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InterQual Remote Jobs

22 fresh jobs found

Utilization Review Nurse(Austin/Richardson TX) (Remote)
Texas, Plano, United States of America

Bracane Company

Clinical Data Collection InterQual MCG Registered Nurse Care Coordination Utilization management Medical terminology RN Managed Care +1

USD 76K+

Utilization Review Nurse-Weekends-Remote
Sentara Park 1330, United States

Concurrent review Inpatient review RN license Retrospective review Milliman InterQual NCQA Discharge planning Health Plan +16

USD 60K+

Medical Director--Claims Management
Remote US, United States

Inpatient care Clinical patient care Computer-Based Review Outpatient services Home health services Grievance and appeals processes Clinical reference materials CMS policies Post-acute care +87

Exec Senior Full Time

USD 223K+

Medical Director - Florida
Remote US, United States

Clinical patient care Health claims Managed Care Knowledge Post-acute services Home health services Family practice Inpatient rehabilitation Hospitalist National Guidelines +73

Exec Senior Full Time

USD 223K+

RC Appellate Clinician - Remote
United States

Tenet Healthcare

Electronic tools Medical necessity criteria ACE Denials management UB04 Patient Accounting InterQual Managed Care Contracts EOB +29

USD 92K+

Pre-Authorization Registered Nurse
Remote US, United States

Medical management systems Rehab Medicaid Experience Health Plan Experience Microsoft Office Word Clinical Nursing InterQual MCG Rehabilitation +53

USD 71K+

Medical Director - Medicaid N. Central
Remote US, United States

Health claims review Computer-Based Review Post-acute services Grievance and appeals processes Post-acute care Humana policies Family practice Clinical group practice management Medical interpretation +92

Exec Senior Full Time

USD 223K+

Medical Director - National Medicare Team
Remote US, United States

Healthcare provider management Medicaid Experience Managed Care Knowledge NCD LCD Humana policies Medical interpretation National Guidelines Clinical group practice management +49

Exec Senior Full Time

USD 223K+

Clinical Review Nurse - Concurrent Review
Remote-FL, United States

Centene Corporation

TruCare Health management systems InterQual Guidelines Health management Medicaid regulations Clinical Review Medical necessity Discharge planning +22

USD 52K+

Utilization Nurse Reviewer (Remote), Day Shift, Utilization Management
Support Center, United States

Adventist HealthCare

Typing 50+ WPM Clinical Chart Review Milliman Resource Utilization CMS guidelines InterQual Windows Environment Discharge planning Utilization Review +9

USD 77K+

RC Appellate Clinician - Remote
United States

Tenet Healthcare

Medical necessity criteria UB04 Denials management Patient Accounting Managed Care Contracts InterQual EOB Healthcare industry expertise Healthcare Management +27

USD 92K+

Medical Director - Care Plus
Remote US, United States

Grievance processes Health claims review Outpatient services Grievance and appeals processes Post-acute care Clinical group practice management Commercial health insurance Hospitalist Inpatient rehabilitation +90

Exec Senior Full Time

USD 223K+

Medical Director - Mid West Region
Remote US, United States

Computer-Based Review Outpatient services Grievance and appeals processes Post-acute care Humana policies Hospitalist Medical interpretation National Guidelines Family practice +83

Exec Mid Full Time

USD 223K+

Medical Director - Southeast Region
Remote US, United States

Computer-Based Review Health claims review Post-acute services Grievance and appeals processes Outpatient services Inpatient rehabilitation Post-acute care Clinical group practice management Commercial health insurance +87

Exec Senior Full Time

USD 223K+

Case Manager- Out of Network Management- System Services- Remote -Full Time- Days
System Services-Telecommuter, United States

Sharp HealthCare

Health plan criteria MCG Clinical Nursing Healthcare Coordination InterQual Patient Assessment Utilization Review Utilization management Consultation +6

USD 60K+

Medical Director - Gulf South
Remote US, United States

Post-acute services Grievance and appeals processes Community Groups Outpatient services Clinical group practice management Commercial health insurance Inpatient rehabilitation Post-acute care Humana policies +88

Exec Senior Full Time

USD 223K+

Medical Director - Mid West Region
Remote US, United States

Computer-Based Review Community Groups Outpatient services Grievance and appeals processes Inpatient rehabilitation Commercial health insurance Clinical group practice management Post-acute care Humana policies +83

Exec Senior Full Time

USD 223K+

Utilization Review Author (Weekend)
Remote, GA, United States

Milliman Evidence-based criteria Case reviews Management experience InterQual Data Abstraction Basic Computer Intelligent Automation Utilization Review +16

USD 78K+

Medical Director- South Central
Remote US, United States

Community Groups Outpatient services Grievance and appeals processes Post-acute services Clinical group practice management Inpatient rehabilitation Post-acute care Commercial health insurance Humana policies +86

Exec Senior Full Time

USD 223K+

Medical Director - Pacific SW
Remote US, United States

Health claims review Community Groups Outpatient services Grievance and appeals processes Clinical group practice management Commercial health insurance Inpatient rehabilitation Post-acute care Humana policies +84

Exec Senior Full Time

USD 223K+

Medical Director - Northeast Region
Remote US, United States

Community Groups Outpatient services Post-acute services Grievance and appeals processes Clinical group practice management Commercial health insurance Post-acute care Inpatient rehabilitation CMS policies +88

Exec Senior Full Time

USD 223K+

Medical Director - Southeast Region
Remote US, United States

Health claims review Community Groups Outpatient services Post-acute services Grievance and appeals processes Clinical group practice management Commercial health insurance Inpatient rehabilitation Humana policies +84

Exec Senior Full Time

USD 223K+

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