Remote Junior Healthcare Jobs
7,771 Junior Healthcare jobs available for remote work from home. Apply for positions such as Personal Injury Case Manager (experience in GA and/or Illinois), Pharmacist - Care Team, Clinical Review Nurse - Concurrent Review and more! Discover the best work-from-home or hybrid, full- and part-time jobs.
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Manage personal injury cases from intake through case progression, maintaining accurate files and tracking documentation, treatment, budgets, billing, and deadlines. Communicate with clients and coordinate with attorneys, insurers, medical providers, and other stakeholders in Georgia and Illinois.
Provide comprehensive medication management for home-based patients, collaborating with primary care providers and interdisciplinary teams to optimize therapy, manage chronic conditions, and support care transitions. Educate patients and providers, monitor outcomes and adherence, document care, contribute to quality improvement, and improve pharmacy workflows and service metrics.
Conduct concurrent reviews to assess members’ health, medical necessity, appropriate care settings, and level of care, while evaluating acuity, resource use, length of stay, and discharge plans. Document findings, collaborate with providers and medical leadership on determinations, support timely transitions between care settings, and identify opportunities to improve appropriate care.
Direct Medicare Part C appeals, support appeal nurses and the Second Look Review process, and provide rotational after-hours and weekend coverage. Monitor IRE activity, support utilization management strategy, collaborate with quality and compliance teams, educate staff on Medicare policy, and improve appeals efficiency and clinical consistency.
Lead utilization review and quality assurance activities, direct case management, and provide clinical expertise and business direction for medical management programs. Serve as a clinical and business liaison to providers and facilities, and conduct predetermination and claims reviews using clinical, coding, and reimbursement expertise.
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Direct the day-to-day operations of a designated department, supervise employees, and ensure the quality of service. Depending on qualifications and unit needs, oversee clinical case management activities, perform case management duties, and handle related human resources, reporting, and limited sales or marketing responsibilities.
Conduct clinical assessments and screenings, prioritize member needs, and collaborate with the multidisciplinary team to develop and carry out individualized care plans. Coordinate communication and care rounds, use electronic tools, and build trusting relationships with members living with serious illness.
Conduct clinical assessments and screenings, prioritize member needs, and collaborate with nurse practitioners, registered nurses, and the interdisciplinary team to develop and carry out individualized care plans. Coordinate communication and care rounds, use electronic tools, and build trusting relationships with members to support a compassionate, person-centered care experience.
Provide virtual clinical care through telephonic triage, video appointments, and email follow-ups, coordinating with patients’ primary care providers. Participate in clinical rounds and daily team huddles while delivering evidence-based care to patients.
Conduct clinical assessments and screenings, prioritize member needs, and collaborate with nurse practitioners, registered nurses, and the multidisciplinary team to develop and carry out individualized care plans. Coordinate communication and care rounds, use electronic tools, and build trusting relationships with members to support a coordinated, person-centered experience.
Provide virtual clinical care through telehealth visits, telephone triage, video appointments, and email follow-ups. Collaborate with virtual and in-office care teams through daily huddles and participate in ongoing clinical learning.
Supervise and develop case managers who support children in the state foster care system, including advocating for children and assessing their health and social needs. Coordinate connections to community agencies and support the agency’s therapeutic foster care, family recruitment and training, adoption, and home study services.
The Utilization Review Nurse performs prospective, concurrent, and retrospective reviews to determine the medical necessity of requested care using evidence-based criteria. They also coordinate discharge planning and collaborate with the Case Management team to ensure appropriate follow-up and cost-effective healthcare delivery.
Investigate and triage healthcare system failures, coordinate with L1, L3, product, vendors, and client teams, and perform approved data corrections and reprocessing. Reconcile and validate data across interfaces, maintain audit trails and operational reports, and help prevent recurring failures through process improvements and automation.
