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Clinical Judgment Remote Jobs

57 fresh jobs found

Clinical Care Navigator
Remote

Crisis assessment Psycho education Crisis support Solution-focused approaches Professional documentation Mindfulness Safety Planning Ethical Standards Tech-savvy +33

USD 66K+

Global Care Navigator - Italy
Remote

Bilingual Italian Mental Health Care Safety Planning Ethical Standards Mental health services Tech Bilingual (English Triage Crisis Management +30

EUR 44K+

Care Manager RN
Work At Home-Colorado

High-Speed Internet Clinical Tools RN license Data Review Telephonic Communication Member engagement Policies and procedures RN licensure Acute care +18

USD 60K+

Clinical Care Navigator - After Hours
Remote

Solution-focused approaches Professional documentation Crisis support Multi-disciplinary teamwork Safety Planning Ethical Standards Tech Tech-savvy CBT +31

USD 66K+

Primary Care Nurse Practitioner (Hybrid, Part-Time)
Remote, United States

Digital healthcare Patient management Empathetic care Digital-first healthcare Synchronous video Operational Rigor Virtual medicine Data-Driven Care Resourcefulness +20

Senior Mid Part Time

USD 156K+

Utilization Management Nurse Consultant
Work At Home-Washington

Med/surg Coverage determination Long Term Care Benefit utilization Benefit management Clinical Criteria Telephonic Communication Medical necessity Telemetry +30

Senior Mid Full Time

USD 64K+

Case Manager RN - Maternity/Fertility
Work At Home-Ohio

Ob-gyn Maternity Infertility Women's Health Telephonic case management Integrative functions Clinical resources Clinical Tools Holistic approach +24

USD 54K+

Unit Manager Clinical Operations
Downers Grove (3500 Lacey Road)

Health Care Service Corporation

Managed Care Policies Managed Care Knowledge URAC PC Proficiency Clinical Care PC Utilization Review Disease Management Clinical Judgment +22

USD 67K+

Virtual Primary Care Physician (TX Licensure)
Remote, United States

Empathetic care Patient management Digital-first healthcare Virtual medicine Synchronous video Operational Rigor Resourcefulness Family Medicine Technology Utilization +17

USD 276K+

Virtual Primary Care Physician (PA Licensure)
Remote, United States

Empathetic care Patient management Digital-first healthcare Virtual medicine Synchronous video Operational Rigor Resourcefulness Family Medicine Technology Utilization +17

USD 276K+

Virtual Primary Care Physician (OH Licensure)
Remote, United States

Empathetic care Patient management Digital-first healthcare Virtual medicine Synchronous video Operational Rigor Resourcefulness Family Medicine Technology Utilization +17

USD 276K+

Virtual Primary Care Physician (NM Licensure)
Remote, United States

Empathetic care Digital-first healthcare Synchronous video Virtual medicine Patient Communication Operational Rigor Resourcefulness Family Medicine Technology Utilization +17

USD 276K+

Virtual Primary Care Physician (NJ Licensure)
Remote, United States

Empathetic care Digital-first healthcare Synchronous video Virtual medicine Patient Communication Operational Rigor Resourcefulness Family Medicine Technology Utilization +17

USD 276K+

Virtual Primary Care Physician (MO Licensure)
Remote, United States

Empathetic care Synchronous video Digital-first healthcare Operational Rigor Virtual medicine Resourcefulness Family Medicine Technology Utilization Evidence-Based Care +18

USD 276K+

Virtual Primary Care Physician (MI Licensure)
Remote, United States

Empathetic care Patient management Digital-first healthcare Virtual medicine Synchronous video Operational Rigor Resourcefulness Family Medicine Technology Utilization +17

USD 276K+

Virtual Primary Care Physician (IN Licensure)
Remote, United States

Empathetic care Patient management Digital-first healthcare Virtual medicine Synchronous video Operational Rigor Resourcefulness Family Medicine Technology Utilization +17

USD 276K+

Virtual Primary Care Physician (IL Licensure)
Remote, United States

Empathetic care Patient management Digital-first healthcare Virtual medicine Synchronous video Operational Rigor Resourcefulness Family Medicine Technology Utilization +17

