Remote Medical Necessity Jobs
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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
81 jobs
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Care Manager
Care Manager
17 day ago
Lucet (formerly New Directions + Tridiuum)
- Remote: United States
- Full time
Care CoordinationEducational AssessmentClinical Social WorkInternal DocumentationBehavioral HealthCrisis Prevention
Patient Access Case Manager
Patient Access Case Manager
22 day ago
Boston Scientific
- Remote: United States
- Full time
AppealsPrior AuthorizationMedical NecessityPain ManagementMedical Record ManagementSoftware Systems
Physician Reviewer, Utilization Management
Physician Reviewer, Utilization Management
30+ days ago
Oscar Health
- Remote: United States
- Junior (1-2 years)
- 211 - 277K
Evidence-Based PracticeClinical AssessmentsMedical NecessityUtilization ManagementManaged CareClinical Practices
Nurse Inpatient Coding Auditor, CIC or CCS certified
Nurse Inpatient Coding Auditor, CIC or CCS certified
30+ days ago
ProgenyHealth, LLC
- Remote: United States, Texas (USA)
- Mid-level (2-5 years)
- 19 - 19K
ICD Coding (ICD-9/ICD-10)Medical NecessityInpatient CodingHuman Interface GuidelinesNursingCppunit
Clinical Reviewer - LPN
Clinical Reviewer - LPN
30+ days ago
TriWest Healthcare Alliance
- Remote: United States, Azerbaijan, Arizona (USA)
- Senior (5-10 years)
- 58 - 74K
Managed CareClinical NursingMedical NecessityUtilization ManagementMedical GuidelineClinic Management Systems
PB Coder (Coding Specialist ll)
PB Coder (Coding Specialist ll)
30+ days ago
Oregon Health & Science University
- Remote: United States, Oregon (USA)
- 61 - 82K
ICD Coding (ICD-9/ICD-10)CPT CodingMedflow EMR3M EncoderMedical NecessityMedical Record Management
Virtual Utilization Review Specialist - PART TIME WEEKENDS
Virtual Utilization Review Specialist - PART TIME WEEKENDS
24 day ago
Ensemble Health Partners
- Remote: United States
- Part time
Care CoordinationUtilization ManagementClinical AssessmentsMedical NecessityClinical Quality ManagementNurse Licensure Compact
Board Certified -Texas Licensed Physicians (M.D, D.O.) - Multiple Specialties
Board Certified -Texas Licensed Physicians (M.D, D.O.) - Multiple Specialties
30+ days ago
Dane Street, LLC
- Remote: United States
Clinical ConsultingInsurance ReviewsMedical NecessityEvidence-Based PracticeMedical Licensing (Health Law)Credential Manager
Senior Coding Quality Specialist
Senior Coding Quality Specialist
15 day ago
CorroHealth
- Remote: United States
- Full time
Coding TheoryAuditingInpatient CodingMedical NecessityBillingHuman Interface Guidelines
CRT Claims Examiner
CRT Claims Examiner
30+ days ago
Integra Partners
- Remote: United States, Michigan (USA)
- Full time
- Senior (5-10 years)
- 70 - 70K
Claims And Litigation ManagementRevenue ManagementMedical NecessityBillingBillingPrior Authorization
Associate Medical Director, Diagnostic Imaging
Associate Medical Director, Diagnostic Imaging
30+ days ago
Lifelancer
- Remote: United States
- Full time
- Junior (1-2 years)
Evidence-Based PracticeMedical ImagingRadiologyPeer-To-PeerMedical NecessityClinical Practices
Pre-Service Utilization Management LVN
Pre-Service Utilization Management LVN
10 day ago
CommonSpirit Health
- Remote: United States
- Full time
Utilization ManagementClinical InformaticsMedical NecessityICD 503Benefits AdministrationMedical Abbreviations
Virtual Utilization Review Specialist
Virtual Utilization Review Specialist
15 day ago
Ensemble Health Partners
- Remote: United States
- Full time
Utilization ManagementClinical AssessmentsMedical NecessityResource ManagementRegulatory ComplianceBasic Patient Care
LPN/LVN Utilization Management Reviewer
LPN/LVN Utilization Management Reviewer
30+ days ago
DCX PH Inc.
