Investigate and process medical necessity appeals requests from members and providers. Prepare recommendations to uphold or deny appeals and ensure resolution within regulatory timeframes.
Remote Healthcare Jobs in United States (10,099)
Remote in = United States
Job category = Healthcare
Pharmacy Technician Representative - Work From Home
Health Care Service Corporation
·
Full Time
·
4 Days Ago
Health Care Service Corporation
Provide assistance to pharmacists and pharmacy coordinators to resolve pharmacy issues and support member programs. Coordinate with internal departments and external vendors to ensure effective member support.
Emergency Medical Services (EMS) Outreach & Partnership Coordinator
Logan Health
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Full Time
·
4 Days Ago
Logan Health
Develop and implement strategic initiatives to expand air and ground ambulance services through proactive outreach and partnership building. Collaborate with internal quality teams and represent EMS programs at community events to improve regional access to emergency care.
RN Utilization Management
Arkansas Blue Cross Blue Shield
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Full Time
·
4 Days Ago
Arkansas Blue Cross Blue Shield
Performs clinical reviews of prior approvals and medical necessity for inpatient and outpatient services using evidence-based criteria. Collaborates with healthcare providers to ensure cost-effective, high-quality care and compliance with regulatory standards.
Bilingual (Spanish) Advanced Practice Provider (NP or PA): Cardiology
Devoted Health
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Full Time
·
4 Days Ago
Devoted Health
Deliver virtual primary cardiology and heart failure care to seniors, focusing on GDMT optimization and volume management. Collaborate with an interdisciplinary team to conduct assessments, order diagnostics, and develop individualized treatment plans.
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Perform intake of calls from members and providers to screen requests for medical services and approve non-medical services based on benefit plans. Conduct non-medical research including eligibility and benefits verification while maintaining accurate documentation.
Remote Psychiatric Nurse Practitioner - Fee For Service
Thriveworks
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Full Time
·
4 Days Ago
Thriveworks
Perform psychiatric assessments and evaluations for clients aged 14 and up via telemedicine. Prescribe medications and collaborate with clients to create and implement comprehensive care plans.
Part Time Remote Psychiatric Nurse Practitioner - Fee For Service
Thriveworks
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Full Time
·
4 Days Ago
Thriveworks
Perform psychiatric assessments and evaluations for clients aged 14 and up via telemedicine. Prescribe medications and collaborate with clients to create and implement comprehensive care plans.
Field Service Technician – Industrial Bandsaws - Remote PA
Stanley Black & Decker, Inc.
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Full Time
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4 Days Ago
Stanley Black & Decker, Inc.
The role involves troubleshooting, repairing, and calibrating industrial bandsaws and welding equipment for end-users and distributors. Additionally, the technician coordinates with account managers to manage territories and provide cost-effective product recommendations to improve sawing operations.
Licensed Therapist (LCSW, LPCC, LMFT) - Remote 1099 Contract, $75-$90/Session
Daybreak Health
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Full Time
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4 Days Ago
Daybreak Health
Provide evidence-based individual teletherapy to youth ages 11-24 experiencing mild-to-moderate mental health conditions. Collaborate with schools, families, and community partners to provide psychoeducation and support student success.
The Itemization Review Nurse analyzes medical facility charges on UBIB submissions to ensure billing accuracy. They document final conclusions in designated software and provide summaries of billed items.
Oversees daily care coordination operations for the Orlando market, combining hands-on coordination with team leadership and mentoring. Acts as the primary clinical liaison between providers, external home health agencies, and central operations.
(RN) Care Review Clinician - Weekend Role (REMOTE)
Molina Healthcare
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Full Time
·
4 Days Ago
Molina Healthcare
Responsible for verifying that clinical services are medically necessary and align with established guidelines and insurance policies. The role involves analyzing service requests, processing prior authorizations, and collaborating with multidisciplinary teams to ensure cost-effective member care.
