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Medical management Remote Jobs

36 fresh jobs found

Medical Director - Florida
Remote US

Home health services Health claims review Grievance and appeals processes Outpatient services Commercial health insurance Inpatient rehabilitation Post-acute care Clinical group practice management Hospitalist +81

Exec Senior Full Time

USD 223K+

Sr Products Liability Claims Specialist
Telecommuter IL

Legal Coordination Settlement strategies Liability Claims Strategic vendor partnerships Recovery Claims coding Social Security Insurance principles Cost Containment +35

Senior Full Time

USD 90K+

Workers Compensation Claims Representative | Remote | NY Licensing Required
Telecommuter NY

Claims coding Social Security Adjudication Interpretive Medical management PC literate Microsoft Office products Utilization Review Subrogation +21

USD 67K+

Business Analytics Senior Advisor - Clinical/Healthcare Analytics - Remote
Connecticut Work at Home

The Cigna Group

Data Research Claims Data Healthcare Analytics Medical management Statistical modeling Actuarial science Analytic Business Analytics Data Mining +48

Senior Mid Full Time

USD 109K+

Bilingual Disability Case Manager
CA-ON-Ontario-Virtual

Alight Solutions

Occupational interventions Disability case management HR communication Absence Management Rehabilitation Medical management Diversity and Inclusion Case Management Assessment +8

Senior Mid Full Time

CAD 40K+

Senior Personal Health Nurse - Remote
United States

Tenet Healthcare

Behavioral Outcomes Milliman care guidelines Healthcare industry expertise Health education Medical management Clinical Documentation Utilization Review Patient Assessment Care Coordination +19

Senior Full Time

USD 72K+

Disability Case Manager
CA-BC-British Columbia-Virtual

Alight Solutions

Disability case management HR communication Occupational interventions Absence Management Rehabilitation Medical management Case Management Assessment Benefits +6

Senior Mid Full Time

CAD 40K+

New York Personal Injury Protection Adjuster - Remote
USA - NY (Remote)

Allstate Remote-first

Task organization Fraud investigations Personal injury Customer Communications Complex claims Investigative Medical management Working independently Medical Billing +26

USD 41K+

Reviewing Medical Director
Remote US

Grievance processes Care facilitation Post-acute services Health claims review Grievance and appeals processes Outpatient services Commercial health insurance Post-acute care Inpatient rehabilitation +93

Exec Senior Full Time

USD 199K+

Medical Director - Southeast Region
Remote US

Health claims review Post-acute services Grievance and appeals processes Outpatient services Social determinants Inpatient rehabilitation Commercial health insurance Post-acute care Coding practices +80

Exec Senior Full Time

USD 199K+

Medicare Provider Contracting Advisor, New York & New Jersey - Cigna Healthcare - Remote
New York Work at Home

The Cigna Group

Value-Based Reimbursement Provider Relationships Contract language Strategic Positioning Provider Contracting Matrix management Clinical Informatics Network management Medical management +30

Senior Mid Full Time

USD 87K+

Claims Examiner - Workers Compensation (Remote) with CA Claims Experience
Telecommuter CA

Vendor Coordination Claims analysis Claims coding Strategic vendor partnerships Social Security Insurance principles Litigation management Cost Containment Adjudication +30

Senior Mid Full Time

USD 75K+

Primary Nurse Case Admin l - UM - TX
Richardson Texas HQ (1001 E. Lookout Drive)

Health Care Service Corporation

Wellness education Coordination of care Milliman guidelines UM Medical Management Policies CM Database experience Condition Management PC Proficiency +29

USD 58K+

Medical Director - Gulf South
Remote US

Health claims review Commercial health insurance Outpatient services Grievance and appeals processes Social determinants Hospitalist Clinical group practice management Clinical reference materials Inpatient rehabilitation +81

Exec Senior Full Time

USD 199K+

Wellbeing Health Advisor
Albuquerque New Mexico HQ (5701 Balloon Fiesta Parkway)

Health Care Service Corporation

Health management Milliman guidelines Medical Management Policies Web-based tools Database experience Condition Management PC Proficiency Medical management Clinical Care +20

USD 58K+

Medical Director - Pharmacy Appeals
Remote US

Medicare rules Commercial health insurance Clinical group practice management CMS policies Humana policies National Guidelines Rules Business Metrics Practice Management +55

Exec Senior Full Time

USD 199K+

Primary Nurse Case Administrator I
Richardson Texas HQ (1001 E. Lookout Drive)

