Remote Medical Necessity Jobs
Remote from:
Software Development 17838B2B Sales & Account Management 10968CRM & Direct Marketing 10917Product 9303Back-End Development 9223Management and Leadership 8423Data and Analytics 8147finance 8094IT & Engineering 6553Enterprise Sales 6500Project & Program Management 5958Customer Support & Service 5958Sustainability & CSR 5474Sales Leadership & Strategy 5011DevOps & Infrastructure 4737Growth & Performance 3338Front-End Development 2857
89 jobs
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Peer Reviewer - Interventional Cardiology (Contract Remote)
Peer Reviewer - Interventional Cardiology (Contract Remote)
13 day ago
Mountain Pacific
- Remote: Montana (USA)
- Freelance
Cardiology
Peer Reviewer - Diagnostic Radiology (Contract Remote)
Peer Reviewer - Diagnostic Radiology (Contract Remote)
10 day ago
Mountain Pacific
- Remote: Montana (USA)
- Freelance
Evaluation Of CareRadiologyHealthcare QualityMedical Necessity
Peer Reviewer - Physical Medicine & Rehabilitation (Contract Remote)
Peer Reviewer - Physical Medicine & Rehabilitation (Contract Remote)
10 day ago
Mountain Pacific
- Remote: Montana (USA)
- Freelance
Evaluation Of CareHealthcare QualityMedical Necessity
Healthcare Appeals Clinician RN - Remote $10K sign on bonus
Healthcare Appeals Clinician RN - Remote $10K sign on bonus
16 day ago
Conifer Health Solutions
- Remote: Texas (USA)
- Full time
AppealsInterQual CriteriaMedical Necessity
Peer Reviewer (Contract Remote)
Peer Reviewer (Contract Remote)
7 day ago
Mountain Pacific
- Remote: Montana (USA)
- Freelance
Clinical Science Liaison: Medical necessity reviews and Appeals (REMOTE, USA)-MULTIPLE OPENINGS!!!
Clinical Science Liaison: Medical necessity reviews and Appeals (REMOTE, USA)-MULTIPLE OPENINGS!!!
17 day ago
Ambry Genetics
- Remote: California (USA)
- Full time
Genetics TestingMedical NecessityClinical AssessmentsHelp Desk Support
Career Opportunities: Utilization Review Nurse (Remote- Maine RN Only) (30353)
Career Opportunities: Utilization Review Nurse (Remote- Maine RN Only) (30353)
18 day ago
Gainwell Technologies LLC
- Remote: Maine (USA)
- Full time
Utilization ManagementInterQual CriteriaMedical NecessityClinical Documentation
Behavioral Health Utilization Management Review
Behavioral Health Utilization Management Review
13 day ago
AmeriHealth Caritas
- Remote: Pennsylvania (USA)
- Full time
Utilization ManagementBehavioral HealthClinical AssessmentsMedical Necessity
RN Appeals Analyst
RN Appeals Analyst
19 day ago
BlueCross BlueShield of South Carolina
- Remote: Tennessee (USA)
- Full time
Clinical Data AnalysisUtilization ManagementManaged CareMedical Necessity
Emergency Medicine Telecommute Medical Review Stream Physician
Emergency Medicine Telecommute Medical Review Stream Physician
13 day ago
Concentra
- Remote: Texas (USA)
- Full time
Utilization ManagementClinical AssessmentsMedical Licensing (Health Law)
PB Diagnostic Coder (Coding Specialist lll)
PB Diagnostic Coder (Coding Specialist lll)
30 day ago
Oregon Health & Science University
- Remote: Oregon (USA)
- Full time
ICD 503CppunitClinical Documentation
Quality Improvement Coordinator - Behavioral Health
Quality Improvement Coordinator - Behavioral Health
25 day ago
Centene Corporation
- Remote: Washington (USA)
- Full time
Behavioral HealthClinical NursingQuality AssessmentTotal Quality Management
UM Coordinator - LHB
UM Coordinator - LHB
12 day ago
Health Care Service Corporation
- Remote: Illinois (USA), Indiana (USA), Iowa (USA), Kansas (USA), Missouri (USA), Montana (USA), New Mexico (USA), North Carolina (USA), Oklahoma (USA), Pennsylvania (USA), Texas (USA), Wisconsin (USA)
- Full time
Utilization ManagementClinical NursingMedical ManagementCare Management
Utilization Review Nurse
Utilization Review Nurse
30+ days ago
Sidecar Health
- Remote: Florida (USA), Georgia (USA), Kentucky (USA), Ohio (USA)
- Full time
Utilization ManagementMedical GuidelineNursingMedical Necessity
Peer Reviewer - Surgeon (Contract Remote)
Peer Reviewer - Surgeon (Contract Remote)
24 day ago
Mountain Pacific
- Remote: Montana (USA)
- Freelance
Evaluation Of CareGeneral SurgeryHealthcare QualityMedical Necessity
Physician Reviewer - Orthopedic Spine Surgery (Utilization Review)
Physician Reviewer - Orthopedic Spine Surgery (Utilization Review)
2 day ago
Dane Street, LLC
- Remote: New York (USA)
- Fixed term
Utilization ManagementWorkers' Compensation ClaimsMedical NecessityOrthopedics
Field Reimbursement Manager
