This pivotal role involves overseeing and performing utilization reviews, prior authorizations, and making crucial medical necessity determinations for healthcare services. The Medical Director will act as a key clinical expert, ensuring appropriate resource utilization, promoting evidence-based care, and leading peer-to-peer discussions with practitioners.
Remote Jobs & Work From Home Positions in United States (122,554)
Remote in = United States
The specialist manages contract negotiations with physicians and physician groups, simultaneously conducting multiple negotiations to meet growth demands while nurturing provider partnerships. Responsibilities include meeting unit cost targets, improving medical cost and quality, and analyzing the financial impact of complex provider contracts.
Sr. Network Contracting Specialist (North East Region)
Curative HR LLC
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Full Time
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11 Weeks Ago
Curative HR LLC
The Director Network Development oversees the development and management of insurance networks, focusing on improving affordability and quality outcomes while managing provider relationships and negotiation strategies in the NorthEast Region. Responsibilities include managing contract negotiations with large physician groups, meeting unit cost targets, and identifying initiatives to improve total medical cost and quality.
This role involves leading negotiations with large physician groups and ancillary providers, simultaneously managing several contract negotiations to meet growth demands. Key duties include nurturing provider partnerships, maintaining communication with matrix partners, and being responsible for meeting unit cost targets while preserving an adequate network.
Regional Head - Network Development (Mid Atlantic Region)
Curative HR LLC
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Full Time
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11 Weeks Ago
Curative HR LLC
This role is responsible for leading the strategic development, competitive positioning, and operational management of the provider network across the Mid Atlantic Region, ensuring coverage and unit costs are highly competitive against larger health plans. Key functions include leading complex negotiations, managing critical provider relationships, ensuring regulatory compliance, and aligning network strategy with growth and profitability goals.
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The Actuary Manager will apply mathematical and statistical knowledge to support technical functions like rating, pricing, valuation, reserving, and financial forecasting for the health plan. Key duties include building and testing actuarial models, creating monthly reports, developing customized pricing models, and ensuring reserve adequacy through frequent monitoring.
This role involves leading direct financial negotiations with hospitals to secure fair cash-pay rates for high-cost procedures and auditing hospital estimates for coding accuracy, ensuring alignment with clinical necessity. The lead will also review clinical trial protocols to differentiate between sponsor-covered research costs and Standard of Care costs that the health plan should cover.
Associate Director, Medical Affairs (Scientific Communications/Publications)
Cabaletta Bio Inc.
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Full Time
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11 Weeks Ago
Cabaletta Bio Inc.
This role involves managing the end-to-end process for scientific publication planning, ensuring compliance, and collaborating with cross-functional teams to develop manuscripts, abstracts, and presentations. Responsibilities also include managing external vendor execution, budget oversight, and developing comprehensive scientific engagement and congress plans.
This key enterprise leader is responsible for setting the strategic direction, vision, and executional rigor for the company’s biostatistics and data management capabilities, serving as the principal statistical authority across the organization. Key duties include leading and developing the Biostatistics and Data Management functions, providing expert statistical input into clinical development strategy, and overseeing the development and execution of statistical analysis plans for all clinical studies.
Sr. In-House Clinical Research Associate
Cabaletta Bio Inc.
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Full Time
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11 Weeks Ago
Cabaletta Bio Inc.
The Senior In-House CRA supports the planning, execution, and oversight of clinical trials, acting as a key operational partner to clinical sites, CROs, and vendors. This role ensures high-quality trial conduct, strong external relationships, and inspection-ready documentation throughout the study lifecycle.
The Vice President of Regulatory Affairs will lead the global regulatory strategy and execution for an advanced cell therapy product development program, ensuring compliance and guiding interactions with global health authorities like the FDA and EMA. This role involves overseeing the preparation and submission of key regulatory documents such as INDs, CTAs, and BLAs/MAAs, while serving as a primary regulatory advisor to executive leadership.
This role involves serving as the Regulatory Lead for the pivotal program leading to BLA submission, responsible for developing and executing regulatory strategies to support the development and commercialization of cell therapy products. Key duties include managing all regulatory aspects through pivotal studies, preparing applications, managing health authority meetings, and ensuring compliance across global agencies like the FDA and EMA.
Sr. Medical Director, Clinical Development
Cabaletta Bio Inc.
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Full Time
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11 Weeks Ago
Cabaletta Bio Inc.
This physician leader will provide medical oversight and leadership for cell therapy programs in autoimmune diseases, collaborating across clinical operations, regulatory, and manufacturing functions while liaising with investigators and Health Authorities. Key duties include formulating study designs, leading protocol development, ensuring operational efficiency through CRO/vendor management, and participating hands-on in all aspects of clinical study conduct, data review, and reporting.
Certification Specialist
National Minority Supplier Dev
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Part Time
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11 Weeks Ago
National Minority Supplier Dev
The Certification Specialist will evaluate applications, assess compliance with NMSDC standards, facilitate certification interviews, and determine certification outcomes for minority businesses. Essential duties include reviewing documentation, assessing ownership/control, and maintaining objective, well-documented certification decisions.
