinical Criteria Disease Management +21

Entry Mid Full Time

USD 52K+

Utilization Management Nurse Consultant
Work At Home-North Carolina, United States

Multi-systems navigation Navigating multiple systems Keyboarding Coverage determination Benefit management Benefit utilization Clinical Criteria RN licensure Electronic Medical Records +24

USD 52K+

Pharmacy Technician - Prior Authorization - Work From Home
Work At Home-Arizona, United States

Pharmacy Technician Certification Windows-based Software Computerized Pharmacy Systems Medication therapy management Pharmacist Benefits Verification Pharmacy services Pharmacy Technician Clinical Criteria +28

USD 36K+

Special Investigation Unit Nurse Consultant - Remote
Work At Home-Ohio, United States

Certified Coder Internet Explorer Google Chrome Clinical Decision Making Clinical Criteria RN licensure Claims processing Registered Nurse Utilization management +15

Senior Mid Full Time

USD 54K+

Utilization Management Nurse Consultant
Work At Home-Nevada, United States

Clinical call center Clinical Judgement Concurrent review Long Term Care Benefit management Benefit utilization Clinical Criteria Home Health Disease Management +19

USD 58K+

Utilization Management Nurse Consultant
Work At Home-Ohio, United States

Medical Necessity Review Coverage determination Benefit management Benefit utilization Clinical Criteria Telephonic Communication Medical necessity Acute care Clinical Judgment +30

USD 52K+

Utilization Management Nurse Consultant
Work At Home-Pennsylvania, United States

Keyboarding Coverage determination Healthcare Coordination Benefit utilization Benefit management Computer Systems Clinical Criteria Telephonic Communication RN licensure +25

USD 58K+

Utilization Manager Nurse Consultant
Work At Home-Texas, United States

Inpatient utilization Med/surg Coverage determination Benefit utilization Benefit management Clinical Criteria RN licensure Medical necessity Discharge planning +22

USD 58K+

Utilization Management Nurse Consultant
Work At Home-Texas, United States

Medical Necessity Review Coverage determination Benefit utilization Benefit management Clinical Criteria Telephonic Communication Medical necessity Acute care Discharge planning +30

USD 58K+

Utilization Management Nurse Consultant
Work At Home-Arizona, United States

Medical Necessity Review Coverage determination Benefit utilization Benefit management Clinical Criteria Telephonic Communication Medical necessity Acute care Discharge planning +30

USD 52K+

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