FreshRemote.Work

Sign in

Managed Care Remote Jobs

298 fresh jobs found

Field Medical Alignment Director (FMAD), Immunology & Ophthalmology (Remote)
USA - Pennsylvania - North Wales (Upper Gwynedd), United States

Tactical Planning Ophthalmology Innovative Thinking Health Systems Resource Planning Project leadership Immunology Resource Allocation Operational +43

Exec Senior Full Time

USD 187K+

VP, IT Performance and Business Services(Managed Care Background Preferred)
Dayton WFH, United States

Human Capital Strategy M&A Integration IT Governance IT Strategy Infrastructure Management Operations Management Application Development Financial Management Managed Care +18

Exec Senior Full Time

USD 150K+

Case Manager RN
Work At Home-Ohio, United States

Assessment Techniques Healthcare programs Telephonic case management RN license Member engagement Clinical assessments Health Literacy Clinical assessment Acute care +32

USD 54K+

Utilization Management Nurse Consultant (Remote)
Work At Home-Ohio, United States

Post-acute care Navigating multiple systems Coverage determination Benefit utilization RN licensure Benefit management Clinical Criteria Keyboarding Acute care +22

USD 52K+

Medical Director, Clinical Strategy Sleep Medicine
United States

Cohere Health Remote-first

Health plan market Consultative engagements Clinical program design AI capabilities Sleep medicine Software tools Clinical outcomes Clinical Strategy Clinical Intelligence +31

Exec Senior Full Time

USD 250K+

Post Payment Auditor
REMOTE OPTIONS, PHOENIX

State of Arizona

Evidence-based Interventions Healthcare quality Medicaid programs Research methods Report generation Review Equal Opportunity Mathematical Eligibility verification +53

USD 52K+

Enterprise Wide Research Specialist
Albuquerque, NM, United States

Presbyterian Healthcare Services

Healthcare databases Grievance handling Claims processing Managed Care Billing Risk Management Process Improvement Research Management +5

USD 52K+

Director, Market Access Early Pipeline - Remote
Remote Position (USA), United States

Healthcare Dynamics Payer coverage Healthcare Sector Matrix organization Health policy Commercial Excellence Clinical Trial Design Value proposition Emotional Intelligence +31

Exec Senior Full Time

USD 204K+

Pharmacy Technician - Clinical Services (MTM)
Remote-FL, United States

Centene Corporation

Drug Utilization Review Medication therapy management Pharmacy operations Clinical services Telephonic Outreach Pharmacy Technician Triage Bilingual Communication Utilization Review +22

Entry Full Time

USD 52K+

Senior Talent Intelligence Advisor
Remote-MO, United States

Centene Corporation

Talent intelligence Strategic advisory Sourcing channels Information Retrieval Data Extraction Strategic sourcing Workforce Planning Data-Driven Insights Managed Care +19

Senior Full Time

USD 86K+

Utilization Management Nurse Consultant
Work At Home-Missouri, United States

Um certification Med Compass CM/UM certification IT platforms Med/surg Coverage determination Benefit utilization Benefit management RN licensure +23

Entry Mid Full Time

USD 52K+

UM Administrative Coordinator- Medicare- WAH
Remote US, United States

Computations Rehab ICD-10 codes Clinical Leadership ICD Calendar Management Electronic Medical Records Consumer Experiences Utilization Review +51

USD 40K+

Diabetes Sales Associate -- Phoenix -North, AZ
United States of America : Remote

Glucose Monitoring Informatics systems Implantable devices Interventional Pain Therapy Quality System Heart failure Medical technologies Nutrition Products Neuromodulation +37

USD 60K+

Medical Director (PRN) - Hawaii
Remote-HI, United States

Centene Corporation

Clinical quality improvement Health financing Clinical programs Personnel management Health administration Medical Review Clinical Quality Medical Services Accreditation +21

Exec Mid Part Time

USD 202K+

RN Care Manager, Telephonic
Work at Home - Wisconsin, United States

Psycho-social Health Management Health Risk Screening Transitions of Care Prevention Healthcare Delivery Acute care Clinical Care Discharge planning Risk +40

USD 71K+

FWA Payment Integrity Data Analyst III
Ohio WFH, United States

Fraud waste abuse Healthcare Data Analytics ANSI SQL Database relationships Transact-SQL Critical Listening Database Development Hypothesis Testing Statistical techniques +31

Senior Full Time

USD 81K+

Senior Manager, Claims Configuration Operations
Remote-MO, United States

Centene Corporation

Claims Configuration Medical management Quality Standards Health Services Quality improvement Claims Business administration Business strategy Managed Care +19