The Account Executive will manage the entire inbound sales cycle, from initial contact to closing deals, by fielding inquiries, conducting video demonstrations, and building strong customer relationships. A key part of the role involves collecting valuable product feedback for the development team to improve the offering.
Inside Sales - Business Development Salesperson - REMOTE
Infectious Disease Connect
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Full Time
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11 Weeks Ago
Infectious Disease Connect
The Inside Sales Business Development salesperson is responsible for lead development, executing daily cold calling with a minimum of 75 touches per day, and managing territory relationships to achieve sales appointment targets. This role involves developing new prospects and interacting with the existing customer base via phone to increase the organization's Infectious Disease Services and Antimicrobial Software businesses.
The VP of Marketing will be responsible for owning and scaling positive-ROI paid channel efforts across paid social, SEM, and affiliate marketing, while also managing strategy for lifecycle marketing, content, press, and partnerships. This role involves driving go-to-market strategies for new product and market launches and ensuring brand-aligned execution across all channels.
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The Rust Developer will be responsible for designing and implementing smart contracts on Solana and building, maintaining, and improving Switchboard’s existing on-chain infrastructure. This role also involves writing open-source clients for community interaction and participating in feature design and on-call rotations.
Outpatient Weight Management Dietitian
Accomplish Health Services, LL
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Full Time
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11 Weeks Ago
Accomplish Health Services, LL
The Dietitian will provide medical nutrition therapy, including assessment, education, and intervention, while developing and refining care plans in collaboration with patients. They must also deliver tailored health and wellness coaching, acting as an accountability partner to help patients meet their health objectives.
Full-stack Developer with Low-code Caspio Platform experience
Accomplish Health Services, LL
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Full Time
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11 Weeks Ago
Accomplish Health Services, LL
The developer will collaborate with product teams to build innovative solutions using the Caspio low-code platform, focusing on developing custom applications, automating workflows, and integrating systems within an AWS environment. Key tasks include developing user interfaces with HTML/CSS/React.js, designing backend data architecture using Caspio's SQL backend, and managing database integrity and performance.
Obesity Medicine Triage Nurse
Accomplish Health Services, LL
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Full Time
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11 Weeks Ago
Accomplish Health Services, LL
The nurse will deliver prompt and insightful triage via phone or messaging, applying critical thinking and clinical assessment skills to guide patients' healthcare decisions. Responsibilities also include proactive communication with the care team, providing stigma-free care, and maintaining complete medical documentation.
Front Desk Specialist
Accomplish Health Services, LL
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Full Time
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11 Weeks Ago
Accomplish Health Services, LL
The role involves front desk duties such as communicating with patients, managing scheduling, verifying insurance, and processing payments, alongside clinical support tasks like conducting screenings and documenting patient intake in the EMR. Responsibilities also extend to supporting remote workflows for quality assurance and virtual care protocols.
Obesity Medicine Advanced Practitioner (NP)
Accomplish Health Services, LL
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Full Time
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11 Weeks Ago
Accomplish Health Services, LL
The Advanced Practitioner will provide confidential, high-quality, stigma-free, person-centric clinical care via telehealth, which includes initial patient interaction, diagnosis, and developing care plans utilizing pharmacotherapy, nutrition, and coaching. Responsibilities also involve managing daily tasks, reviewing lab results, overseeing patient progress via remote monitoring, and maintaining timely medical records.
The intern will play a key role in building a thorough and accurate cost tracking system, developing SKU-level forecasting projections, and assisting with the implementation of financial reporting software. This role involves quarterbacking project parts and creating processes that will be used by the company long-term.
This role involves leading all stages of email and SMS marketing programs, including deployment, reporting, optimization, and strategy development across multiple markets to build user loyalty and retention. The manager will be responsible for creating and implementing successful retention campaigns, managing personalized trigger communications, and overseeing the implementation and strategy of the loyalty program.
This role involves leading analytics by directing large budgets toward efficient investments and recommending tactics to increase Customer Lifetime Value (LTV). The analyst will be responsible for analyzing large datasets, performing regressions, and drawing conclusions about performance effectiveness.
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This role involves leading analytics, which includes directing large budgets toward efficient investments and recommending tactics to increase customer lifetime value. The individual will be responsible for analyzing data and translating performance into actionable insights.
The intern will be fully immersed in social media and community efforts, assisting with the day-to-day management of the ADAY Instagram account, including brainstorming content and sourcing images. Key tasks involve editing trend-driven videos for Reels, building an engagement strategy, and coordinating content challenges for the ambassador program.
The intern will analyze large datasets and develop custom models to uncover trends and insights within customer and business data, including sales and inventory information. They will also be responsible for creating reports and dashboards to support various business needs across different departments.
The manager will oversee the performance, optimization, and improvement of the company's online presence, focusing on growing and optimizing key site metrics for www.thisisaday.com. Responsibilities include analyzing user behavior, developing A/B testing plans, managing the website development pipeline for US and international markets, and acting as the main contact for site-related systems.
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