229 Medical Management jobs

Delaware, US (Hybrid)

$72.7–116.6K / year

Company : Highmark Inc.

United States (Remote)

$65K / year

At Broadway Ventures , we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions.

United States (Remote)

This is a remote position.

United States (Remote)

$31.00 / hour

At Broadway Ventures , we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions.

United States (Remote)

$23.00 – $27.00 / hour

Scope: The Medical Review Coordinator will perform her/his duties in accordance with MedWatch procedures, MedWatch review standards, URAC standards…

United States (Remote)

$65–70K / year

Scope: The Medical Review Specialist is a Registered Nurse who conducts the Utilization Review process by obtaining medical information and…

United States (Remote)

JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care…

United States (Remote)

Kingman Healthcare Incorporated (KHI) Staff Position Description Position Title: Utilization Review Nurse Position Code: RN-6027 Department: Case…

South Carolina, US (Hybrid)

Job Description Summary The Outpatient CDI Specialist is a hybrid role that combines the expertise of clinical documentation improvement (CDI) and…

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.

United States (Remote)

Company Description Lemonaid Health is dedicated to removing barriers to quality healthcare and transforming primary care through personalized,…

Florida, US (Hybrid)

$25.00 – $41.00 / hour

The Administrative Nurse, LPN will support Clinical Review/Utilization Management processes in pre-service medical review, post-service medical…

Florida, US (Hybrid)

$25.00 – $41.00 / hour

The Administrative Nurse, LPN will support Clinical Review/Utilization Management processes in pre-service medical review, post-service medical…

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)

$27.00 – $49.00 / hour

Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating…

United States (Remote)

$62.7–97.2K / year

Company : Highmark Inc.

United States (Remote)

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

United States (Remote)

$93.4–132.4K / year

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans is hiring a Clinical Claims Reviewer/ RN - Remote!

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.

Florida, US (Hybrid)

$71.2–115.7K / year

The CRN is responsible for performing medical reviews using established criteria to ensure the member is receiving care at the most appropriate level.