Field Reimbursement Manager
30+ days ago
McKesson Canada
- Remote: Iowa (USA)
- Full time
Reimbursement RegulationsPresentation TrainingProject Management
Physician Reviewer - Orthopedic Spine Surgery (Utilization Review)
Physician Reviewer - Orthopedic Spine Surgery (Utilization Review)
6 day ago
Dane Street, LLC
- Remote: New York (USA)
- Freelance
Utilization ManagementWorkers' Compensation ClaimsMedical NecessityOrthopedics
Board Certified OB/GYN-Obstetrics and Gynecology Physician Advisor, Disability
Board Certified OB/GYN-Obstetrics and Gynecology Physician Advisor, Disability
11 day ago
Dane Street, LLC
- Remote: California (USA)
- Freelance
Obstetrics And GynaecologyObstetrics And GynaecologyMedical Necessity
Behavioral Health Utilization Management Review
Behavioral Health Utilization Management Review
10 day ago
AmeriHealth Caritas
- Remote: Pennsylvania (USA)
- Full time
Utilization ManagementBehavioral HealthClinical AssessmentsMedical Necessity
Orthopedic Surgery - Spine Surgeon - NV
Orthopedic Surgery - Spine Surgeon - NV
19 day ago
Dane Street, LLC
- Remote: Nevada (USA)
- Fixed term
Medical NecessityClinical Consulting
Spine Telecommute Medical Review Stream
Spine Telecommute Medical Review Stream
13 day ago
Concentra
- Remote: California (USA)
- Full time
Utilization ManagementClinical AssessmentsMedical Licensing (Health Law)
Field Reimbursement Manager
Field Reimbursement Manager
30+ days ago
CoverMyMeds
- Remote: Iowa (USA)
- Full time
Reimbursement RegulationsPresentation TrainingProject Management
Dentist Telecommute Medical Review Stream
Dentist Telecommute Medical Review Stream
13 day ago
Concentra
- Remote: New Jersey (USA)
- Full time
Utilization ManagementClinical Assessments
New Mexico-Licensed Physician Reviewers (M.D., D.O.)-Multiple Specialties
New Mexico-Licensed Physician Reviewers (M.D., D.O.)-Multiple Specialties
19 day ago
Dane Street, LLC
- Remote: New Mexico (USA)
- Freelance
Insurance Follow-UpMedical NecessityClinical Consulting
Clinical Appeal Nurse - Remote $10K Sign on Bonus
Clinical Appeal Nurse - Remote $10K Sign on Bonus
16 day ago
Conifer Health Solutions
- Remote: Texas (USA)
- Full time
InterQual CriteriaMedical Necessity
Peer Reviewer - Nephrologist (Contract Remote)
Peer Reviewer - Nephrologist (Contract Remote)
25 day ago
Mountain Pacific
- Remote: Montana (USA)
- Freelance
Nephrology
LPN – Utilization Management (Shift Care Team)
LPN – Utilization Management (Shift Care Team)
28 day ago
The CKHobbie Group
- Remote: Pennsylvania (USA)
- Full time
Care CoordinationUtilization ManagementPediatric NursingCompliance Management
PM&R Telecommute Medical Review Stream
PM&R Telecommute Medical Review Stream
13 day ago
Concentra
- Remote: Texas (USA)
- Full time
Utilization ManagementClinical AssessmentsMedical Licensing (Health Law)
Physician Reviewer - (Ophthalmology, Otolaryngology, OB/GYN)
Physician Reviewer - (Ophthalmology, Otolaryngology, OB/GYN)
19 day ago
Dane Street, LLC
- Remote: North Carolina (USA)
- Freelance
Insurance ReviewsMedical NecessityClinical Consulting
Revenue Integrity Coding Specialist, REMOTE, Revenue Integrity Management, FT, 08A-4:30P
Revenue Integrity Coding Specialist, REMOTE, Revenue Integrity Management, FT, 08A-4:30P
30+ days ago
Baptist Health
- Remote: Florida (USA)
- Full time
ICD 503Cppunit
Prior Authorization Medical Clinician
Prior Authorization Medical Clinician
19 day ago
WellSense Health Plan
- Remote: Massachusetts (USA)
- Full time
Utilization ManagementClinical AssessmentsMedical Necessity
Physician Reviewer, Neurological Surgery - NV
Physician Reviewer, Neurological Surgery - NV
19 day ago
Dane Street, LLC
- Remote: Nevada (USA)
- Fixed term
Utilization ManagementAdvisory CircularMedical NecessityClinical Consulting
Clinical Review Clinician - Appeals
Clinical Review Clinician - Appeals
3 day ago
Centene Corporation
- Remote: United States
- Full time
Clinical Data AnalysisAppealsNurse Licensure CompactMedical Necessity
Revenue Integrity Coding Specialist, REMOTE, Revenue Integrity Management, FT, 08A-4:30P
Revenue Integrity Coding Specialist, REMOTE, Revenue Integrity Management, FT, 08A-4:30P
30+ days ago
Baptist Health
- Remote: Florida (USA)
- Full time
ICD 503Cppunit
RN Clinical Review Clinician - Appeals
RN Clinical Review Clinician - Appeals
17 day ago
Centene Corporation
- Remote: United States
- Full time
Utilization ManagementNurse Licensure Compact
Board Certified Behavior Analyst (BCBA)/Behavioral Health Utilization Management- Remote in VA!
