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MCG 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+

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+

Nurse Supervisor, Utilization Management Clinical Quality
Remote

Nurse Management HEDIS measures Clinical auditing Escalations RN licensure Insurance experience Ncqa standards Healthcare quality MCG +37

USD 88K+

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+

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+

RN Telephonic Care Manager - Remote, WA
Work at Home - Washington, United States

Autonomous decision-making Telephonic care management Advanced Computer Multidisciplinary teamwork Computer navigation CMS guidelines MCG Home Care Clinical Nursing +54

USD 71K+

24/7 Clinical Navigation and Support Care Manager - Evernorth Health Services - Remote
Minnesota Work at Home, United States

The Cigna Group

Confidentiality regulations Cigna Telephonic consultation Biopsychosocial assessment Brief therapy Employee assistance programs Solution focused therapy Safety Planning Substance Use Disorders +35

USD 65K+

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+

Behavioral Health 24/7 Clinical Navigation and Support Care Manager - Evernorth Health Services - Remote
Minnesota Work at Home, United States

The Cigna Group

Confidentiality regulations Telephonic consultation Biopsychosocial assessment Brief therapy Employee assistance programs Solution focused therapy MCG De-escalation Clinical Judgment +32

Senior Mid Full Time

USD 65K+

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+

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+

Behavioral Health Medical Director - Medicaid
Remote US, United States

Computer-Based Review CGX Community Groups Clinical reference materials CMS policies Medical background MCG Medical Director Clinical evaluation +48

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- 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+

Telephonic Nurse Case Manager
HGB SCA Remote PA, United States

Holistic approach Tricare MCG Evidence-based medicine Clinical Nursing Medical Services Accreditation Motivational interviewing Utilization Review +45

USD 71K+

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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