Remote RN Clinical Coordinator - Medicaid Appeals
UnitedHealthcare
- Remote job
UnitedHealth Group is seeking a Clinical Coordinator RN for a Telecommute role in Texas. You will conduct comprehensive clinical reviews of appeals, evaluate medical records, and provide independent clinical judgment on medical necessity and functional needs. The role emphasizes thorough documentation and collaboration within a remote team, with weekday daytime hours. Ideal candidates have Medicaid experience and familiarity with H6516/H2060 assessments, plus strong computer skills and reliable #J-18808-Ljbffr UnitedHealthcare
- ...is seeking an experienced appeals liaison to work remotely within the Eastern and Central... ...role focuses on review of clinical information to determine... ...must hold an active RN or LPN/LVN license with several... ...Responsibilities include coordinating with Medical Directors, maintaining...Remote job
- UnitedHealth Group is seeking a Remote Appeals Clinician in Texas. You will... ...comprehensive reviews of Medicaid-related assessments (H6516/H2... ...records, and provide independent clinical judgments on medical... ...Requirements include a Texas RN license and 2+ years in Medicaid...Remote jobFlexible hours
- ...Clinical Coordinator Under the general direction of the Associate Director... ...respond to inquiries related to appeals following clinical... ...equivalent experience required OR RN licensed to practice in Massachusetts... ...Working Conditions Remote/desk work with- some...Remote workWork experience placementWork at office
$29 - $52 per hour
...have the flexibility to work remotely as you take on some tough challenges... ...: Conduct comprehensive clinical reviews of appealed H6516 and H2060 assessment... ...~ Current unrestricted Texas RN license ~2+ years of experience working in Medicaid ~2+ years of experience...Remote workHourly payMinimum wageFull timeWork experience placementLocal areaWork from homeMonday to Friday$59 - $60 per hour
WE’RE HIRING: REMOTE REGISTERED NURSE (RN) 100% REMOTE | MONDAY-FRIDAY | $59-$60/HR We are looking for... ...an active NY RN license Medicare and Medicaid experience preferred Managed Care experience... ...Authorization experience Grievance & Appeals experience preferred, but not...Remote workMonday to Friday- ...RN Appeals Writer - Remote Detailed review, analysis and extraction of clinical information from patient medical records and drafting of effective narratives for Medicare and Medicaid appeals documentation and briefs in support of denied cases under appeal at all levels...Remote jobWork experience placement
- ...Description Job Description LTSS Appeals Nurse (Remote) We are seeking a detail-... ...will perform high-volume clinical reviews within the appeals... ...York Registered Nurse (NY RN) license. Residency:... ...CDPAP). Prior experience in Medicaid managed care, health plans,...Remote workLocal areaMonday to FridayFlexible hoursShift work
$102.18k
...Lead Appeals And Grievances RN Salary Range: $102,183.00 (Min.) - $163,492.0... ...Appeals and Grievance (A&G) clinical unit. This position is responsible... ...least 2 years in Medicare/ Medicaid in a managed care/ health... ..., holidays, a hybrid remote schedule, and occasional flexibility...Remote workShift workWeekend work- ...MES Solutions is seeking a self-driven RN or LPN to join our team as a Clinical Quality Assurance Coordinator. This 100% remote role focuses on quality review of peer review reports, ensuring evidence-based rationales, and compliance with client agreements and regulatory...Remote work
$29 - $52 per hour
...have the flexibility to work remotely* as you take on some tough challenges... ..., and state resources Coordinate care across the continuum and... ...~ Current unrestricted Texas RN license ~2+ years of... ...Qualifications Experience with Medicaid, LTSS, or long-term care...Remote workHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$29 - $52 per hour
...health-related information to ensure quality coordinated care and services are provided... ...Qualifications: ~ Current unrestricted Texas RN license ~2+ years of experience in a community... ...up to 75% in assigned region to visit Medicaid members in their homes and/or other...Remote workHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home- A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities include developing cases, researching...Remote work
$29 - $52 per hour
...have the flexibility to work remotely* as you take on some tough challenges... ..., and state resources Coordinate care across the continuum and... ...~ Current unrestricted Texas RN license ~2+ years of... ...Qualifications: Experience with Medicaid, LTSS, or long-term care...Remote workHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaWork from home$29 - $52 per hour
...have the flexibility to work remotely as you take on some tough challenges... ...to ensure quality coordinated care and services are provided... ...~ Current unrestricted Texas RN license ~2+ years of experience... ...: Experience with Medicaid, LTSS, or long-term care services...Remote workHourly payMinimum wageFull timeWork experience placementWork at officeLocal areaFlexible hours- ...MES Solutions is seeking a Registered Nurse (RN) to join our Clinical Quality Assurance team as a Clinical Quality Assurance Coordinator. This 100% remote role focuses on reviewing peer review reports, ensuring evidence-based rationales, and maintaining compliance with...Remote work