- Remote: United States
- Full time
- Mid-level (2-5 years)
Medical NecessityUtilization ManagementService ReviewClinical DocumentationInterQual CriteriaEvaluation Of Care
Appeals Analyst (RN)
Appeals Analyst (RN)
Today
BlueCross BlueShield of South Carolina
- Remote: United States
- Full time
Clinical Data AnalysisMedical NecessityHome Health CareOnline CommunicationRehabilitationHealthcare Delivery Models
Care Manager
Care Manager
17 day ago
Lucet (formerly New Directions + Tridiuum)
- Remote: United States
- Full time
Care CoordinationEducational AssessmentClinical Social WorkInternal DocumentationBehavioral HealthCrisis Prevention
Clinical Reviewer - LPN
Clinical Reviewer - LPN
30+ days ago
TriWest Healthcare Alliance
- Remote: United States, Azerbaijan, Arizona (USA)
- Senior (5-10 years)
- 58 - 74K
Managed CareClinical NursingMedical NecessityUtilization ManagementClinic Management SystemsInterQual Criteria
Medical Director – Inpatient Utilization Management
Medical Director – Inpatient Utilization Management
30+ days ago
Wellmark Blue Cross and Blue Shield
- Remote: United States, Iowa (USA)
- Mid-level (2-5 years)
Evidence-Based PracticeInpatient CareMedical NecessityChange ManagementMedical Licensing (Health Law)Medical Practice Experience
IN PATIENT Coder/Abstractor (Remote)
IN PATIENT Coder/Abstractor (Remote)
30+ days ago
Sentara Healthcare
- Remote: United States
- Full time
- Mid-level (2-5 years)
- 47 - 68K
CPT CodingEncoder ProDemographic AnalysisInpatient CodingICD 503Medical Necessity
Physician Advisor, Utilization Review Management
Physician Advisor, Utilization Review Management
15 day ago
Sutter Health
- Remote: United States
- Full time
Utilization ManagementHealthcare Delivery ModelsCare ManagementClinical DocumentationHealth Reimbursement ArrangementMedical Necessity
Board Certified-Texas Licensed Physician Reviewer-Multiple Specialties
Board Certified-Texas Licensed Physician Reviewer-Multiple Specialties
30+ days ago
Dane Street, LLC
- Remote: United States, Texas (USA)
- Full time
Medical Licensing (Health Law)Medical NecessityUtilization Management
Connecticut-Licensed Physician Reviewers (M.D., D.O.)-Multiple Specialties
Connecticut-Licensed Physician Reviewers (M.D., D.O.)-Multiple Specialties
30+ days ago
Dane Street, LLC
- Remote: United States
- Fixed term
Medical NecessityUtilization ManagementClinical AssessmentsCare Management
Board Certified NC - Licensed Physician Reviewers - Multiple Specialties
Board Certified NC - Licensed Physician Reviewers - Multiple Specialties
30+ days ago
Dane Street, LLC
- Remote: United States, North Carolina (USA)
Medical Licensing (Health Law)Medical NecessityUtilization ManagementOrthopedics
Board Certified-Colorado Licensed Physician Reviewers-Multiple Specialties
Board Certified-Colorado Licensed Physician Reviewers-Multiple Specialties
30+ days ago
Dane Street, LLC
- Remote: United States
- Full time
Medical NecessityUtilization ManagementGovernment Contracting
Weekend RN Reviewer 
Weekend RN Reviewer
30+ days ago
Cohere Health
- Remote: United States
- Mid-level (2-5 years)
- 28 - 28K
Clinical MedicineUtilization ManagementNursingMedical NecessityInternal DocumentationMedical Practice Experience
Utilization Review Specialist
Utilization Review Specialist
30+ days ago
Assembly Health
- Remote: United States
- Full time
Utilization ManagementBehavioral HealthHospital ExperienceAnalyticsMedical NecessityBilling
PTA - Utilization Management Reviewer
PTA - Utilization Management Reviewer
30+ days ago
DCX PH Inc.
- Remote: United States
- Full time
- Mid-level (2-5 years)
Medical NecessityInterQual CriteriaService ReviewClinical DocumentationCare Management SoftwareUtilization Management
HIM PB Coding Specialist 2
HIM PB Coding Specialist 2
30+ days ago
St. Charles Health System
- Remote: United States
- Full time
ICD 503CppunitHuman Interface GuidelinesHealth Information ManagementEncoder ProMedical Necessity
Remote Marketplace Medical Director
Remote Marketplace Medical Director
30+ days ago
Centene Corporation
- Remote: United States
- Full time
Clinical GovernanceUtilization ManagementClinical AssessmentsQuality AssessmentCare CoordinationMedical Necessity
Denials Management Specialist (RN required), Per Diem. Remote within local geography.
Denials Management Specialist (RN required), Per Diem. Remote within local geography.
30+ days ago
St. Luke's University Health Network
- Remote: United States, Pennsylvania (USA)
- Freelance
- Mid-level (2-5 years)
AppealsClinical NursingCommercial InsurancesMedical NecessityUtilization ManagementCare Management
Board Certified-New York Licensed Physician Reviewers-Multiple Specialties
Board Certified-New York Licensed Physician Reviewers-Multiple Specialties
30+ days ago
Dane Street, LLC
- Remote: United States, New York (USA)
- Full time
Utilization ManagementMedical NecessityNeurologyNeurosurgeryOrthopedics