Health Care Service Corporation

Wellness education UM Milliman guidelines Lotus Notes Medical Management Policies CM Coordination of care Database experience Condition Management +31

USD 58K+

Medical Director - Grievances and Appeals
Remote US

Health claims review Rehab Hospitalist Geriatrics Medical background Family practice Medical interpretation Internal Medicine Medical Director +42

Exec Senior Full Time

USD 241K+

Primary Nurse Case Admin l - CM - TX
Richardson Texas HQ (1001 E. Lookout Drive)

Health Care Service Corporation

Wellness education Milliman guidelines UM CM Coordination of care Lotus Notes Medical Management Policies Database experience Condition Management +31

USD 58K+

Case Management Coordinator II (NICU/Infertility/Mother Baby)
Richardson Texas HQ (1001 E. Lookout Drive)

Health Care Service Corporation

CM Medical Management Policies Database experience PC Proficiency Medical management Discharge planning PC Disease Management Clinical Care +22

USD 58K+

Case Management Coordinator II
Richardson Texas HQ (1001 E. Lookout Drive)

Health Care Service Corporation

Medical Management Policies CM Database experience PC Proficiency Discharge planning Medical management Disease Management PC Clinical Care +22

USD 58K+

Medicare Provider Contracting Lead Analyst - Remote - Cigna Healthcare
Connecticut Work at Home

The Cigna Group

Contract language Strategic Positioning Provider Contracting Medical management Credentialing Contracting Consultative Financial Managed Care +23

Senior Mid Full Time

USD 67K+

Claims Examiner - Workers Compensation
Telecommuter NY

Claims coding Strategic vendor partnerships Social Security Insurance principles Cost Containment Litigation management Rehabilitation Adjudication Interpretive +27

Senior Mid Full Time

USD 69K+

Oncology Nurse (RN) Case Management Lead Analyst - Evernorth Health Services - Remote
Pennsylvania Work at Home

The Cigna Group

Oncology Nursing Disease Prevention Shared Decision Making Digital Messaging Health promotion Internet Research Clinical Acumen Behavior Change Medical management +30

Senior Mid Full Time

USD 75K+

RN- Maternity Nurse Case Manager-Remote
Pennsylvania Work at Home

The Cigna Group

Disease Prevention Shared Decision Making Digital Messaging Health promotion Internet Research Behavior Change Clinical Acumen Medical management Cultural Sensitivity +27

USD 75K+

Oncology Nurse (RN) Case Management Lead Analyst -Evernorth Health Services - Remote
Pennsylvania Work at Home

The Cigna Group

Disease Prevention Oncology Nursing Shared Decision Making Digital Messaging Health promotion Telephonic Communication Internet Research Behavior Change Clinical Acumen +31

Senior Mid Full Time

USD 75K+

Short Term Disability (STD)/Absence Claims Manager I
Remote - United States

Disability claims Contract Interpretation Windows applications Plan Design Disability Insurance Medical management Leadership Development Claims management Outlook +17

USD 40K+

RN SNP Nurse Case Management Sr. Analyst - Work from Home, Southeast Region-5
Arizona Work at Home

The Cigna Group

Health advocacy Internet Research Medical management Clinical assessment Clinical Care Conflict Management RN MS Word Clinical knowledge +28

Senior Mid Full Time

USD 68K+

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+

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+

Medicare National Value-Based Partnerships Senior Analyst - Cigna Healthcare - Remote
Tennessee Work at Home

The Cigna Group

Value-based contracting Organizational agility Network Operations Medical management Operational processes Credentialing Agility Contracting Financial +24

Senior Mid Full Time

USD 58K+

RN- Nurse Case Manager-Chronic Kidney Disease- Remote
Pennsylvania Work at Home

The Cigna Group

Shared Decision Making Digital Messaging Health promotion Behavior Change Internet Research Clinical Acumen Medical management Cultural Sensitivity Health Services +27

USD 75K+

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+

LIability Complex Claims Examiner | Commercial Claims Experience | Remote
Telecommuter NJ

Claims coding Liability Claims Strategic vendor partnerships Social Security Insurance principles Liability Cost Containment Litigation management Rehabilitation +30

Senior Mid Full Time

USD 66K+

RN Case Manager- NICU- Remote
Pennsylvania Work at Home

The Cigna Group

Digital Messaging Shared Decision Making Behavior Change Health promotion Internet Research Clinical Acumen Medical management Cultural Sensitivity Health Services +27

USD 75K+

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