The UM Nurse determines the medical necessity of inpatient admissions and continued stays based on evidence-based guidelines. They are also responsible for reviewing incoming referrals and authorization requests for clinical appropriateness and standards of care.
Remote Healthcare Jobs (12,276)
Job category = Healthcare
The CRA II will independently monitor Phase II-IV clinical trials for a global pharmaceutical partner, ensuring compliance with ICH-GCP and sponsor SOPs. Key tasks include conducting site visits, managing study documentation, and maintaining strong relationships with investigators across various therapeutic areas.
Lead clinical trial monitoring for Phase II-IV studies, ensuring compliance with ICH-GCP and sponsor SOPs. Manage site qualification, initiation, and close-out visits while maintaining high data integrity and participant safety.
Team Lead, Hospital Maintenance - South (Mars Veterinary Health)
Banfield Pet Hospital
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Full Time
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5 Weeks Ago
Banfield Pet Hospital
Supervise a team of Hospital Maintenance Specialists and manage regional facility repairs and preventive maintenance. Responsible for hiring, scheduling, and overseeing projects like painting, plumbing, and electrical repairs to ensure practice standards are met.
Team Lead, Hospital Maintenance - North (Mars Veterinary Health)
Banfield Pet Hospital
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Full Time
·
5 Weeks Ago
Banfield Pet Hospital
Supervise a team of Hospital Maintenance Specialists to ensure quality control and timely completion of facility projects. Manage regional maintenance programs, including hiring, scheduling, and overseeing repairs such as painting, plumbing, and electrical work.
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The role involves managing medication-related tasks, reviewing prior authorizations for GLP-1 therapies, and assisting members with lifestyle resources. It also requires coordinating between members and vendors while maintaining accurate records of engagement.
Consultant, Managed Care Policy, Baptist Health
Baptist Health System, Inc.
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Full Time
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5 Weeks Ago
Baptist Health System, Inc.
The consultant identifies and resolves payer contract discrepancies and underpayments to recover lost revenue. They collaborate with internal departments to draft formal disputes and develop solutions for systemic payer issues.
Licensed Clinical Therapist - Full Time (Remote/Multiple Locations)
Brightli
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Full Time
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5 Weeks Ago
Brightli
Assess, diagnose, and treat clients through individual, group, and family counseling using evidence-based interventions. Manage comprehensive intake processes, develop individualized treatment plans, and maintain detailed clinical documentation.
Licensed Clinical Therapist - Part Time (Remote/Multiple Locations)
Brightli
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Full Time
·
5 Weeks Ago
Brightli
Assess, diagnose, and treat clients through individual, group, and family counseling using evidence-based interventions. Manage comprehensive intake processes, develop individualized treatment plans, and maintain detailed clinical documentation.
Bilingual Nurse Practitioner 100% Virtual, CareBridge
Elevance Health
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Full Time
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5 Weeks Ago
Elevance Health
Collaborate with providers and families to develop complex care plans for adult patients with chronic conditions via virtual modalities. Provide urgent healthcare, manage medication, and coordinate resources to maximize patient health and independence.
Principal Technical Analyst - MMIS - Medicaid Pharmacy
Gainwell Technologies LLC
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Full Time
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5 Weeks Ago
Gainwell Technologies LLC
The Principal Technical Analyst provides hands-on technical analysis, SQL development, and system troubleshooting for MMIS and Medicaid Pharmacy environments. They translate functional requirements into technical specifications and ensure data integrity across the software development life cycle.
Virtual Clinical Pharmacist - 26-08
PriMed Management Consulting Services, Inc.
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Full Time
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5 Weeks Ago
PriMed Management Consulting Services, Inc.
Support the development of programs and policies to optimize medication and manage chronic disease states. Collaborate with physicians and quality teams to improve patient outcomes and ensure compliance with CMS Star quality measures.
Clinical Pharmacist
Clinical Solutions Pharmacy Services
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Full Time
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5 Weeks Ago
Clinical Solutions Pharmacy Services
The Clinical Pharmacist provides clinical assessments, medication reviews, and formulary management for correctional facility clients. They serve as a clinical liaison, creating reports and providing education to both staff and patients to ensure optimal therapeutic outcomes.
Analyze high-dollar claim referrals and trigger reports to identify financial exposure and determine medical necessity. Manage stop loss claims and coordinate with providers and stakeholders to ensure cost-effective medical care.
Interpret home sleep tests and supervise Nurse Practitioners while providing evidence-based telemedicine care for various sleep disorders. Develop individualized treatment plans and monitor longitudinal patient data to drive precision management outcomes.
