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Healthcare Regulations Remote Jobs

55 fresh jobs found

Senior Machine Learning Scientist, NLP/LLM
Chicago, NYC, SF, Remote

DNA sequencing Healthcare data integration Conference participation Scientific Publishing Unstructured clinical notes Model improvement Question answering Clinical prediction Relation extraction +64

Senior Mid Full Time

USD 130K+

Product Manager - Community Hospitals / Regulatory - Remote
Remote - US

Altera Digital Health Remote-first

HL7 standards Interoperability solutions Interoperability standards Product development lifecycle Regulatory Analysis Health IT Solutions TouchWorks Altera Opal DbMotion +37

USD 90K+

Care Manager (Behavioral Health)
Remote-MO, United States

Centene Corporation

Remote Care Delivery Nursing Licenses Social Work Licenses Behavioral health interventions In-home visits Outcome monitoring Healthcare Benefits Education Behavioral health assessment Provider collaboration +62

USD 55K+

PFS Quality Assurance Specialist
Remote Loveland CO, United States

Financial data interpretation Healthcare auditing Work Independently Charge capture Patient registration Billing compliance Healthcare Regulations Report generation Training and education +24

USD 57K+

Clinical Care Reviewer II - Must have Multistate License or Indiana License
Dayton WFH, United States

Case referral Project assistance Elective inpatient care Outpatient procedures Acute inpatient care Change resiliency Medical advisement Durable Medical Equipment RN licensure +50

USD 61K+

Clinical Director, Women's Health
San Francisco, California, United States - Remote

Oura Health Ltd

Ob/gyn expertise Digital health program development Clinical experience in women’s health Digital health transformation Wearable health technology Scientific publication External research collaboration Research study design Healthcare system integration +49

Exec Senior Full Time

USD 178K+

Claims Auditor
Remote Phoenix AZ, United States

IDX Claims System Productivity Monitoring DRGs Work Independently Claims compliance Claims auditing ICD-10 Coding ICD-9 CPT coding +23

USD 69K+

Software Engineer I-Remote, USA
Remote, United States

ORM tools Mvc frameworks Development tools Symfony ORM LIMS MVC Front-end development NoSQL databases +46

Entry Full Time

USD 100K+

Senior Analyst, Special Investigations Unit
Waltham Massachusetts Office, United States

Education materials development Data pattern recognition Investigation strategy development Healthcare data security Investigation Reporting Fraud scheme development Healthcare claims analysis Healthcare fraud detection Investigation Support +42

Senior Mid Full Time

USD 55K+

Senior Machine Learning Scientist, NLP
Chicago, NYC, SF, Remote

AI model development Model improvement Imaging data Molecular DNA Clinical prediction Question answering Relation extraction Unstructured clinical notes Industry collaboration +53

Senior Mid Full Time

USD 130K+

Prior Authorization Specialist
United States

DrFirst Remote-first

Business Rules Management Technology Adaptability Technical Background Insurance Verification Independent work Healthcare IT Healthcare Regulations Prior authorization Remote work +8

USD 40K+

Product Analyst
Remote, United States

Epic creation Claims corrections HIPAA X12 271 Claims editing HIPAA X12 837 HIPAA X12 270 HIPAA X12 834 Claims integration Agile ceremonies +53

Entry Mid Full Time

USD 101K+

Grievance & Appeals Nurse, RN (Remote)
CA, United States

Inland Empire Health Plan

Case categorization Member advocacy Appeals processing Grievance Management Clinical Oversight Medical Review Healthcare Regulations Triage Quality improvement +6

USD 91K+

Clinical Coordinator
United States - Remote

United Energy Workers Healthcare

Clinical Competency Assessment Staffing Coordination Patient scheduling Resource Coordination Clinical Oversight Compliance monitoring Clinical Training Healthcare Regulations Performance Improvement +8

Senior Mid Full Time

USD 75K+

Care Manager (RN)
Remote-WA, United States

Centene Corporation

Monitoring and follow-up Care intervention Person-centered care Healthcare provider instructions Community resource navigation Care plan revision Care gap resolution Provider collaboration Cost-effective care +55

USD 55K+

Coding Specialist
Remote

Evergreen Nephrology

Billing compliance Quality Initiatives Medical Documentation Telephony Healthcare Regulations Risk Adjustment ICD-10 Performance Improvement Training Programs +16

USD 56K+

Manager, Compliance - Remote
Home, United States

Prime Therapeutics

Regulatory Change Management Policy governance Training Solutions Metrics Development Regulatory Guidance Regulatory reporting Pharmacy benefit management Healthcare Regulations Healthcare Compliance +34