Monitor and manage incidents and service requests, including ticket intake, triage, prioritization, routing, SLA tracking, stakeholder updates, and closure. Monitor production batch jobs, file transfers, and real-time API availability; document and escalate failures or other issues to L2 and track them through resolution.
Conduct personal care assessments using the Wisconsin Personal Care Screening Tool, develop and oversee person-centered care plans, and obtain and review physician orders. Provide training and education to participants and care providers, coordinate with other care professionals, and complete required documentation, follow-up, and prior authorization submissions.
Develop and execute provider engagement plans that improve quality performance and risk adjustment accuracy across Medicaid, Medicare, and Marketplace programs. Coach providers, address practice barriers, coordinate data and training activities, and track engagement outcomes in collaboration with health plan teams.
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Provide in-person and telephone medical case management for injured workers, coordinating with patients, families, physicians, employers, and other care providers. Assess progress and treatment plans, support discharge and long-term care planning, and arrange services and equipment while traveling locally to meet workers' needs.
Oversee daily Tier 1 customer support and Tier 2 product health operations, including case queues, workload distribution, SLA performance, prioritization, and escalations. Coach team members, uphold customer communication and process standards, and report operational risks, trends, and training needs to the Customer Health Manager.
Gather and assess demographic and clinical information for inpatient admissions and outpatient treatment, then determine medical necessity, certify or deny treatment, and assign an appropriate length of stay. Document reviews, communicate concerns to claims staff and other stakeholders, and support the goals of the Case Management department.
Provide administrative and operational support to executives, coordinate projects and internal systems, and research healthcare regulations and compliance updates. Use AI tools to improve productivity and manage the organization’s social media content, engagement, and basic performance reporting.
Provide administrative and operational support to executives, including scheduling, communications, meeting coordination, and maintaining internal systems. Research healthcare regulations and industry practices, support compliance documentation, use AI tools to improve productivity, and manage the organization’s social media accounts.
The Traveling HRA Nurse Practitioner performs comprehensive health risk assessments and physical examinations at patients' places of residence. They are responsible for accurate documentation, medication reconciliation, and providing patient education on wellness and preventive care.
Assess members’ behavioral and psychosocial needs, connect them and their families with appropriate care resources, and develop care plans when needed. Monitor progress toward desired outcomes, address barriers to effective care, and use appropriate strategies to support members’ wellness.
Coordinate and monitor individualized care plans for members with complex behavioral, medical, social, and community needs, ensuring appropriate, cost-effective services and improved health outcomes. Collaborate with members, families, providers, and interdisciplinary teams; advocate for members, assess care effectiveness, and maintain accurate records and reports.
Manage and evaluate clinical pharmacy programs and therapeutic interventions to control pharmacy costs, improve quality measures, and support member care in coordination with interdisciplinary teams. Develop and implement utilization, formulary, medication review, reporting, and quality improvement initiatives while ensuring regulatory compliance and communicating with members, providers, and employer clients.
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Conduct wellness, high-risk, and transition-of-care visits primarily through telehealth, with occasional in-home visits, and document patient histories, symptoms, medications, tests, and screenings. Identify care gaps, educate patients, coordinate recommended interventions with primary care teams, and complete records promptly while maintaining HIPAA confidentiality.
Provide telephonic health education and coaching to disease management members, supporting sustainable behavior change, self-management, and program outcomes. Assess member needs and barriers, encourage preventive care and incremental health improvements, and collaborate with members, department associates, and the multidisciplinary clinical team.
Provides telephonic health coaching and education to disease management program members, supporting behavior change, self-management, and improved health outcomes. Assesses members’ needs and barriers, develops individualized action plans, encourages preventive care, and may coordinate with multidisciplinary clinical teams.
Engage cardiologists, pediatric endocrinologists, key opinion leaders, treatment centers, pharmacies, and healthcare institutions with evidence-based scientific messages, while developing the territory and supporting product launches. Plan and manage accounts, address access barriers with internal teams, organize scientific activities, and share field insights to inform brand and access strategies.
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