Provide clinical leadership and oversight for post-acute utilization management across home health, SNF, and DME. Drive strategic initiatives to optimize site-of-care, improve quality, and reduce the cost of care for Medicare Advantage members.
Remote Healthcare Jobs in United States (10,101)
Remote in = United States
Job category = Healthcare
Act as the primary point of contact for the Home Health division, handling high-volume inquiries from nurses and care centers via phone and email. Responsibilities include coordinating scheduling needs, resolving payroll inquiries, and documenting cases in Salesforce.
Lead the end-to-end design and execution of accredited continuing medical education for optometrists and ophthalmologists. This includes conducting needs assessments, developing curricula, managing clinical faculty, and measuring educational outcomes.
Principal, Scientific & Medical Affairs
Pattern Bioscience
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Full Time
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1 Week Ago
Pattern Bioscience
Support external clinical studies by managing site selection, initiation, and routine monitoring for diagnostic assays. Act as a liaison between clinical sites and internal teams to ensure studies are conducted according to GCP and company SOPs.
Associate Director / Director, Medical Science Liaison – Women’s Health
BESTMSLs
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Full Time
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1 Week Ago
BESTMSLs
The role focuses on engaging key opinion leaders and healthcare providers in the Women's Health therapeutic area to drive scientific exchange and insight generation. The individual will translate complex clinical data into actionable strategies and support the development of non-promotional medical education materials.
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Speciality Client Partner - Healthcare Payer/Provider (Remote - Eastern/Central Region US
NTT DATA Americas, Inc.
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Full Time
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1 Week Ago
NTT DATA Americas, Inc.
Senior Director, Provider Contracting - Evernorth Health Services
The Cigna Group
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Full Time
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1 Week Ago
The Cigna Group
This role assists the VP of Pharma Strategy and Contracting in setting and executing rebate contract strategies for various books of business. It involves managing pharmaceutical manufacturer relationships and collaborating with cross-functional teams to maximize value and cost savings.
Perform evidence-based medical necessity reviews for pathology cases using specialized case management software. Conduct peer-to-peer consultations with providers to discuss treatment appropriateness and recommend alternative services.
The coordinator manages day-to-day operations of behavioral health studies, including participant recruitment, data collection, and regulatory compliance. They serve as the primary liaison between investigators, clinical staff, and external sponsors to ensure study protocols are followed.
Support a centralized nurse triage team by executing protocol-based workflows, collecting focused patient data, and coordinating care. Responsibilities include managing work queues, scheduling appointments, and escalating high-risk clinical cases.
The Care Coordinator manages the VIEW telehealth program by coordinating services and advocating for youth and families to avoid out-of-home placement. Responsibilities include developing community resource programs, serving as a liaison between agencies, and participating in a 24/7 crisis on-call rotation.
Physician Coding Education Specialist- Orthopedics & Surgical Specialties
CU Medicine
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Full Time
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1 Week Ago
CU Medicine
The specialist provides formal and informal coding and regulatory education to physicians and advanced practice providers regarding professional services billing. Responsibilities include designing educational materials, conducting training sessions, and collaborating with leadership to manage provider orientation.
Pharmacy System Testing Manager
Gainwell Technologies LLC
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Full Time
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1 Week Ago
Gainwell Technologies LLC
Provide senior leadership over pharmacy PBM quality and testing for large-scale Medicaid implementations. Manage end-to-end testing strategies, budgets, and multi-vendor teams to ensure compliant and high-quality pharmacy solutions.
The Senior CRA oversees clinical trial site management and monitoring activities to ensure compliance with ICH-GCP and regulatory standards. Key duties include conducting site visits, managing patient recruitment, and mentoring junior CRA team members.
Provides strategic medical leadership and operational oversight for global clinical research programs in Hematology and Oncology. Acts as the primary medical interface between sponsors and sites to ensure patient safety, protocol compliance, and high-quality trial execution.
The specialist assesses the medical necessity and appropriateness of healthcare services by reviewing medical records and treatment plans. They also lead quality improvement initiatives and provide education to clinicians regarding documentation standards.
Senior Clinical Research Associate - CNS/Psychiatry - West Coast - Remote
Worldwide Clinical Trials
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Full Time
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1 Week Ago
Worldwide Clinical Trials
Manage research activities at clinical sites, including site identification, start-up, and close-down. Conduct study initiation visits and ensure compliance with regulatory requirements and safety reporting.
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Provide high-level technical and clinical support for neuromodulation devices to optimize patient outcomes and drive therapy adoption. Mentor and train junior Clinical Specialists while collaborating with Territory Managers to grow the sales territory.
Provide high-quality clinical and technical support for neuromodulation therapies to optimize patient outcomes and drive therapy adoption. Mentor and train junior Clinical Specialists while collaborating with Territory Managers to identify sales opportunities.
Provide high-quality clinical and technical support for neuromodulation therapies to optimize patient outcomes and drive therapy adoption. Mentor and train junior Clinical Specialists while collaborating with Territory Managers to identify sales opportunities.
Health Systems Strategy & Insights Senior Advisor
Cigna Healthcare
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Full Time
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1 Week Ago
Cigna Healthcare
Lead competitive intelligence research focused on health systems and provider-owned organizations to inform strategy and product development. Translate complex market data into executive-ready insights and leverage AI tools to automate research and synthesis.
Coordinate care for members with chronic conditions and social determinants of health through comprehensive assessments and individualized care plans. Perform telephonic engagement to provide disease management education and collaborate with interdisciplinary teams for optimal health outcomes.
Coordinate care for members with chronic conditions and social determinants of health through comprehensive assessments and individualized care plans. Perform telephonic engagement to provide disease management education and collaborate with interdisciplinary teams for optimal health outcomes.
The role is responsible for providing therapeutic area and product expertise through scientific exchange and medical engagement with healthcare professionals. It involves executing medical strategies, gathering customer insights, and supporting clinical research and data dissemination.
The role is responsible for providing therapeutic area expertise and scientific exchange with healthcare professionals across assigned geographies to support Pfizer's portfolio. It involves executing medical strategies, gathering customer insights, and supporting clinical research and data dissemination.
The role is responsible for providing therapeutic area and product expertise through scientific exchange and medical engagement with healthcare professionals in assigned geographies. It involves contributing to medical strategy by identifying gaps in clinical practice and supporting research and data dissemination.
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Responsible for providing therapeutic area and product expertise through scientific exchange and medical engagement with healthcare professionals in assigned geographies. The role involves gathering customer insights to inform medical strategy and supporting clinical research and data dissemination.
Clinical Application Specialist (Cardiac Therapies) Central NJ
Merit Medical Systems, Inc.
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Full Time
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1 Week Ago
Merit Medical Systems, Inc.
Provides clinical training on Merit products to sales representatives, medical staff, and physicians. Acts as a liaison between customers and sales teams to support product evaluations, troubleshoot issues, and develop training materials.
Clinical Assessment Manager Oasis Specialist - Home Health - Full Time - Remote
Bridge Home Health and Hospice
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Full Time
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1 Week Ago
Bridge Home Health and Hospice
The Clinical Assessment Manager coordinates OASIS reviews and plan of care development to ensure appropriate delivery of patient services. They educate staff on CMS guidelines and conduct record reviews to promote quality home care performance.
Therapist, Multisystemic Therapy
Thompson Child & Family Focus
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Full Time
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1 Week Ago
Thompson Child & Family Focus
Provide intensive in-home services to youth aged 12-17 and their families using the evidence-based Multisystemic Therapy model. Collaborate with families, schools, and community partners to address behavioral challenges and foster long-term positive outcomes.
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