Senior Full Time

USD 105K+

Trainer II
Remote-AZ, United States

Centene Corporation

Pharmacy operations Adult Learning Theory Training Programs Process Development Procedures Effective Communication Pharmacy Auditing Facilitation +12

USD 55K+

Compliance Analyst II
Dayton WFH, United States

Corrective Action Management Audit Support Healthcare operations Regulatory knowledge Training and education Policy Development Root Cause Analysis Managed Care Medicare +25

Entry Mid Full Time

USD 70K+

Pharmacist - Medication Therapy Management (Work From Home)
Work At Home-Arizona, United States

Medication therapy management Pharmacist Phone Clinical assessment Retail Pharmacy Managed Care Medicare Health care +16

USD 105K+

Behavioral Health Coaching and Support Care Manager - Evernorth Health Services - Remote
Minnesota Work at Home, United States

The Cigna Group

Chemical dependency Autism Eating disorders Telephonic counseling Health care services Treatment plans Health education Client-facing Health coaching +33

USD 65K+

Key Account Manager - Transplant - Seattle, WA
USA - WA - Virtual, United States

Healthcare Professionals Healthcare Industry Knowledge Reimbursement Issues Pharmaceuticals Managed Care Influencing BioTech Adaptability Reimbursement +16

USD 154K+

Key Account Manager - Transplant - Los Angeles, North
USA - CA - Virtual, United States

Healthcare Professionals Healthcare Industry Knowledge Reimbursement Issues Pharmaceuticals Managed Care Influencing BioTech Adaptability Reimbursement +16

USD 154K+

Part time Remote Customer Service Representative
Rockford, IL, United States

Claims review HMO Medicare Advantage Predictive Analytics Managed Care Health Insurance Jira Written communication Teams +6

Mid Part Time Full Time

USD 38K+

Field Reimbursement Specialist - Boston, MA
US - Massachusetts - Boston -Field/Remote, United States

Collaborative territory strategic plan Insurance forms Formulary coverage Financial assistance programs Patient health information Benefits investigation Payer prior authorization Reimbursement process Reimbursement issue resolution +48

USD 155K+

Field Reimbursement Specialist - White Plains, NY
US - New York - New York - Field/Remote, United States

Reimbursement process Financial assistance programs Payer prior authorization Formulary coverage Benefits investigation Patient health information Reimbursement issue resolution Patient Support Programs Claims resolution +45

USD 155K+

Field Reimbursement Specialist Senior Manager - West
US - California - Thousand Oaks - Field/Remote, United States

Reimbursement strategy Workflow Development Access and Reimbursement Payer Product Access Client satisfaction Business reviews Inflammation Specialty Pharmacy +46

Senior Full Time

USD 187K+

Field Reimbursement Specialist - Chicago, IL
US - Illinois - Chicago - Field/Remote, United States

Insurance forms Financial assistance programs Collaborative territory strategic plan Formulary coverage Reimbursement process Payer prior authorization Patient health information Benefits investigation Reimbursement issue resolution +50

USD 155K+

Field Reimbursement Specialist - Detroit, MI
US - Michigan - Detroit-Field/Remote, United States

Collaborative territory strategic plan Insurance forms Formulary coverage Financial assistance programs Patient health information Benefits investigation Payer prior authorization Reimbursement process Reimbursement issue resolution +48

USD 155K+

Field Reimbursement Specialist - Kansas City, MO
US - Missouri - Kansas City -Field/Remote, United States

Patient health information Formulary coverage Payer prior authorization Financial assistance programs Reimbursement process Benefits investigation Reimbursement issue resolution Patient Support Programs Claims resolution +48

USD 155K+

Field Reimbursement Specialist - San Francisco, CA
US - California - Thousand Oaks - Field/Remote, United States

Collaborative territory strategic plan Insurance forms Formulary coverage Financial assistance programs Benefits investigation Reimbursement process Patient health information Payer prior authorization Reimbursement issue resolution +51

USD 155K+

Field Reimbursement Specialist - Indianapolis, IN
US - Indiana - Indianapolis - Field/Remote, United States

Reimbursement process Financial assistance programs Payer prior authorization Formulary coverage Benefits investigation Patient health information Reimbursement issue resolution Patient Support Programs Claims resolution +45

USD 155K+

Field Reimbursement Specialist - Columbia, SC
US - South Carolina - Columbia - Field/Remote, United States

Reimbursement process Financial assistance programs Payer prior authorization Formulary coverage Benefits investigation Patient health information Reimbursement issue resolution Patient Support Programs Claims resolution +45

USD 155K+

Field Reimbursement Specialist - Dallas North, TX
US - Texas - Houston - Field/Remote, United States

