The Medical Case Manager provides in-person and telephonic case management to injured workers, involving various stakeholders like physicians and employers, utilizing nursing knowledge to discuss and evaluate treatment plans for appropriateness and cost-effectiveness. Responsibilities also include attending provider visits, discharge planning conferences, conducting home visits, and negotiating the delivery of necessary medical equipment and services.
Remote Healthcare Jobs in United States (10,032)
Remote in = United States
Job category = Healthcare
The Medical Case Manager provides in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing, planning, implementing, and evaluating patient progress while ensuring treatment plans are appropriate, medically necessary, and cost-effective.
The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals, aiming to support quality treatment and timely return to work. This involves assessing treatment plan appropriateness, communicating with physicians, and explaining conditions and plans to patients, families, and adjusters.
Bilingual Telephonic Case Manager I
CorVel Corporation
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Full Time
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12 Weeks Ago
CorVel Corporation
The Bilingual Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals, aiming to support quality treatment and timely return to work. This involves assessing treatment plan appropriateness, communicating with physicians, and explaining medical conditions to various stakeholders.
The Medical Case Manager provides in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing treatment plans for appropriateness and medical necessity, attending provider visits, and developing long-term care strategies.
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The Medical Case Manager will provide in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing treatment plans for appropriateness and necessity, attending various provider and facility visits, and conducting home evaluations.
The Itemization Review Nurse analyzes charges on a UBIB submitted by a medical facility by collecting supporting data to determine the accuracy of billed charges. This role requires appropriate documentation of work and final conclusions in the designated computer program.
The Medical Case Manager facilitates recovery for injured workers by providing in-person and telephonic case management, collaborating closely with patients, providers, and employers. Responsibilities include assessing treatment plans for appropriateness and medical necessity, attending provider visits, and implementing necessary care like negotiating equipment delivery.
The Professional Review Nurse analyzes medical services to determine the appropriateness of charges on medical bills and reviews medical reports to assess the quality of medical care provided. Key duties involve identifying review necessity, collecting and analyzing data, and using clinical expertise to detect inappropriate billing practices and errors.
The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals, aiming to support quality treatment and timely return to work. Responsibilities include providing medical case management, assessing treatment plan appropriateness, and communicating recommendations to physicians and payers.
The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals, aiming to support quality treatment and timely return to work. This involves assessing treatment plan appropriateness using clinical expertise and communicating directly with treating physicians to evaluate and recommend alternative care options.
The Market Physician Executive leads the in-home multi-specialty care model, overseeing clinical strategies, policies, and daily operations, including direct patient care and supervision of clinical and operations teams. A primary focus is delivering exceptional outcomes through disease detection, evidence-based clinical pathways, and managing total cost of care and quality improvement metrics.
The Medical Case Manager will provide in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing, planning, implementing, and evaluating patient progress while ensuring treatment plans are appropriate, medically necessary, and cost-effective.
The Scheduling Coordinator is responsible for participating in the daily operations and maintenance of the Medical Scheduling Departments, primarily by facilitating and scheduling medical services for claimants. Essential functions include proactively monitoring and managing files, identifying potential problems, proposing solutions to ensure no delay in care, and providing telephonic and written customer support.
The Scheduling Coordinator is responsible for participating in the daily operations and maintenance of the Medical Scheduling Departments, primarily by facilitating and scheduling medical services for claimants. Essential functions include proactively monitoring and managing files using proprietary web-based applications and providing telephonic and written customer support services.
The Medical Case Manager will provide in-person and telephonic case management, working closely with injured workers, physicians, and providers to facilitate recovery. Responsibilities include assessing, planning, implementing, and evaluating patient progress, ensuring treatment plans are appropriate, medically necessary, and cost-effective.
The Clinical Adherence Nurse will conduct patient outreach and engagement primarily through video messaging and consultations to enroll patients in a medication adherence program. Key duties involve providing personalized clinical support, motivational coaching, medication reconciliation, and monitoring adherence through video-based interactions.
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The Medical Case Manager will provide in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing treatment plans for appropriateness and medical necessity, attending provider visits, and coordinating necessary care like durable medical equipment.
