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MCG Remote Jobs

10 fresh jobs found

Appeals Review Nurse
Remote

NCCN Medical decision support tools Level of care reviews Medical necessity reviews Milliman care guidelines Evidence-Based Guidelines InterQual MCG Clinical Guidelines +16

Entry Mid Full Time

USD 70K+

Medical Director - Northeast Region
Remote US

Commercial health insurance Post-acute services Grievance and appeals processes Outpatient services Coding practices Clinical group practice management Judgement Inpatient rehabilitation Hospitalist +80

Exec Senior Full Time

USD 199K+

REMOTE Utilization Review Nurse - ED - 10 am - 6 pm, 11 am - 7 pm OR 12 pm - 8 pm
GBMC Hospital

GBMC HealthCare

MCG InterQual Electronic Medical Records Utilization Review Oral communication Critical thinking Written communication Time Management Organizational +3

USD 64K+

Medical Director - National Medicare Team
Remote US

Commercial health insurance Project team participation Managed Care Knowledge Clinical Standards Clinical group practice management Humana policies Medical interpretation Medical background National Guidelines +42

Exec Senior Full Time

USD 199K+

Medical Director- South Central
Remote US

Post-acute services Clinical group practice management Clinical Standards Grievance and appeals processes Outpatient services Coding practices Inpatient rehabilitation Medical background Clinical reference materials +78

Exec Senior Full Time

USD 199K+

Medical Director - Home Health - OneHome/Home Solutions
Remote US

Dynamic Environment Interpretative CMS Medicare Clinical Standards Inpatient Care Clinical reference materials Humana policies Medical interpretation CMS policies +44

Exec Senior Full Time

USD 199K+

Medical Director - Pharmacy Appeals
Remote US

Medicare rules Clinical group practice management Humana policies National Guidelines CMS policies Rules InterQual MCG Medical Director +51

Exec Senior Full Time

USD 199K+

Post Acute Utilization Management Nurse (Intermountain Region)
Work at Home - Washington

MCG guidelines Inpatient rehabilitation CMS guidelines Health Plan Experience Interpreting Criteria Clinical Nursing Milliman guidelines Milliman Medical Services +43

USD 69K+

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

The Cigna Group

Therapeutic Modalities ASAM CALOCUS Behavioral Consultation Telephonic Consultation Crisis Risk Assessment LOCUS Clinical navigation MCG +28

Senior Mid Full Time

USD 65K+

Medical Director--Claims Management
Remote US

Medicare Guidelines Inpatient Care Grievance and appeals processes Coding practices Outpatient services MCG Inpatient rehabilitation National Guidelines Post-acute care +73

Exec Senior Full Time

USD 199K+

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