FreshRemote.Work

Sign in

Managed Care Remote Jobs

240 fresh jobs found

Remote Customer Service Representative, Healthcare
Dallas, TX, United States

HMO Predictive Analytics Claims processing Managed Care Jira Teamwork Written communication Documentation Healthcare +4

USD 40K+

Regional Sales Manager – Nashville, NC
Nashville, North Carolina, United States

Tandem Diabetes Care

Insulin infusion pumps Diabetes technology Endocrinology Market development Diabetes Diabetes Care Market trends Field Sales Managed Care +17

Senior Full Time

USD 152K+

Sr. Territory Manager - Central Boston
Boston, Massachusetts, United States

Tandem Diabetes Care

Team cooperation Strategic business planning Insulin infusion pumps Insulin pump therapy Diabetes technology Endocrinology Diabetes Diabetes Care Business Planning +6

Senior Mid Full Time

USD 107K+

Territory Manager - South Boston/Providence, RI
Boston, Massachusetts, United States

Tandem Diabetes Care

Strategic business planning Insulin infusion pumps Team cooperation Insulin pump therapy Diabetes technology Endocrinology Diabetes Diabetes Care Business Planning +5

USD 98K+

Manager, Provider Network
Remote-TX, United States

Centene Corporation

Network account management Quality Initiatives Provider Contracting Claims payment Supervisory Procedures Contracting Claims Network +16

USD 86K+

Project Manager V
Remote-MO, United States

Centene Corporation

Managed care experience Planview Network management Smartsheet Quality Standards Clinical operations Supervisory Atlassian Agile Methodology +21

Senior Full Time

USD 105K+

Senior Data Scientist
Remote IL CHI METRO, United States

Time Series DataRobot Gradient boosting Random Forest Regression analysis Statistical models Cluster analysis Predictive models Neural Networks +81

Senior Full Time

USD 129K+

Provider Engagement Administrator III
Remote-WA, United States

Centene Corporation

HBR analysis Claims reimbursement Claims billing Value based performance Cost and utilization Interpersonal relationships Network performance Provider engagement Provider Relations +29

Senior Mid Full Time

USD 68K+

Pharmacy Coordinator II
Remote-WA, United States

Centene Corporation

Formulary process Grievances Prior authorizations Managed care experience Provider Relations Cost analysis Utilization Review Medical management Prior authorization +16

Entry Mid Full Time

USD 44K+

Senior Data Scientist – Model Risk Management
Remote US, United States

Statistical Analytics Analytic Data manipulation Risk Predictive Modeling Data Mining SAS Presentations BI +48

Senior Mid Full Time

USD 117K+

Business Analyst IV - Claims
Remote-MO, United States

Centene Corporation

Managed Care Information Provider reimbursement methodologies Risk Evaluation Claims analysis Process redesign Policy Implementation Claims payment Reimbursement methodologies Operational performance +32

Entry Senior Full Time

USD 86K+

Encounters Systems Analyst III (Remote)
Ohio WFH, United States

Claims Analytic Processes Claims IT Processes Health Claims Processing Claims operations Hcpcs coding Billing Processes Reimbursement methodologies SSIS Regulatory reporting +23

Senior Full Time

USD 81K+

Complex Denials Consultant
Remote, MD, United States

Contractual appeals Payer-provider relations Appeal writing Administrative appeals Denials Reimbursement methodologies Contract Review Intelligent Automation Workflow Orchestration +10

USD 78K+

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+

Lead Compliance Coordinator
Remote-NE, United States

Centene Corporation

Government programs Public Health Policy Recordkeeping Health policy Audits Public health Health Insurance Regulatory Managed Care +9

Senior Mid Full Time

USD 55K+

Community Marketing Representative II-Northeastern Region Indiana (Fort Wayne, IN)
Indiana WFH, United States

Managed care principles Community outreach Microsoft Suite Regulatory requirements CRM systems Managed Care Microsoft PowerPoint Medicare Medicaid +21

USD 53K+

Primary Nurse Case Admin I ONSITE
Richardson Texas HQ (1001 E. Lookout Drive), United States

Health Care Service Corporation

Wellness education Milliman guidelines Medical Management Policies CM UM Database experience Condition Management Coordination of care Lotus Notes +34

USD 60K+

Behavioral Health Inpatient Care Manager - Initial Clinical Examiner Team- Evernorth Health Services- Remote
California Work at Home, United States