- ...services, seeks an accomplished Medical Appeals Coordinator Position: Medical Appeals Coordinator... ...hire!!! Pay rate: $24/hr on W2 Note: REMOTE role with possibility The schedule for... ...products (Part A & B) related to clinical and non-clinical services, quality of service...Remote workTemporary workLocal areaFlexible hours3 days per week1 day per week
$37.31 - $66.91 per hour
...RN Clinical Coordinator Emergency Room Partnering for a stronger, healthier world. At CommonSpirit Health, we believe in the healing power... ...Hours/Pay Period: 72 Requisition ID: 2026-475127 Remote: No Weekly Schedule: nights Category: Staff Nurse...Remote workFull timePart timeReliefRelocation packageShift workNight shift$90k - $100k
...patients and staff regarding clinical questions. If additional information... ...community agencies to ensure coordinated care Analyzing clinical data... ...Active California RN BSN License 1-2 years of experience... ...Location: This job is fully remote. Our agency is located in the...Remote workFull time$118k - $125k
...compensation at the time of posting. Position Summary Seeking a Clinical Coordinator III (RN) to work within the outpatient practice of the Center For... ...in the electronic medical record (Epic). Provide remote patient monitoring and assessment in collaboration with supervising...Remote workTemporary workWork at officeLocal area- MES Solutions is seeking a self-driven RN or LPN to join as Clinical Quality Assurance Coordinator, focusing on high-quality peer review reports. This remote role requires strong clinical knowledge, meticulous QA, and adherence to client specifications and regulatory standards...Remote jobMonday to Friday
- ExamWorks is seeking a self-driven RN or LPN to join as Clinical Quality Assurance Coordinator. You will ensure peer review reports meet high-quality standards,... ...cite current medical references. The role is fully remote with a Mon-Fri 10:00am-6:30pm CST schedule and...Remote job
- ExamWorks is seeking a self-driven RN or LPN to join our team as Clinical Quality Assurance Coordinator. This role is fully remote, with a Mon-Fri schedule 10:00am-6:30pm CST, occasional weekends/holidays. You will perform QA review of peer review reports, addendums, and...Remote job
- ...interpretation and complex review determinations for appeals across Medicare, Medicaid, and Commercial lines. This fully remote leadership role requires board certification, a valid medical license, and extensive clinical experience. You will collaborate with cross-...Remote jobWork from home
- ExamWorks, Inc. seeks a self-driven RN or LPN to join as a Clinical Quality Assurance Coordinator in a 100% remote role. You will review peer review reports, ensure alignment with client agreements and regulatory standards, and maintain professional documentation. The...Remote jobMonday to FridayWeekend work
- MES Solutions is seeking a Clinical Quality Assurance Coordinator (RN/LPN) to review peer reports and ensure accuracy, compliance with client agreements, and regulatory standards. This 100% remote role aligns clinical expertise with quality control across cases. The position...Remote jobMonday to Friday
- MES Solutions is seeking a Clinical Quality Assurance Coordinator to ensure exceptional quality in peer review case reports. This remote role involves working Monday to Friday, performing... ...compliance. Candidates must hold an active RN/LPN nursing license and have at least...Remote jobMonday to Friday
- ALWP is seeking a Remote RN Clinical Care Coordinator for Los Angeles County. The role involves coordinating clinical care for waiver clients, developing Individualized Service Plans, and monitoring services to ensure quality and compliance. The coordinator will also participate...Remote job
- Compassus is seeking a Hospice RN Clinical Coordinator to oversee administrative and management functions in the absence of the Director of Clinical... ...and ensure compliance with state and federal regulations. Remote role with local travel to Osage Beach and nearby cities....Remote jobLocal area
- Join to apply for the Clinical Coordinator - LPN or RN role at Paradigm 2 days ago Be among the first 25 applicants Join to apply for the Clinical... ...brief introduction to Paradigm. We are seeking a full-time remote Clinical Coordinator (LPN or RN). The position is...Remote workFull timePart timeFor contractorsReliefLive inLocal areaMonday to FridayFlexible hoursWeekend work
- We are seeking a Clinical Coordinator to assist with all clinical needs for our Georgia patients. The... ...Atlanta area as well as working from remote depending on training and productivity.... ...Assistant (CMA) or licensed nurse (i.e. LPN or RN). Must be licensed in the state of...Remote workFull timeMonday to FridayFlexible hours
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