37 Clinical Review Manager jobs

United States (Remote)

$73–125K / year

Job Description A bit about this role: The Clinical Readmission Manager is responsible for conducting prepayment and post-payment clinical reviews of…

United States (Remote)

About the Role We are seeking Registered Nurses with at least 5 years of clinical experience — bedside nursing, case management, clinical nurse…

Seattle, Washington, US (Hybrid)

$62.00 – $98.00 / hour

Providence is calling for a Clinical Program Manager RN – Cognitive Care within Providence’s Neuroscience Clinical Institute - Hybrid The Clinical…

United States (Remote)

$150K / year

About Seven Starling Seven Starling is a leading virtual provider of women's behavioral health services supporting every stage of their reproductive health.

Austin, Texas, US (Hybrid)

Overview The Nurse Navigator is responsible for the navigation of patients through complex healthcare environments for the optimization of care and outcomes.

United States (Remote)

$35.00 – $40.00 / hour

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw…

United States (Remote)

$82.7–96.5K / year

Job Description A bit about this role: The Clinical Guide Part A will be part of the Utilization Management team, responsible for inpatient,…

United States (Remote)

$78–88K / year

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges.

United States (Remote)

This is a remote position.

Pennsylvania, United States (Remote)

Imagine a career at one of the nation's most advanced health networks.

United States (Remote)

$100–130K / year

At Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America’s seniors.

Oklahoma, United States (Remote)

$75.3–135.4K / year

Position Purpose: Supervises Prior Authorization, Concurrent Review, Retrospective Review Clinical Review and/or Appeals team to ensure appropriate…

Oklahoma, United States (Remote)

$87–161.3K / year

Position Purpose: Manages Prior Authorization, Concurrent Review, Retrospective Review Clinical Review and/or Appeals team to ensure appropriate care to members.

Arkansas, United States + 6 more (Remote)

To learn more about Arkansas Blue Cross and Blue Shield Hiring Policies, please click here .

Ohio, United States (Remote)

$62.7–100.4K / year

Job Summary: The Transitions Coordinator- Post Acute is responsible for monitoring and managing the functions related to member level of care…

Alabama, United States + 20 more (Remote)

Company Archimedes About Us Archimedes - Transforming the Specialty Drug Benefit - Archimedes is the industry leader in specialty drug management solutions.

United States (Remote)

$20.00 – $26.00 / hour

About Guideway Care Guideway Care is The Patient Activation Company™ .

United States (Remote)

$71.1–97.8K / year

Become a part of our caring community Shift/availability details: Full time 40 hours a week scheduled for 8 hour shifts, 5 days a week.

Texas, United States (Remote)

Position Purpose: Perform duties related to the day-to-day operations of the Service Management functions for Foster Care members to achieve the…

United States (Remote)

$72–81K / year

Scope: The Case Manager manages an individual caseload using the case management process in order to meet the needs of the MedWatch, LLC customers and consumers.