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Medicaid regulations Remote Jobs

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14 fresh jobs found
Informatics Nurse - Pre-Payment Reviewer
REMOTE OPTIONS, PHOENIX State of Arizona logo State of Arizona
Program Integrity Federal and State Statutes Report creation Medicaid programs Interdisciplinary Collaboration Medicaid regulations Cognos Policies and procedures System Implementation +59
Mid Full Time
USD 71K+
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Senior Clinical Review Nurse - Prior Authorization
Remote-NY, United States Centene Corporation logo Centene Corporation
Service authorization Medical appropriateness Authorization requests Health management systems Clinical reviews Health management Medicaid regulations Clinical Information Clinical Review +25
Senior Mid Full Time
USD 60K+
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Credit Resolution Representative - Remote
United States Tenet Healthcare logo Tenet Healthcare
Pbar Refund analysis Star Medicare regulations ACE HCFA 1500 UB04 Meditech Call Center Environment +31
Entry Full Time
USD 51K+
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RN Clinical Review Clinician_Appeals
Remote-CA, United States Centene Corporation logo Centene Corporation
Appeals processes Interdepartmental Collaboration Ncqa standards Clinical reviews Medicaid regulations Researching NCQA Clinical Review Guidelines +27
Mid Full Time
USD 95K+
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Clinical Review Nurse - Concurrent Review
Remote-NY, United States Centene Corporation logo Centene Corporation
Health management systems Health management Medicaid regulations Guidelines Medical necessity Clinical Review Discharge planning Utilization Acute care +20
Mid Full Time
USD 95K+
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Clinical Review Nurse - Concurrent Review
Remote-CA, United States Centene Corporation logo Centene Corporation
Health management systems Health management Medicaid regulations Guidelines Clinical Review Medical necessity Discharge planning Utilization Acute care +20
Mid Full Time
USD 95K+
Preview Apply
Clinical Review Nurse - Prior Authorization
Remote-CA, United States Centene Corporation logo Centene Corporation
Service authorization Medical appropriateness Authorization requests Health management systems Clinical reviews Health management Medicaid regulations Guidelines Clinical Information +23
Mid Full Time
USD 95K+
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Case Manager I (RN/MSW) - Medicare/DSNP team
Yakima, Washington, United States; Seattle, Washington, United States Community Health Plan of Washington logo Community Health Plan of Washington
Workflow systems Telephonic case management Medicaid regulations Clinical assessment Home Health Discharge planning Community Health Social Work Clinical Experience +19
Mid Full Time
USD 77K+
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Clinical Analyst I
Remote, United States Cotiviti logo Cotiviti
Coding validation Medical procedures Payment policy Claims payment Payment Medicaid regulations Healthcare Analytics ICD HCPCS +31
Mid Full Time
USD 70K+
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Clinical Review Nurse - Concurrent Review
Remote-FL, United States Centene Corporation logo Centene Corporation
TruCare Health management systems InterQual Guidelines Health management Medicaid regulations Clinical Review Medical necessity Discharge planning +22
Mid Full Time
USD 52K+
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Clinical Review Nurse - Prior Authorization (RN)
Remote-CA, United States Centene Corporation logo Centene Corporation
RN licensure Service authorization Medical appropriateness Authorization requests Guidelines Clinical reviews Health management systems Medicaid regulations Health management +24
Mid Full Time
USD 95K+
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Credit Resolution Representative - Remote
United States Tenet Healthcare logo Tenet Healthcare
Refund analysis UB04 HCFA 1500 Medicare regulations Managed Care Contracts Call Center Environment Hospital billing Contract Interpretation Medicaid regulations +30
Entry Full Time
USD 51K+
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Sr. Professional Network Strategy
Remote US, United States Humana logo Humana
Provider network operations Medicaid Experience Network strategy Research analysis Medicaid regulations Research and Analysis Qualitative analysis Growth Strategy Healthcare administration +42
Senior Mid Full Time
USD 86K+
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Associate Counsel, Medicaid
Full Time Remote - North Carolina, United States Blue Cross NC logo Blue Cross NC
Improvement Legal services Medicaid regulations Contract drafting Legal research Policy Development Contract management Medicaid Continuous Improvement +6
Mid Full Time
USD 110K+
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