Collaborative territory strategic plan Insurance forms Benefits investigation Formulary coverage Payer prior authorization Financial assistance programs Reimbursement process Patient health information Reimbursement issue resolution +53

USD 155K+

Field Reimbursement Specialist - Seattle, WA
US - Washington - Seattle - Field/Remote, United States

Patient health information Formulary coverage Payer prior authorization Financial assistance programs Reimbursement process Benefits investigation Reimbursement issue resolution Patient Support Programs Claims resolution +48

USD 155K+

Field Reimbursement Specialist Senior Manager - North - Central US
US - Illinois - Chicago - Field/Remote, United States

Training program improvement Reimbursement strategy Access and Reimbursement Workflow Development Payer Product Access Client satisfaction Business reviews Inflammation +46

Senior Full Time

USD 187K+

Field Reimbursement Specialist - Pittsburg, PA
US - Pennsylvania - Philadelphia - Field/Remote, United States

Insurance forms Financial assistance programs Collaborative territory strategic plan Formulary coverage Reimbursement process Payer prior authorization Patient health information Benefits investigation Reimbursement issue resolution +50

USD 155K+

Manager, HP Contracting & Service
North Carolina WFH, United States

Configuration Testing Critical Listening Network management Regulatory requirements Microsoft Outlook Contract Negotiation Managed Care Teaching Configuration +17

USD 81K+

Health Partner Network Manager
North Carolina WFH, United States

Provider network management Provider Recruitment Critical Listening Network management Contracting Regulatory requirements Microsoft Outlook Managed Care Teaching +17

USD 70K+

UM Administration Coordinator (Gulf South Region)
Work at Home - Louisiana, United States

Computations ICD-10 codes ICD Electronic Medical Records Consumer Experiences Utilization Review ICD-10 Authorization Prior authorization +45

Entry Mid Full Time

USD 40K+

Clinical Pharmacist for FL and VA- Remote!
Sentara Health Plan AvMed Gainesville, United States

Online pharmacy adjudication systems Pharmacotherapy Pharmaceutical care management Health Plan Verification Judgment Medical terminology Managed Care Decision making +6

USD 119K+

Behavioral Health Clinical Liaison
Tempe - 1870 W. Rio Salado Pkwy, Ste 2A (10415), United States

Centene Corporation

Outpatient Substance use Treatment plans Substance Use Disorder Substance abuse Provider education Clinical Information Clinical assessment Medical management +25

USD 68K+

Field Reimbursement Specialist - Houston, TX
US - Texas - Houston - Field/Remote, United States

Collaborative territory strategic plan Insurance forms Formulary coverage Financial assistance programs Benefits investigation Reimbursement process Patient health information Payer prior authorization Reimbursement issue resolution +51

USD 155K+

Care Management Support Assistant
Work at Home - Kentucky, United States

Computational Tasks Clerical Tasks Operational Support Microsoft Access Clinical support BI Care management Claims Healthcare services +39

USD 38K+

Compliance Analyst II
Mississippi WFH, United States

Corrective Action Management Audit Support Provider engagement Healthcare operations Regulatory knowledge Training and education Policy Development Root Cause Analysis Managed Care +25

Entry Mid Full Time

USD 63K+

Patient Access Director, Bone
US - California - Thousand Oaks - Field/Remote, United States

Insight-driven strategies Patient support strategy Marketing messages Fulfillment journey Rapid Response Brand Planning Promotional Materials Payer Access and Reimbursement +44

Exec Senior Full Time

USD 199K+

Field Reimbursement Specialist - Austin, TX
US - Texas - Houston - Field/Remote, United States

Patient health information Formulary coverage Payer prior authorization Financial assistance programs Reimbursement process Benefits investigation Reimbursement issue resolution Patient Support Programs Claims resolution +48

USD 155K+

Field Reimbursement Specialist - Dallas South, TX
US - Texas - Houston - Field/Remote, United States

Patient health information Reimbursement process Formulary coverage Financial assistance programs Benefits investigation Payer prior authorization Reimbursement issue resolution Patient Support Programs Healthcare provider education +50

USD 155K+

Field Reimbursement Specialist - Newark, NJ
US - New Jersey - Newark -Field/Remote, United States

Patient health information Financial assistance programs Benefits investigation Formulary coverage Payer prior authorization Reimbursement process Reimbursement issue resolution Patient Support Programs Claims resolution +46

USD 155K+

Field Reimbursement Specialist - Phoenix, AZ
US - Arizona - Phoenix - Field/Remote, United States

Patient health information Payer prior authorization Financial assistance programs Reimbursement process Formulary coverage Benefits investigation Reimbursement issue resolution Phoenix Claims resolution +46

USD 155K+

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