Medical Science Liaison / Senior Medical Science Liaison - Southwest
Sobi
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Full Time
·
4 Days Ago
Sobi
The MSL serves as a field-based scientific expert engaging with healthcare professionals to exchange clinical and research knowledge. They provide educational and research support for the immunology franchise and report field intelligence to the company.
Proactively source and recruit clinical talent using various channels including cold calling, job boards, and social media. Manage the ATS, conduct candidate screenings, and collaborate with hiring managers to build a strong pipeline of clinicians.
Conduct virtual biopsychosocial assessments and establish treatment needs for clients across various age groups. Coordinate with multidisciplinary teams and referral sources to facilitate intake into the virtual intensive outpatient program.
Conduct virtual biopsychosocial assessments and establish treatment needs for clients across various age groups. Coordinate with multidisciplinary teams and referral sources to facilitate intake into the virtual intensive outpatient program.
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The Clinical Admissions Therapist conducts virtual biopsychosocial assessments to determine the appropriateness of clients for the intensive outpatient program. They are responsible for establishing treatment needs, constructing provisional diagnoses, and coordinating with multidisciplinary teams to facilitate intake.
Conduct virtual biopsychosocial assessments and determine the appropriateness of clients for the intensive outpatient program. Coordinate with multidisciplinary teams and referral sources to facilitate seamless intake and admission processes.
Conduct virtual biopsychosocial assessments and establish treatment needs for clients across various age groups. Coordinate with multidisciplinary teams and referral sources to facilitate intake into the virtual intensive outpatient program.
Conduct virtual biopsychosocial assessments and establish treatment needs for clients across various age groups. Coordinate with multidisciplinary teams and referral sources to facilitate intake into the virtual intensive outpatient program.
Conduct virtual biopsychosocial assessments and establish treatment needs for clients across various age groups. Coordinate with multidisciplinary teams and referral sources to facilitate intake into the virtual intensive outpatient program.
Conduct virtual biopsychosocial assessments and establish treatment needs for clients across various age groups. Coordinate with multidisciplinary teams and referral sources to facilitate intake into the virtual intensive outpatient program.
Conduct virtual biopsychosocial assessments and establish treatment needs for clients across various age groups. Coordinate with multidisciplinary teams and referral sources to facilitate intake into the virtual intensive outpatient program.
Conduct virtual biopsychosocial assessments and establish treatment needs for clients across various age groups. Coordinate with multidisciplinary teams and referral sources to facilitate intake into the virtual intensive outpatient program.
Conduct virtual biopsychosocial assessments and establish treatment needs for clients across various age groups. Coordinate with multidisciplinary teams and referral sources to facilitate intake into the virtual intensive outpatient program.
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The Clinical Admissions Therapist conducts virtual biopsychosocial assessments to determine the appropriateness of clients for the intensive outpatient program. They are responsible for establishing provisional diagnoses and coordinating with multidisciplinary teams to facilitate intake.
Manage end-to-end state licensing, renewals, and registrations for multi-state mental health providers. Act as the primary liaison to state licensing boards and maintain expertise in state-specific laws and regulations.
Participate in and co-facilitate group, individual, and family therapy sessions for high-acuity clients under clinical supervision. Collaborate with an interdisciplinary care team to provide coordinated, virtual behavioral health treatment.
Manage a group of clinicians by providing supervision, training, and auditing to ensure best practices in behavioral health. Maintain a clinical caseload and facilitate weekly group treatment sessions while assisting the Clinical Director with scheduling and curriculum.
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Healthcare Jobs in Other Countries
Remote Healthcare Jobs in Canada
461
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244
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122
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120
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107
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97
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82
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62
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60
Remote Healthcare Jobs in Georgia
59
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58
Remote Healthcare Jobs in Philippines
58
Remote Healthcare Jobs in Brazil
51
Remote Healthcare Jobs in Italy
49
Remote Healthcare Jobs in Argentina
46
Other Categories in United States
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31904
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23816
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22777
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6461
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5382
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4863
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3343
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2691
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2326
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1889
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1618
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1118
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1072
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632
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