The Utilization Review Nurse evaluates clinical information for inpatient and outpatient admissions to certify medical necessity and determine appropriate lengths of stay. They also communicate with stakeholders, document all review activities, and ensure compliance with safety and regulatory standards.
Remote Jobs & Work From Home Positions in United States (119,991)
Remote in = United States
The Itemization Review Nurse analyzes medical facility billing charges to ensure accuracy against submitted documentation. They are responsible for documenting conclusions in the system and maintaining compliance with department standards.
Cost Report Auditor
WPS—A health solutions company
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Full Time
·
5 Weeks Ago
WPS—A health solutions company
The Cost Report Auditor conducts audits and desk reviews of Medicare Cost Reports to ensure compliance with CMS regulations. They analyze financial and statistical data to verify the accuracy of provider submissions and support effective healthcare reimbursement.
The Account Executive will manage a portfolio of employee benefits accounts by delivering proactive service, including renewals, compliance, and strategic consulting. They will act as a trusted advisor to clients while collaborating with internal teams to ensure high-quality service and long-term retention.
The Head of Government Sales will lead a high-performing team to secure contracts with state governmental agencies and drive revenue growth. They will build strategic relationships with key stakeholders and influence policies to align company goals with public sector needs.
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Coding Specialist III
UT Southwestern Medical Center
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Full Time
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5 Weeks Ago
UT Southwestern Medical Center
The Coding Specialist III performs advanced, accurate, and compliant coding for high-complexity surgical and procedural encounters within an academic medical center. They also resolve coding-related edits, analyze denial trends, and collaborate with providers to ensure documentation accuracy and regulatory compliance.
The Senior Account Executive manages client relationships and drives service excellence for the Keenan Pharmacy Purchasing Coalition. They are responsible for executing client strategies, analyzing pharmacy utilization data, and providing consultative solutions to manage costs.
The Clinical Education Specialist coordinates student clinical placements by maintaining relationships with clinical sites and University Partners. They manage placement data within Salesforce and Exxat CRM systems while ensuring compliance with HIPAA and FERPA standards.
Psychiatric Mental Health Nurse Practitioner - PMHNP
Blackbird Health
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Full Time
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5 Weeks Ago
Blackbird Health
The Psychiatric Mental Health Nurse Practitioner will conduct comprehensive psychiatric evaluations, develop personalized treatment plans, and provide medication management for children and adolescents. They will also collaborate with an interdisciplinary team to ensure integrated care and maintain patient safety through proactive monitoring.
The AI Engineer will lead the development of scalable, real-time AI/ML applications and integrate LLMs and agent-based systems into core engineering workflows. They are responsible for establishing AI governance, conducting R&D, and driving the transformation toward AI-native engineering practices.
The Senior Software Engineer for QE will design, develop, and maintain automated test frameworks for web and mobile applications. They will collaborate with cross-functional teams to integrate testing into CI/CD pipelines and ensure high-quality software delivery.
District Service Quality Manager (COL-D2-Indianapolis)
Subaru of America, Inc.
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Full Time
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5 Weeks Ago
Subaru of America, Inc.
The District Service Quality Manager leads field investigations to resolve technical issues and monitors product quality at retail locations. They also provide expert technical assistance, manage warranty authorizations, and represent the company in legal or arbitration matters.
The Medical Case Manager facilitates the recovery of injured workers by coordinating care between patients, families, and medical providers. They are responsible for assessing treatment plans for medical necessity and cost-effectiveness while conducting regular in-person visits.
The manager is responsible for leading the successful delivery of strategic technology programs and projects within a matrixed environment. They will oversee resource allocation, team performance, and process improvements to ensure high-quality solutions are delivered on time and within budget.
Telehealth Board Certified Behavior Analyst (BCBA)
Centria Autism
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Full Time
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5 Weeks Ago
Centria Autism
Provide high-quality clinical oversight for in-home ABA services through remote coaching and supervision of behavior technicians. Develop individualized behavior plans and lead virtual family training sessions to ensure consistent, assent-based care.
The Strategic Sourcing Specialist will manage sourcing functions by partnering with internal teams to deliver on customer requirements for maintenance and special projects. They will also support the creation and evaluation of sourcing events while building relationships with key service providers and suppliers.
Middle School Math Teacher - Arizona Connections Academy
Connections Academy
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Full Time
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5 Weeks Ago
Connections Academy
The teacher will manage instructional programs from home, utilizing digital tools to provide synchronous and asynchronous instruction. They are responsible for grading, maintaining student records, and collaborating with parents and staff to ensure student progress.
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Provide virtual small-group instruction in math and English language arts while following provided lesson plans. Maintain accurate records of student progress and communicate effectively with students and parents.
Executive Director, Revenue Cycle and Patient Access Transformation
The Wilshire Group
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Full Time
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5 Weeks Ago
The Wilshire Group
The Executive Director provides strategic and operational leadership for enterprise-wide front-end revenue cycle services, patient access operations, and ambulatory scheduling. This role drives financial performance, optimizes workflows, and leads large-scale Epic and EMR-enabled transformation initiatives.
The role involves developing a robust enterprise data architecture and defining strategic roadmaps for data platforms and analytics. You will lead the operationalization of data governance, quality, and security programs while collaborating with senior leadership to drive organizational data capabilities.
The Fire Protection Field Representative will conduct vital fire protection studies and collaborate with diverse clients to assess risk. This role involves gathering data, analyzing community fire protection capabilities, and providing constructive feedback through field assignments.
The Senior AI Platform Engineer will partner with executive leadership and product teams to identify AI enablement needs and build scalable AI platform solutions. This role involves designing AI best practices, implementing agentic coding tools, and mentoring internal teams to improve efficiency through AI-powered tooling.
The Senior Business Development Manager is responsible for acquiring new clients and driving revenue growth for complex clinical and analytical studies in the cosmetics and personal care sectors. This role involves building senior-level relationships, leading consultative sales cycles, and managing commercial negotiations for bespoke study solutions.
You will architect and write high-quality production code while leading the team in modernizing software development practices. The role involves integrating AI tools to increase delivery speed and building robust, scalable systems for benefits access.
The Enterprise Account Executive will manage high-level relationships with C-suite executives at hotel brands and management companies to drive portfolio-wide revenue. They will collaborate with property-level teams to execute account strategies and ensure successful adoption of Visiting Media's solutions.
The specialist will manage high-severity commercial auto liability claims, including coverage analysis and litigation oversight. They will also leverage AI-powered tools to enhance claim accuracy and collaborate with various stakeholders to maintain service standards.
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The Renewable Energy Underwriter is responsible for the credit analysis and underwriting of renewable energy projects, including solar, energy storage, and energy efficiency financing. The role involves evaluating project-level economics, assessing risks, and preparing credit memoranda to ensure compliance with internal policies and regulatory standards.
The Digital Ad Operations Coordinator manages the end-to-end campaign delivery lifecycle, ensuring accurate setup, launch, and performance monitoring. They coordinate with internal teams and external partners to optimize campaign delivery and maintain financial accuracy through billing reconciliation.
The Sr. Manager, PMO is responsible for the successful delivery of complex, cross-functional projects by managing scope, budget, and timelines. They will lead project teams, drive stakeholder communication, and align program roadmaps with organizational goals.
The Account Director will lead high-profile automotive client programs, providing strategic counsel and managing integrated communications. They are responsible for orchestrating premium events, influencer partnerships, and media relations to elevate brand presence.
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