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12 fresh jobs found
Associate Medical Director, Orthopedic Surgery
United States Cohere Health logo Cohere Health  Remote-first
Orthopedic surgery Peer-to-peer discussions Evidence-Based Guidelines Clinical reviews Clinical Intelligence Clinical Review Medical necessity Clinical Acumen Utilization Review +11
Senior Mid Full Time
USD 200K+
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Senior Clinical Review Nurse - Prior Authorization
Remote-NY, United States Centene Corporation logo Centene Corporation
Service authorization Medical appropriateness Authorization requests Health management systems Clinical reviews Health management Medicaid regulations Clinical Information Clinical Review +25
Senior Mid Full Time
USD 60K+
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Sr Onsite Clinical Care Navigator--Mission Hospital Asheville
Full Time Remote - North Carolina, United States Blue Cross NC logo Blue Cross NC
Clinical reviews Comprehensive assessments Healthcare Coordination Medical necessity Discharge planning Clinical Care Community Resources Referrals Utilization management +7
Senior Mid Full Time
USD 75K+
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Associate Medical Director, Spine Surgery
United States Cohere Health logo Cohere Health  Remote-first
Neurosurgery Orthopedic surgery Spine surgery Peer-to-peer discussions Evidence-Based Guidelines Clinical reviews Clinical Intelligence Clinical Review Medical necessity +14
Senior Mid Full Time
USD 250K+
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RN Clinical Review Clinician_Appeals
Remote-CA, United States Centene Corporation logo Centene Corporation
Appeals processes Interdepartmental Collaboration Ncqa standards Clinical reviews Medicaid regulations Researching NCQA Clinical Review Guidelines +27
Mid Full Time
USD 95K+
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Clinical Review Nurse - Prior Authorization
Remote-CA, United States Centene Corporation logo Centene Corporation
Service authorization Medical appropriateness Authorization requests Health management systems Clinical reviews Health management Medicaid regulations Guidelines Clinical Information +23
Mid Full Time
USD 95K+
Preview Apply
Care Manager, BH - Remote in PA
Remote PA Newtown 18940, United States Magellan Health logo Magellan Health  Remote-first
Telephone triage DSM V Clinical reviews Substance abuse Discharge planning Outpatient Care Crisis Intervention Tracking Triage +18
Mid Full Time
USD 58K+
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Medical Director, Operations, Ortho/Spine
United States Cohere Health logo Cohere Health  Remote-first
Clinical decision guidelines Medical coverage policies Physician training Remote workforce management AI in Healthcare Peer-to-peer discussions Clinical reviews Clinical Intelligence Software tools +23
Exec Senior Full Time
USD 270K+
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Sr Clinical Solutions Spec-Vascular Access
REMOTE- Ohio, United States Medline Industries, LP logo Medline Industries, LP
Clinical process enhancement Bedside clinical experience Quality investigations Waste assessments Utilization reviews Workshop coordination Clinical presentations Infection Prevention Vascular access +17
Senior Full Time
USD 87K+
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Episodic Care Manager
Full Time Remote - North Carolina, United States Blue Cross NC logo Blue Cross NC
Medical necessity assessment Health care coordination Case review Clinical reviews Clinical evaluation Medical policy Medical necessity Clinical Documentation Clinical knowledge +7
Mid Full Time
USD 68K+
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HMSA Intake Precert Care Manager - Remote Hawaii
Remote HI Honolulu 96813, United States Magellan Health logo Magellan Health  Remote-first
DSM V Telephone triage Clinical reviews Substance abuse Discharge planning Outpatient Care Triage Tracking Crisis Intervention +17
Mid Full Time
USD 58K+
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Behavioral Health Care Manager Remote, must be Licensed and Reside in California
Remote CA San Diego 92126, United States Magellan Health logo Magellan Health  Remote-first
Inpatient care DSM-5 DSM V Telephone triage Clinical reviews Substance abuse Discharge planning Outpatient Care Triage +19
Mid Full Time
USD 58K+
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