USD 276K+

Virtual Primary Care Physician (HI Licensure)
Remote, United States

Empathetic care Patient management Virtual medicine Digital-first healthcare Synchronous video Operational Rigor Resourcefulness Family Medicine Technology Utilization +18

USD 276K+

Virtual Primary Care Physician (GA Licensure)
Remote, United States

Empathetic care Patient management Digital-first healthcare Virtual medicine Synchronous video Operational Rigor Resourcefulness Family Medicine Technology Utilization +17

USD 276K+

Virtual Primary Care Physician (FL Licensure)
Remote, United States

Empathetic care Patient management Digital-first healthcare Virtual medicine Synchronous video Operational Rigor Resourcefulness Family Medicine Technology Utilization +17

USD 276K+

Virtual Primary Care Physician (CT Licensure)
Remote, United States

Empathetic care Patient management Digital-first healthcare Virtual medicine Synchronous video Operational Rigor Resourcefulness Family Medicine Technology Utilization +17

USD 276K+

Virtual Primary Care Physician (CA Licensure)
Remote, United States

Empathetic care Digital-first healthcare Synchronous video Virtual medicine Patient Communication Operational Rigor Resourcefulness Family Medicine Technology Utilization +17

USD 276K+

Virtual Primary Care Physician (AZ Licensure)
Remote, United States

Empathetic care Patient management Digital-first healthcare Virtual medicine Synchronous video Operational Rigor Resourcefulness Family Medicine Technology Utilization +17

USD 276K+

Virtual Primary Care Physician
Remote, United States

Empathetic care Synchronous communication Patient-centered care Digital-first healthcare Synchronous video Operational Rigor Virtual medicine Asynchronous communication Data-Driven Care +19

USD 276K+

Primary Nurse Case Admin l - UM - TX
Richardson Texas HQ (1001 E. Lookout Drive)

Health Care Service Corporation

Wellness education Coordination of care Milliman guidelines UM Medical Management Policies CM Database experience Condition Management PC Proficiency +29

USD 58K+

Case Manager RN
Work At Home-Pennsylvania

Integrative functions Telephonic assessment Clinical resources Clinical Tools Holistic approach Data Review Policies and procedures Care Planning RN licensure +18

USD 60K+

Wellbeing Health Advisor
Albuquerque New Mexico HQ (5701 Balloon Fiesta Parkway)

Health Care Service Corporation

Health management Milliman guidelines Medical Management Policies Web-based tools Database experience Condition Management PC Proficiency Medical management Clinical Care +20

USD 58K+

Primary Nurse Case Administrator I
Richardson Texas HQ (1001 E. Lookout Drive)

Health Care Service Corporation

Wellness education UM Milliman guidelines Lotus Notes Medical Management Policies CM Coordination of care Database experience Condition Management +31

USD 58K+

Medical Director - Orthopedic Spine Surgeon - Remote - eviCore
Florida Work at Home

The Cigna Group

Orthopedic spine surgery Evidence-based medical reviews Automated processes Evidence-Based Decision Making Case Management Software Computer Applications Federal Laws Healthcare Regulations Medical necessity +22

Exec Senior Full Time

USD 196K+

Utilization Management Nurse Consultant- Specialty Medications
Work At Home-Arizona

Clinical documentation systems Clinical Judgement Clinical call center Benefit utilization Phone Benefit management Clinical Criteria Clinical Documentation Prior authorization +17

Senior Mid Full Time

USD 52K+

Behavioral Analysis Utilization Management Clinical Consultant
Work At Home-Florida

Behavior Analysis Claims review Clinical Practice Guidelines Benefit utilization Benefit management Clinical Guidelines Clinical Criteria Electronic Medical Records Evidence-Based Care +26

USD 52K+

Case Manager RN (Remote)
Work At Home - Utah

Integrative functions Clinical resources Clinical Tools Holistic approach Data Review Policies and procedures Care Planning RN licensure Member engagement +21