Senior Mid Full Time

USD 81K+

VP of Clinical Operations - Remote (US)
Remote (US)

Theoria Medical

Program integration Cross-departmental collaboration Monday Strategic alignment Remote patient monitoring Healthcare Management Protocol Development Healthcare Regulations Evidence-based practices +18

Exec Senior Full Time

USD 160K+

Paralegal - Remote (US)
Novi, Mi

Theoria Medical

E-discovery tools Monday Remote patient monitoring Healthcare Regulations Monday.com Legal research Policy Development Risk mitigation Telemedicine +18

Senior Mid Full Time

USD 100K+

Director, LifeStance Labs
USA-Remote, United States Li LifeStance Health

Qualitative Methods Design research Data-driven methodologies Quantitative methods Human-centered design Healthcare Regulations Emerging Technologies Industry trends Business strategy +21

Exec Senior Full Time

USD 175K+

Technical Program Manager
United States

Metabase Healthcare Regulations Technical Program Management Virtual care Risk assessments Process Automation Process Optimization Data Pipelines Data-driven decision making +20

USD 150K+

Complex Denials Consultant
Remote, MD, United States

Payer-provider relations Appeals process Healthcare providers Denials Reimbursement methodologies Contract Review Workflow Orchestration Intelligent Automation Legal writing +18

USD 78K+

Associate Vice President Regulatory & Healthcare Compliance Counsel
US-PA-Remote Location, United States

Agilent Technologies

Business Oversight Global regulations Legal Counseling Adverse event reporting Food Materials Healthcare Regulations FDA regulations Training Programs +25

Senior Mid Full Time

USD 209K+

Payer Relations Manager
Remote , USA, United States

Payer Relations Payer contracting Cloud-based technology Technology-driven VLOOKUP Formulas Healthcare Regulations Negotiations Healthcare administration +25

USD 70K+

PAC Nurse IRF/LTAC
Remote

Evidence-based care guidelines Telephonic nursing Quality Assessment Home health care Healthcare Regulations Operational processes Registered Nurse Utilization management Clinical expertise +10

USD 72K+

TPR Pro Fee Coding Ops Director (Remote based in US)
United States

Tenet Healthcare

ICD-PCS Coding management General information technologies Coding Quality AHIMA Ethical coding Productivity standards Pcs RCM +37

Exec Senior Full Time

USD 120K+

Sr Manager, Provider Data Operations Implementation (Implementation experience a must)
Dayton WFH, United States

Provider data management Contract administration Provider Relations Healthcare Regulations Prior authorization Healthcare administration Project Planning Credentialing Enrollment +50

Senior Full Time

USD 92K+

Senior Manager, Compliance Audit and Monitoring
Remote

Delegation oversight External communications Internal control Corrective action plans Models Compliance monitoring Strategic Guidance Healthcare Regulations Audit Management +35

Senior Full Time

USD 118K+

Associate General Counsel, Regulatory and Privacy
Remote

Legal interpretation Provider licensing Audit Response Privacy laws Regulatory Frameworks Legal Experience Regulatory Guidance Healthcare Delivery Clinical Practice +19

Senior Mid Full Time

USD 204K+

Senior Manager of Patient Support, Payments
Des Moines, Iowa, United States, Hybrid, Remote

Call Center Software Healthcare Regulations Outbound Calling Patient Support CRM systems Payments HIPAA CRM Interpersonal +7

Senior Full Time

USD 80K+

Senior Data Integration and Operations Specialist
United States-%LABEL POSITION TYPE REMOTE WITHIN ONE%

T-SQL HEDIS EDI Interoperability MuleSoft FHIR Risk Adjustment Healthcare Regulations Healthcare IT +28

Senior Full Time

USD 120K+

Medical Director - EviCore - Remote (Family Medicine, Internal Medicine or Emergency Medicine)
Florida Work at Home, United States

The Cigna Group

Evidence-based medical reviews Medical case reviews Evidence-Based Decision Making Cigna Automated processes Federal Laws Clinical Judgment Computer Applications Case Management Software +24

Entry Mid Full Time

USD 203K+

Senior Clinical Effectiveness Researcher
Remote

Included Health

Actuarial sciences Health informatics Healthcare quality Regression analysis Clinical Quality Healthcare Regulations Manual Dexterity In-person care Specialty care +48

