45 Compliance Review jobs

United States (Remote)

$82–87K / year

The Clinical Compliance Auditor II is responsible for ensuring Guidehealth’s clinical operations, utilization management activities, and delegated…

United States (Remote)

$82–87K / year

The Clinical Compliance Auditor II is responsible for ensuring Guidehealth’s clinical operations, utilization management activities, and delegated…

Riverside, California, US (Hybrid)

Job Description Job Summary Provides support for clinical facility site reviews.

United States (Remote)

$47.00 – $63.00 / hour

Thank you for considering a career at Ensemble!

United States (Remote)

Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance…

United States (Remote)

$27.00 – $49.00 / hour

Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance…

United States (Remote)

Overview The Manager, Utilization Review Nursing is responsible for the operational oversight and leadership of Sendero Health Plans’ Utilization…

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)

$70–75K / year

The Utilization Management Registered Nurse is responsible for performing utilization review activities in compliance with federal and state…

United States (Remote)

We are seeking experienced US registered nurses to review and assess AI-generated responses from a health coaching agent, with a focus on safety,…

United States (Remote)

Overview HealthEdge® offers AI-powered operational infrastructure for health insurance companies, guaranteeing an enduring financial edge in an…

United States (Remote)

$66.3–84K / year

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

United States (Remote)

$34.00 – $61.00 / hour

Position Purpose: Act as the liaison for all statewide appeals, fair hearings, review organizations, and other external type appeals.

United States (Remote)

$68.4–105.9K / year

Company : Highmark Inc.

United States (Remote)

Overview NAH reserves the right to make hiring decisions based on applicants' state of residence if outside the state of Arizona.

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.

United States (Remote)

Summary We are currently hiring for a Managed Care Coordinator I to join BlueCross BlueShield of South Carolina.

Pennsylvania, US (Hybrid)

$72.7–116.6K / year

Company : Endorsed Job Description : JOB SUMMARY This is a full-time hybrid work from home position requiring travel within the assigned territory.

United States (Remote)

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and…

United States (Remote)

This is a remote position.