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6 fresh jobs found
Appeals and Grievances Clinical Specialist – RN, LPN, or Dental Hygienist - 100% Remote
Remote - NY, United States Healthfirst logo Healthfirst
Clinical Case Development Macess Dental Hygienist Hyland Medicare Guidelines Care Management Systems TruCare Case Resolution CCMS +18
Mid Full Time
USD 71K+
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UM Case Manager - 100% Remote
Remote - NY, United States Healthfirst logo Healthfirst
NYSDOH regulations PT ST OT Notifications CMS regulations Milliman LMSW LMHC +25
Mid Full Time
USD 71K+
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Utilization Review Author (Weekend)
Remote, GA, United States R1 RCM logo R1 RCM
Milliman Evidence-based criteria Case reviews Management experience InterQual Data Abstraction Basic Computer Intelligent Automation Utilization Review +16
Mid Full Time
USD 78K+
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Utilization Review Author
Remote, GA, United States R1 RCM logo R1 RCM
Case reviews Management experience Evidence-based criteria Milliman Data Abstraction InterQual Basic Computer Intelligent Automation Workflow Orchestration +15
Mid Full Time
USD 78K+
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Utilization Management Nurse (Gulf South Region)
Work at Home - Louisiana, United States Humana logo Humana
Milliman Interpreting Criteria Health Plan Experience MCG Clinical Nursing Medical Services Acute care Consumer Experiences Discharge planning +46
Mid Full Time
USD 71K+
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Medical Director (Clinical Chart Validation Team)
Remote, United States Cotiviti logo Cotiviti
Decision support software Chart validation Provider Billing Milliman DRG ICD-9 Coding accuracy MCG InterQual +32
Exec Senior Full Time
USD 190K+
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