Conduct utilization reviews to determine medical necessity across various post-acute care services. Collaborate with providers and internal staff to ensure evidence-based care decisions and meet service level agreements.
Remote Healthcare Jobs (12,285)
Job category = Healthcare
RN Care Manager
Alternate Solutions Health Network
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Full Time
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1 Week Ago
Alternate Solutions Health Network
The RN Care Manager oversees the development and continuity of patient plans of care while serving as a liaison between field staff and interdisciplinary teams. They manage healthcare costs through utilization management and ensure compliance with regulatory and governmental standards.
Part Time Remote Licensed Talk Therapist - Fee For Service
Thriveworks
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Full Time
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1 Week Ago
Thriveworks
Provide compassionate, evidence-based telehealth mental health care to a diverse range of clients, including couples and children. Maintain a consistent caseload and utilize modern clinical technology and EHR tools for session management.
Part Time Remote Licensed Talk Therapist - Fee For Service
Thriveworks
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Full Time
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1 Week Ago
Thriveworks
Provide compassionate, evidence-based telehealth mental health care to a diverse range of clients, including couples and children. Maintain a consistent caseload and utilize modern clinical technology and EHR tools for session management.
The role involves performing clinical documentation reviews for home health and hospice records to ensure accuracy and regulatory compliance. The manager will analyze trends to provide process improvement recommendations and handle appeals for denied services.
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Certified Pharmacy Technician (Hybrid - Onsite/Remote)
AnewHealth
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Full Time
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1 Week Ago
AnewHealth
Provide exceptional customer service in a phone-based environment by processing prescriptions and managing patient care issues. Act as a liaison between clinical pharmacists and medical professionals to ensure accurate medication profiles and successful patient onboarding.
Remote Overnight Emergency Radiologist
Radiology Partners
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Full Time
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1 Week Ago
Radiology Partners
Interpret general emergency, urgent care, and inpatient imaging for the HonorHealth network across multiple modalities. Provide overnight coverage for Level 1 trauma and inpatient studies using an AI-enabled IT platform.
Provide remote telehealth care to Medicare members, focusing on STARS measure compliance and emergency department discharge confirmation. Support pharmacy operations by supervising technicians and verifying the accuracy of prescriptions.
Clinical Psychologist-Telehealth (PhD or Psy D)
LifeStance Health
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Full Time
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1 Week Ago
LifeStance Health
Provide evidence-based mental healthcare services to children, adolescents, and adults in an outpatient setting. Responsibilities include conducting testing intakes, planning assessment batteries, and providing feedback sessions.
Licensed Behavioral Health Therapist-Telehealth Only
LifeStance Health
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Full Time
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1 Week Ago
LifeStance Health
Provide high-quality behavioral healthcare to children, adolescents, and adults in an outpatient setting. Deliver personalized mental health treatment through both telemedicine and potentially in-person services.
Licensed Clinical Professional Counselor (LCPC)-Telehealth
LifeStance Health
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Full Time
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1 Week Ago
LifeStance Health
Provide high-quality behavioral healthcare to adult, child, and adolescent populations. Deliver evidence-based, medically driven treatment services in both outpatient and digital health settings.
Licensed Clinical Social Worker (LCSW)-Telehealth
LifeStance Health
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Full Time
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1 Week Ago
LifeStance Health
Deliver high-quality behavioral healthcare to adult, child, and adolescent populations. Provide evidence-based, medically driven treatment services in both outpatient and digital health settings.
Coordinate all admissions to facilities in alignment with budgeted census projections. Review clinical data on potential referrals to assess suitability for various buildings.
Coordinate all admissions to facilities in alignment with budgeted census projections. Review clinical data on potential referrals to assess suitability for various buildings.
Lead the implementation, launch, and scaling of population genomics programs for health systems and health plans. Serve as the primary operational advisor and relationship lead to drive clinical and research value for partners.
Lead and develop the Patient Care Coordination team to ensure high-quality support for daily care operations and patient interactions. Oversee clinical support tasks, manage patient escalations, and drive operational efficiency through KPI analysis and process improvements.
The Clinical Staff Pharmacist provides direct patient care by monitoring medication prescribing and administration and conducting medication reconciliations. They also collaborate with physician groups to develop clinical guidelines and supervise pharmacy technicians in dispensing medications.
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Conduct initial evaluations and develop collaborative treatment plans involving medication and therapy for clients. Provide proactive monthly follow-ups and various modalities of talk therapy to achieve treatment goals.
Act as the primary contact for patients to navigate treatment pathways and manage reimbursement processes. Coordinate with healthcare stakeholders and monitor patient adherence to ensure timely access to therapy.
Health Program Data, Performance, Reporting & Systems Lead (New Mexico REMOTE)
IIIIIIUS
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Full Time
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1 Week Ago
IIIIIIUS
Lead the data strategy, performance monitoring, and reporting systems for the Rural Health Transformation Program in New Mexico. Oversee the development of dashboards and analytical frameworks to support provider sustainability and federal reporting requirements.
Family Nurse Practitioner - Remote (Florida Licensed)
Sprinter Health
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Full Time
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1 Week Ago
Sprinter Health
Conduct virtual wellness visits, health assessments, and medication reviews for patients in their homes. Coordinate care with in-home clinical team members to evaluate vitals and manage preventive care interventions.
The Nurse Appeals Lead investigates complex member and provider grievances and appeals to determine medical necessity. They provide leadership to appeals staff and serve as a subject matter expert for medical policy development.
Associate Director - Clinical Operations - Healthcare
Guidehouse
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Full Time
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1 Week Ago
Guidehouse
Lead the design and delivery of integrated clinical, operational, and financial optimization programs for hospitals and health systems. Manage multi-workstream engagements to improve performance across supply chain, workforce productivity, and revenue management.
Lead complex performance improvement engagements for healthcare clients, managing budgets and ensuring successful clinical outcomes. Develop customized solutions to improve care coordination, reduce length of stay, and mentor consulting teams.
Provide comprehensive case management for members with complex medical and psychosocial needs across PA, DE, and WV. Coordinate care plans by collaborating with physicians, community resources, and interdisciplinary teams to ensure cost-effective, high-quality healthcare.
Provide telephonic clinical assessments, nursing triage, and patient education to diverse populations across the health continuum. Coordinate with team members to direct patients to appropriate care levels and perform outbound follow-up calls.
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Conduct research using grey literature and large datasets to summarize disease prevalence and forecast disease numbers. Collaborate with experts to develop methodology strategies and deliver custom epidemiology reports to external clients.
Utilization Management Physician Advisor, CA Licensed (Part Time)
Alignment Health
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Full Time
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1 Week Ago
Alignment Health
Perform medical necessity and utilization reviews for inpatient, outpatient, and post-acute cases to optimize service use and ensure quality of care. Act as a clinical leader and liaison between medical staff and the utilization review team to improve member outcomes.
Conduct telephonic assessments and develop personalized care plans to improve member health outcomes. Coordinate care across providers and resources while collaborating with a multidisciplinary team to remove barriers to care.
Manage assigned patient cases and projects, providing telephone support to patients, healthcare professionals, and funding bodies. Responsibilities include clinical monitoring, data collection, adverse event reporting, and documenting all activities in program-specific databases.
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