31 Regulatory Compliance 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…

United States (Remote)

$83–132.8K / year

Job Summary: The Manager, Clinical Appeals is responsible for the oversight of all clinical appeals activities ensuring consistency of services and…

Harrisburg, Pennsylvania, US (Hybrid)

Category: Health Care Location: Harrisburg Pennsylvania United States Seeking a Registered Nurse (RN) – Expert Medical Examination Consultant to…

United States (Remote)

$68.4–105.9K / year

Company : Highmark Inc.

United States (Remote)

Welcome! We’re excited you’re considering an opportunity with us!

United States (Remote)

$83–132.8K / year

Job Summary: The Manager, Utilization Management is responsible for the oversight of all utilization management activities ensuring consistency of…

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…

Iowa, US (Hybrid)

$75.3–135.4K / year

Position Purpose: Supervises the care coordination team that serves long-term care members to promote quality and efficacy of care management delivery.

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)

$84.5–90K / year

Overview HarmonyCares is a leading national value-based provider of in-home primary care services for people with complex healthcare needs.

United States (Remote)

It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: Lead a team dedicated to delivering high-quality,…

Roanoke, Virginia, US (Hybrid)

$89.5–136.5K / year

City/State Roanoke, VA Work Shift First (Days) Overview: Sentara Health is looking to hire an Integrated Case Manager, RN.

Chattanooga, Tennessee, US (Hybrid)

At Curana Health, we're on a mission to radically improve the health, happiness, and dignity of older adults—and we're looking for passionate people…

United States (Remote)

$18.00 – $28.00 / hour

Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers…

United States (Remote)

$62.7–100.4K / year

Job Summary: *Nights - every other weekend, every other holiday* *Shift differential* Essential Functions: Utilize assessment skills and…

North Carolina, US (Hybrid)

At Curana Health, we're on a mission to radically improve the health, happiness, and dignity of older adults—and we're looking for passionate people…

United States (Remote)

$35.00 – $40.00 / hour

Job Summary At Fuze Health, we put patients first and tirelessly address the most pressing needs in healthcare.

United States (Remote)

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

United States (Remote)

We are more than a health system.