Senior Full Time

USD 25K+

Clinical Effectiveness Research Analyst
Remote

Included Health

Actuarial sciences Health informatics Healthcare quality Regression analysis Clinical Quality Healthcare Regulations Manual Dexterity In-person care Specialty care +52

USD 25K+

Payer Relations Manager
Remote , USA, United States

Payer Relations Payer contracting Technology-driven Cloud-based technology VLOOKUP Formulas Healthcare operations Healthcare Regulations Negotiations +26

USD 70K+

Clinical Documentation Integrity (CDI) Specialist- 2nd Level Reviewer- Remote
Home Office: San Antonio, TX, United States

Chart Review Encoder Quality review Provider education Coding Guidelines Healthcare Regulations Clinical Documentation Quality Billing +13

USD 80K+

Product Owner - DSS/Business Intelligence & Analytics)
Any city, TX, US, 99999

Gainwell Technologies

Microsoft ADO CMS Requirements HITECH Reporting Solutions CMS guidelines Product Vision Posting Healthcare Analytics Healthcare Regulations +66

Senior Mid Full Time

USD 100K+

VP, Product & Engineering
Remote

Functional medicine Low-code tools UX/UI Design DO Healthcare Regulations No-code tools Engineering management UI Design AI technologies +10

Exec Senior Full Time

USD 200K+

Sr. Product & Regulatory Counsel
USA

Product counseling Technology applications Legal advice Healthcare Regulations Healthcare Technology Risk mitigation Product Design Data privacy Product Development +17

Senior Full Time

USD 221K+

Network Adequacy Reporting Analyst II
Dayton WFH, United States

Quest Analytics Network Adequacy Standards T/PL-SQL Cognizant Facets Provider data management Provider network Facets NCQA Healthcare Regulations +31

Entry Mid Full Time

USD 61K+

Compliance Analyst - Pharmacy
Des Moines, Iowa, United States, Hybrid, Remote

Pharmacy operations Healthcare Regulations Issue Resolution Auditing Regulatory Compliance Healthcare Data analysis Analytical Organizational +3

Entry Mid Full Time

USD 80K+

Senior Clinical Operations Analyst
United States

Provider onboarding Addiction recovery Harm reduction Healthcare Regulations Substance Use Disorder Credentialing Asana Clinical operations Telemedicine +11

Senior Mid Full Time

USD 70K+

Sr. Coding & Compliance Manager (Remote)
Remote - United States

CPC Coding compliance CMS guidelines Financial Operations Healthcare Regulations Medical Coding HCPCS ICD-10 Cross-functional Teams +21

Senior Full Time

USD 165K+

Director, Care Advice Line (Registered Nurse)
Remote, USA, United States

Clinical Guidance Population health management Athena Operational Management Healthcare Regulations Population health Healthcare administration Triage Operations Management +23

Exec Senior Full Time

USD 118K+

Sr. Strategic Clinical Advisor
Remote

Spring Health Remote-first

EAP programs Health plans Benefits consulting Clinical Strategy Clinical programs Clinical Leadership Mindfulness Precision Mental Healthcare Program Design +25

Senior Full Time

USD 132K+

Senior Litigation & Product Counsel
Remote - USA

Clover Health Remote-first

Regulatory investigations Internal Investigations Healthcare Regulations Value-based care Legal research CMS Litigation Claims Risk mitigation +10

Senior Full Time

USD 189K+

Sr Clinical Consultant - Remote
Remote - CA

Altera Digital Health Remote-first

Health informatics Clinical Consultation Altera Opal TouchWorks Health IT Solutions DbMotion EHR systems Health IT Healthcare Regulations +27

Senior Full Time

USD 91K+

Medical Director - Pediatric Otolaryngology- EviCore
Florida Work at Home, United States

The Cigna Group

Evidence-based reviews Evidence-Based Decision Making Evidence-based medical reviews Medical case reviews Case Management Software Federal Laws Automated processes Computer Applications Cigna +25

Exec Senior Full Time

USD 203K+

Director, Pricing and Contracting
New York, New York

Axsome Therapeutics Inc

Rebate Administration Government pricing CNS Disorders Healthcare Regulations Pricing strategy Contract management Market Access Pharmaceutical Reimbursement +14

Exec Senior Full Time

USD 190K+

Expert Demo Specialist - Hospital Financials & Clinicals / Remote
Kansas City, Missouri, United States

Altera Digital Health Remote-first

Demo environment configuration Hospital revenue cycle management Leadership in healthcare Software demonstrations Allscripts Clinical Solutions Clinical Workflows TouchWorks Health IT Solutions +31

Senior Mid Full Time

USD 90K+

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