The Cigna Group

Technology navigation Technology systems Treatment plans Mental Health Counseling Medical necessity Behavioral healthcare Utilization Review Discharge planning Health Services +25

USD 65K+

Sr. Manager Enterprise Quality Engineering
Dayton WFH, United States

Metrics and KPIs Testing Protocols Automation Frameworks Healthcare Regulations Quality Engineering Test Automation Managed Care CI/CD Continuous Improvement +11

Senior Full Time

USD 110K+

Triage Nurse - RN -Must live within 1hr of Ridgeland MS 39157
Mississippi WFH, United States

Health information service Clinical triage Critical reasoning Critical Listening Nursing process Cultural Competence Provider engagement Computer Applications Regulatory requirements +13

USD 55K+

Primary Nurse Case Admin I ONSITE - Dallas
Richardson Texas HQ (1001 E. Lookout Drive), United States

Health Care Service Corporation

Wellness education Milliman guidelines Coordination of care Lotus Notes Medical Management Policies UM CM Database experience Condition Management +34

USD 60K+

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+

Communications Intern (Undergraduate - Summer)
Remote-FL, United States

Centene Corporation

Training and Development Regulatory Managed Care Communications Business Education Research Training

Entry Internship Full Time

USD 50K+

Tele-Triage Licensed Practical Nurse- LPN
LOUISVILLE, KY, United States

BrightSpring Health Services

Symptom assessment Medication coordination Nursing care plans Tele-triage Patient Communication LPN Care Plans Triage Clinical Documentation +14

USD 40K+

Director, Finance and Performance Management
Remote-MO, United States

Centene Corporation

ROI calculations Cross-Functional Team Management KPI Tracking Strategic initiatives Issue Resolution Cross-functional Teams Business strategy Health Insurance Managed Care +14

Exec Senior Full Time

USD 145K+

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+

Diabetes Sales Associate -- Lubbock, TX
United States of America : Remote

Glucose Monitoring Nutrition Products Interventional Pain Therapy Implantable devices Molecular diagnostics Quality System Informatics systems Neuromodulation Cardiac Rhythm Technologies +36

USD 60K+

Provider Data Coordinator II
Remote-MS, United States

Centene Corporation

Provider data issues Provider data management Microsoft Access Claims Network Databases Health Insurance Managed Care Data Management +10

USD 44K+

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+

Provider Data Coordinator I
Remote-MS, United States

Centene Corporation

Network Administrative Support Databases Health Insurance Managed Care Medicare Medicaid Data Management Access +8

Entry Full Time

USD 38K+

Health Insurance FP&A Analyst IV
Ohio WFH, United States

M&A processes RFP processes Relational Database Software Financial due diligence Business Intelligence Tools Pricing strategies Financial modeling Business Intelligence Managed Care +8

Entry Senior Full Time

USD 81K+

Quality Improvement Coordinator - Behavioral Health
Remote-WA, United States

Centene Corporation

Clinical Nursing Grievances Quality of care Clinical Quality Program Evaluation Healthcare administration Appeals HEDIS Medical necessity +19

USD 66K+

Supervisor, Quality Improvement
Remote-AR, United States

Centene Corporation

Managed care experience Effective Business Communication Lotus Notes HEDIS Procedures Supervisory Quality improvement Health Insurance Managed Care +20

USD 68K+

Care Manager, Telephonic Behavioral Health
HGB SCA Remote TX, United States

Comprehensive care planning Telephonic care management Educational program coordination Solution-oriented approaches Community resource identification Tricare Clinical Nursing Care Planning Motivational interviewing +59

USD 59K+

Clinical Investigator Behavioral Health
Remote-MO, United States

Centene Corporation

Investigative support Provider education Medical necessity Fraud detection Procedures Medical Records Report Writing CMS Claims +14

USD 55K+

Behavioral Health Clinical Liaison
Remote-FL, United States

Centene Corporation

Outpatient Treatment plans Substance use Substance abuse Provider education Clinical assessment Procedures Treatment Planning Health Services +28

USD 68K+

Remote Supervisor-Quality Improvement/Accreditation
Albuquerque, NM, United States

Presbyterian Healthcare Services

Clinical processes Accreditation Quality improvement Auditing Managed Care Program Management Regulatory Compliance Critical thinking Team Leadership +13