The specialist will manage prior authorization requests and appeals with insurance carriers to ensure patients receive necessary medications. This involves receiving prescriptions, rectifying rejected claims, and conducting third-party authorization requests.
The Quality Nurse ensures the organization provides quality patient care by leveraging relationships across teams, patients, and providers, participating in clinical and quality management activities like audits and medical record reviews. Major duties include performing chart audits, interacting with patients for counseling, tracking quality results for continuous improvement, and collaborating with the Director on auditing processes and training.
The Clinical Supervisor provides clinical supervision and oversight to limited-license clinical staff, ensuring compliance with state and Medicaid guidelines, and is responsible for reviewing and signing off on case notes, treatment plans, and documentation.
The professional will support the Director of Health and Safety in managing and enhancing the Environmental, Health, and Safety (EHS) program for the West Business Unit, focusing on subcontractor oversight and ensuring regulatory compliance. Key duties include project leadership, conducting H&S prequalification of subcontractors, assisting client service teams, and developing/reviewing H&S plans.
Full-Time Clinical Director (CORE Program)
Georgia Families in Transition
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Full Time
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12 Weeks Ago
Georgia Families in Transition
The Clinical Director provides remote clinical oversight, supervision, and after-hours crisis support for the CORE Program to ensure high-quality, compliant behavioral health services. This role involves guiding therapists, strengthening guardian engagement, and promoting client stability and retention.
The Registered Nurse Care Manager provides member-centric case management services including assessment, planning, coordination, evaluation, and advocacy across the healthcare continuum. Responsibilities involve screening candidates, developing care plans with goals, reviewing tests, providing education, and facilitating coordination among providers to ensure quality, cost-effective outcomes.
The Associate Medical Director supports the CMO by overseeing the administration of procedures, protocols, and standards to ensure the efficiency and quality of healthcare delivered to Network Health members, including chairing quality and accreditation committees. Key duties involve assisting with monitoring care appropriateness, participating in utilization management decisions, contributing to quality guideline development, and providing medical consultation on various complex issues.
Chief Medical Officer, Lupus Therapeutics LLC
Lupus Research Alliance Inc.
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Full Time
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12 Weeks Ago
Lupus Research Alliance Inc.
The Chief Medical Officer provides leadership on all clinical research and care initiatives for people with lupus, overseeing business operations to support clinical development programs and advisory activities leveraging the Lupus Clinical Investigators Network (LuCIN). This role involves generating new business opportunities, representing the organization as a clinical expert, and communicating program outcomes to various constituents.
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TELEHEALTH MENTAL HEALTH PROFESSIONAL
Nocturnal Enterprises LLC
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Full Time
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12 Weeks Ago
Nocturnal Enterprises LLC
The professional will conduct remote evaluations to diagnose patients using DSM-5 criteria and issue prescription letters for Emotional Support Animals (ESAs) and Psychiatric Service Animals (PSAs) in compliance with state and federal laws. Key duties include maintaining accurate HIPAA-compliant records and providing ethical, patient-centered care via telehealth.
Director, Study Physician (U.S. Remote)
Adagene Incorporated
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Full Time
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12 Weeks Ago
Adagene Incorporated
The Study Physician provides medical expertise and oversight for the entire clinical trial lifecycle, focusing on medical monitoring and assessing drug-induced safety findings in light of patient safety. Key functions include supervising external contract organizations, ensuring project plans align with SOPs and regulations, and leading sponsor study processes like kick-off meetings and TMF setup.
This role involves formulating and implementing management policies and operational practices to enhance organizational efficiency, while also leading major assignments impacting the organization's operations. The analyst will provide expert consultation to management and be actively involved in strategic planning and resolving significant operational issues.
Part Time Physician - Virtual Urgent Care
Curative HR LLC
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Full Time
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12 Weeks Ago
Curative HR LLC
The Staff Physician will provide high-quality, evidence-based care to members via telehealth by independently assessing, diagnosing, and treating acute conditions using an advanced AI-assisted clinical framework. Responsibilities also include providing clinical feedback to refine workflows and collaborating to ensure seamless member transitions into other health plan programs.
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