USD 54K+

Utilization Management Nurse Consultant
Work At Home-Pennsylvania

Benefit utilization Coverage determination Benefit management Telephonic Communication Medical necessity Clinical Criteria Acute care Discharge planning Utilization Review +20

USD 58K+

Utilization Manager Nurse Consultant
Work At Home-Texas

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

USD 58K+

Primary Nurse Case Admin l - CM - TX
Richardson Texas HQ (1001 E. Lookout Drive)

Health Care Service Corporation

Wellness education Milliman guidelines UM CM Coordination of care Lotus Notes Medical Management Policies Database experience Condition Management +31

USD 58K+

Case Manager RN
Work At Home-Arizona

Telephonic Communication RN license Clinical Tools Data Review Policies and procedures RN licensure Acute care Member engagement Discharge planning +20

USD 54K+

Utilization Management Nurse Consultant
Work At Home-Ohio

Benefit utilization Coverage determination Benefit management Long Term Care Telephonic Communication Clinical Criteria Medical necessity Home Health Discharge planning +30

USD 52K+

Case Manager RN
Work At Home-Missouri

Integrative functions Health Assessment Telework Telephonic Communication RN license Clinical Tools Clinical resources Holistic approach Data Review +22

USD 54K+

Utilization Management Nurse Consultant
Work At Home-Texas

Benefit utilization Coverage determination Benefit management Long Term Care Telephonic Communication Medical necessity Clinical Criteria RN licensure Home Health +32

USD 58K+

Case Manager RN (Remote, OH)
Work At Home-Ohio

Telephonic assessment Clinical resources Clinical Tools Holistic approach Data Review Policies and procedures RN licensure Care Planning Network management +21

USD 54K+

Utilization Management Nurse Consultant
Work At Home-North Carolina

Multi-systems navigation Benefit utilization Coverage determination Benefit management Navigating multiple systems Keyboarding Clinical Criteria Fast-paced Environment RN licensure +24

USD 52K+

Complex Case Manager RN (Remote)
PA, Working at Home - Pennsylvania

Highmark Health

Quality outcomes Dialectical behavior therapy Disease Processes Condition Management Healthcare operations Cultural Competency Disease Management Cognitive Behavioral Therapy Analytic +19

Senior Mid Full Time

USD 57K+

Case Manager RN- Pennsylvania
Work At Home-Pennsylvania

Emergency department Long Term Care Clinical resources Clinical Tools Holistic approach Data Review Policies and procedures RN licensure Discharge planning +23

USD 60K+

UM Nurse Consultant - Prior Authorization
Work At Home-Ohio

Benefit utilization Coverage determination Benefit management Navigating multiple systems Medical necessity Clinical Criteria Keyboarding RN licensure Discharge planning +27

USD 52K+

Case Manager RN
Work At Home-Georgia

Telephonic assessment Transplant Critical care Clinical resources Clinical Tools Holistic approach Data Review Policies and procedures RN licensure +15

Senior Mid Full Time

USD 54K+

Utilization Management Nurse Consultant
Work At Home-Nevada

Concurrent review Clinical Judgement Clinical call center Benefit utilization Benefit management Long Term Care Clinical Criteria Home Health Acute care +20

USD 58K+

Case Manager RN
Work At Home-Ohio

Clinical resources Clinical Tools Holistic approach Data Review Policies and procedures RN licensure Care Planning Member engagement Clinical Practice +15

USD 54K+

Case Manager RN- Maternity/Fertility
Work At Home-Arizona

Maternity Telephonic case management Ob-gyn Infertility Women's Health RN license Clinical resources Clinical Tools Holistic approach +23

USD 54K+

Utilization Managment Nurse Consultant
Work At Home-California

Benefit management Benefit utilization Coverage determination Long Term Care Clinical Criteria Medical necessity Telephonic Communication RN licensure Utilization Review +29

Entry Mid Full Time

USD 64K+

Clinical Case Manager Behavioral Health DSNP
Work At Home-Pennsylvania

Provider coordination Substance abuse Technological Clinical Tools Data Review Care Planning Crisis Intervention Utilization Review Discharge planning +19

USD 60K+

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