Region Director Medical Informatics - California
California Region
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Full Time
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5 Weeks Ago
California Region
Lead the implementation and direction of Medical Informatics strategy across the California Region to optimize EHR systems and standardize clinical workflows. Partner with IT and clinical leadership to drive operational excellence and manage a high-performing team.
Deliver compassionate, high-quality nursing care through critical assessments and the implementation of individualized patient care plans. Collaborate with interdisciplinary teams to ensure optimal patient outcomes and safe transitions of care.
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Coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and return to work. Communicates with physicians, patients, and adjusters to evaluate treatment appropriateness and recommend alternative care options.
Behavioral Health Clinical Reviewer
Acentra Health, LLC
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Full Time
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5 Weeks Ago
Acentra Health, LLC
Conduct administrative and process-based reviews of medical records for Applied Behavior Analysis (ABA) services to ensure compliance and medical appropriateness. Act as a liaison for providers and collaborate with supervisors to monitor quality and improve review processes.
Prom & Formal Dress Seamstress – Alterations – Birdsboro, PA
Thimble Alterations
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Full Time
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5 Weeks Ago
Thimble Alterations
Perform complex alterations on prom, pageant, and special event dresses, including work with sequins and beading. Conduct professional fittings and manage client timelines to deliver high-quality finishing.
Prom & Formal Dress Seamstress – Alterations – Bethlehem, PA
Thimble Alterations
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Full Time
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5 Weeks Ago
Thimble Alterations
Perform complex alterations on prom, pageant, and special event dresses, including work with sequins, beading, and tulle. Conduct professional fittings and manage client timelines to deliver high-quality finishing.
Formalwear Seamstress – Dress & Suit Alterations – Bethesda, MD
Thimble Alterations
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Full Time
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5 Weeks Ago
Thimble Alterations
Perform high-quality alterations on suits, tuxedos, and women's formalwear including gowns and cocktail dresses. Conduct professional fittings, take precise measurements, and manage client timelines.
Evening Gown & Cocktail Dress Seamstress – Alterations – Beaver Falls, PA
Thimble Alterations
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Full Time
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5 Weeks Ago
Thimble Alterations
Perform high-quality alterations on evening gowns, cocktail dresses, and other formalwear, including hemming and bodice adjustments. Conduct professional fittings and manage client timelines to ensure precise garment delivery.
Evening Gown & Cocktail Dress Seamstress – Alterations – Baltimore, MD
Thimble Alterations
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Full Time
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5 Weeks Ago
Thimble Alterations
Perform high-quality alterations on formal evening and cocktail wear, including hemming and bodice adjustments. Conduct client fittings and manage timelines to deliver finished garments.
Care Coordinator
BCFS Health & Human Services
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Full Time
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5 Weeks Ago
BCFS Health & Human Services
The Care Coordinator assesses minor clients for protocol eligibility and facilitates coordinated responses among advocates, law enforcement, and medical providers. They are responsible for managing care coordination meetings, documenting grant metrics, and maintaining stakeholder relationships.
Supervisor, Health Information Management
Ensemble Health Partners
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Full Time
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5 Weeks Ago
Ensemble Health Partners
Oversees day-to-day HIM operations to ensure accurate, timely, and compliant handling of health records and information workflows. Coordinates team efforts, monitors performance, and ensures adherence to regulatory standards and HIPAA compliance.
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Regional Environmental, Health & Safety Manager
Restaurant Technologies
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Full Time
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5 Weeks Ago
Restaurant Technologies
Lead the implementation and continuous improvement of EHS programs and policies across the Northeast and Southeast US regions. Partner with leadership to ensure compliance with OSHA, EPA, and DOT regulations while driving a culture of safety.
Team Lead, Hospital Maintenance - North (Mars Veterinary Health)
Mars Veterinary Health
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Full Time
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5 Weeks Ago
Mars Veterinary Health
Supervise a team of Hospital Maintenance Specialists, managing hiring, scheduling, and performance to ensure facility standards are met. Oversee regional repair projects, preventive maintenance, and contractor management for veterinary clinics.
Team Lead, Hospital Maintenance - South (Mars Veterinary Health)
Mars Veterinary Health
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Full Time
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5 Weeks Ago
Mars Veterinary Health
Supervise a team of Hospital Maintenance Specialists to ensure quality control and timely completion of facility projects. Manage regional maintenance programs, including hiring, scheduling, and overseeing repairs such as painting, plumbing, and electrical work.
Provide expert mental health care to adults via an online therapy platform. Focus on client care while utilizing AI documentation tools to manage caseloads.
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