Senior Mid Full Time

USD 95K+

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+

Director, Clinical Pharmacy
Remote US, United States

Drug Utilization Analysis Formulary Development Pharmacy benefit management Clinical pharmacy Development programs Home health services Medication Adherence PBM Corporate Communications +44

Exec Senior Full Time

USD 168K+

Case Manager- Sheboygan and Ozaukee Counties
Work at Home - Wisconsin, United States

Health and Wellness Coordination Driver safety program Social service care management Community integration Family Care Prevention Social services Health and wellness Human services +39

USD 53K+

Data and Reporting Professional
Remote US, United States

Self-Service Tools Consumer Experience Development programs Qlikview Home health services Medication Adherence KPI KPI Analysis Microsoft Office Applications +61

USD 60K+

Manager, Vendor Management
Remote-AL, United States

Centene Corporation

Software data programs Healthcare Management Procedures Public health Health Insurance Managed Care Vendor Management Access Software +13

USD 86K+

Finance Analyst II - Managed Care
Remote-MO, United States

Centene Corporation

Provider expansion Reimbursement methodologies Data reconciliation Market Growth Financial Forecasting Healthcare systems CMS Contracting Network +20

USD 55K+

Claims Research Specialist
Remote-PA, United States

Centene Corporation

Medicaid benefits Claims billing Government programs Claims payment Provider Relations Referrals Procedures Claims processing Data integrity +10

USD 77K+

Senior Project Manager
Remote-FL, United States

Centene Corporation

IVR technology Managed care experience Avaya Project documentation Telephony Contact center Cross-functional Team Leadership Project management tools Healthcare experience +21

Senior Full Time

USD 86K+

Analyst, Payer Accountability
Remote, TN, United States

Payer Guidelines Revenue cycle services Physician billing Commercial payors Hospital billing Intelligent Automation Workflow Orchestration Revenue Cycle Managed Care +17

Entry Mid Full Time

USD 43K+

Clinical Account Manager
Remote-MO, United States

Centene Corporation

Clinical interventions Disease state management Benefit design Drug therapy Formulary management Drug Utilization Review Clinical pharmacy Pharmacy operations Clinical programs +18

USD 105K+

Medical Specialist I - Dermatology - Houston East
Remote - United States, United States

Reimbursement programs Dermatology Sales Performance Biopharmaceutical Biologics Biotechnology Operational Excellence Contract Negotiation Managed Care +5

Senior Mid Full Time

USD 141K+

Senior Care Manager
Remote-NY, United States

Centene Corporation

Healthcare outcomes Substance Use Disorders Service coordination Treatment options Care Plans Substance use Home visits Service plans Healthcare Coordination +29

Senior Full Time

USD 72K+

Growth Strategy Consultant
Remote NY NYC METRO, United States

Strategy Consulting Articulate Research and Analysis Medicare Advantage Investment Banking Qualitative analysis Strategy Development Collaborative Enrollment +41

USD 94K+

Remote Jobs in North America Remote Jobs in Europe Remote Jobs in South America Remote Jobs in Asia/Pacific Remote Jobs in Middle East Remote Jobs in Africa Full Time Remote Jobs Part Time Remote Jobs Internship Remote Jobs Contract Remote Jobs Temporary Remote Jobs Freelance Remote Jobs Mid-Level Remote Jobs Senior-Level Remote Jobs Entry-Level Remote Jobs Exec-Level Remote Jobs Lead-Level Remote Jobs Junior-Level Remote Jobs

Remote Jobs with CAD > 80K in Salary Remote Jobs with GBP > 80K in Salary Remote Jobs with EUR > 80K in Salary Remote Jobs with CAD > 100K in Salary Remote Jobs with CAD > 120K in Salary Remote Jobs with PHP > 240K in Salary Remote Jobs with PHP > 60K in Salary Remote Jobs with PHP > 260K in Salary Remote Jobs with PHP > 80K in Salary Remote Jobs with PHP > 40K in Salary Remote Jobs with PHP > 180K in Salary Remote Jobs with GBP > 100K in Salary Remote Jobs with PHP > 200K in Salary Remote Jobs with PHP > 120K in Salary Remote Jobs with PHP > 140K in Salary Remote Jobs with PHP > 220K in Salary Remote Jobs with PHP > 160K in Salary Remote Jobs with PHP > 100K in Salary Remote Jobs with PHP > 280K in Salary Remote Jobs with PHP > 300K in Salary