Board Certified Behavior Analyst (BCBA)/Behavioral Health Utilization Management- Remote in VA!
12 day ago
Sentara Healthcare
- Remote: United States
- Full time
Clinical AssessmentsApplied Behavior Analysis
Concurrent Utilization Review Nurse (Work from Home)
Concurrent Utilization Review Nurse (Work from Home)
24 day ago
Bright Health
- Remote: California (USA)
- Full time
Utilization ManagementMedical GuidelineElectronic Health Record ApplicationsMedical Necessity
Clinical Review Coordinator
Clinical Review Coordinator
30+ days ago
Soleo Health
- Remote: California (USA)
- Full time
Clinical Data AnalysisInfusionsPrior AuthorizationMedical Necessity
Corporate Medical Director - Medicare Grievances and Appeals (32-Hours)
Corporate Medical Director - Medicare Grievances and Appeals (32-Hours)
11 day ago
Humana
- Remote: United States
- Full time
Clinical AssessmentsMedical Necessity
Concurrent Utilization Review Nurse (Work from Home)
Concurrent Utilization Review Nurse (Work from Home)
24 day ago
NeueHealth
- Remote: California (USA)
- Full time
Utilization ManagementMedical Guideline
Clinic Coder - Clinic Coding Services - FT - Day
Clinic Coder - Clinic Coding Services - FT - Day
13 day ago
Stormont Vail Health
- Remote: United States
- Full time
ICD 503CPT CodingElectronic Medical Record
Virtual Utilization Review Specialist - PART TIME WEEKENDS
Virtual Utilization Review Specialist - PART TIME WEEKENDS
20 day ago
Ensemble Health Partners
- Remote: United States
- Part time
Utilization ManagementClinical AssessmentsMedical Necessity
Senior Medical Director, Behavioral Health - New Mexico
Senior Medical Director, Behavioral Health - New Mexico
30+ days ago
Magellan Health
- Remote: United States
- Full time
- Senior (5-10 years)
- 222 - 422K
Board Certified Toxicology Physician Advisor, Disability Peer Review
Board Certified Toxicology Physician Advisor, Disability Peer Review
10 day ago
Dane Street, LLC
- Remote: United States
- Freelance
ToxicologyClinical Assessments
Nurse Reviewer - REMOTE
Nurse Reviewer - REMOTE
30+ days ago
UMass Chan Medical School
- Remote: Massachusetts (USA)
- Full time
Clinical Data AnalysisCare ManagementPrior AuthorizationMedical Necessity
RN Reviewer 
RN Reviewer
30+ days ago
Cohere Health
- Remote: United States
- Mid-level (2-5 years)
- 28 - 28K
Utilization ManagementNursing
Pharmacy Prior Authorization Technician
Pharmacy Prior Authorization Technician
3 day ago
ICONMA
- Remote: United States
- Full time
Drug Utilization ReviewPrior AuthorizationMedical Necessity
Utilization Review Nurse(Austin/Richardson TX) (Remote)
Utilization Review Nurse(Austin/Richardson TX) (Remote)
28 day ago
Bracane Company, Inc.
- Remote: Texas (USA)
- Full time
Care CoordinationUtilization ManagementClinical AssessmentsMedical Necessity
REMOTE Registered Nurse - Medical Review Specialist-Bexar County, Texas
REMOTE Registered Nurse - Medical Review Specialist-Bexar County, Texas
30+ days ago
Avosys Technology, Inc.
- Remote: United States, Texas (USA)
- Freelance
- Mid-level (2-5 years)
Internal Documentation
