Senior Medical Management Clinician — Remote RN/LPN
Elevance Health, Inc.
- Remote job
Elevance Health is seeking a Medical Management Clinician Senior to ensure appropriate administration of plan benefits by reviewing clinical information and assessing medical necessity under guidelines and policies. The role may collaborate with providers and serves as a resource for junior clinicians. The position is located in Virginia with virtual full-time work and required in-person training sessions. Schedule is Monday–Friday, 8am–5pm EST, with overtime opportunities. #J-18808-Ljbffr Elevance Health, Inc.
- Elevance Health is seeking a Medical Management Clinician Senior to manage complex utilization reviews and clinical decisions within Virginia. The role... ...or utilization review experience, hold an active RN/LPN license, and may #J-18808-Ljbffr The Elevance Health Companies...Remote jobSenior
- Elevance Health, Inc. is seeking a Medical Management Clinician Senior to ensure accurate administration of plan benefits by reviewing clinical information... ...also serves as a resource for junior clinicians. Remote-friendly with in-person training sessions; schedule is Monday...Remote workSeniorMonday to Friday
$5,000 per month
...Status: Part-Time Is Remote Position: No PayRate... ...Ensures that Medication Aides are maintaining... ...quality resident care Manages shift coverage when staff... ...Requirements: Current state LPN/LVN or RN License if required by... ...Us: As a Sinceri Senior Living company, we are...Remote workSeniorHourly payPart timeShift workWeekend work$60.2k - $107.4k
...State of Texas. The chosen Senior Clinical Administrative RN would be responsible for... ...benefits, contracts, and medical policy Review denial... ...experience, including utilization management, medical necessity review... ...with Medical Directors, clinicians, or cross‑functional...Remote jobSeniorMinimum wageFull timeWork experience placementWork at officeLocal area- ...registered nurse to enhance frail seniors' ability to age in place by... ...care and educate members to manage chronic conditions, reducing hospital... .... Ideal candidates have CA RN licensure, ASN, and 3+ years... .... This role offers mostly remote work from the LA area with occasional...Remote jobSenior
- UnitedHealth Group is seeking a Senior Clinical Administrative RN to support Texas remote reviews of appeals and fair hearings. The role emphasizes clinical review, chart audits, and collaboration with cross-functional teams to ensure accurate determinations and compliance...Remote jobSenior
- Dilkon Medical Center in Dilkon, AZ is seeking an experienced RN Case Manager to coordinate mental health services for pediatric to geriatric patients. You will work with... ..., quality care across WIHCC sites, including remote duties as needed. The role emphasizes adherence...Remote jobSenior
- ...Occupational Health Registered Nurse for a 100% remote role supporting the USPIS contract. The RN will lead national Occupational Medical and Health Services programs, including... ..., wellness initiatives, and medical case management. Occasional travel to training sites is...Remote jobSeniorHourly payContract work
- ...quality, accuracy and regulatory alignment. RN/LPN/LVN license required, with a strong eye... ...evidence-based rationales, proper medical citations, and professional report presentation... ...supporting QA improvements and client satisfaction in a 100% remote setting. #J-18808-LjbffrRemote work
- American Senior Communities seeks a Unit Manager for Rosewalk Village Indy in Indianapolis. The role is full-time days and requires RN or LPN licensure. The Unit Manager oversees nursing care on the unit, supervising licensed staff and ensuring compliance with professional...SeniorFull time
- ...Unit Manager (RN or LPN)Location: Clay County Health and RehabilitationJob... ...Planning - Conduct comprehensive medical assessments, implement... ...LMS offers free courses for senior care, health and human services... ...telemedicine services and remote health monitoring to advanced...Remote workLocal areaShift workNight shiftDay shiftAfternoon shift
- Lansdowne Village in Missouri seeks a Unit Manager (LPN or RN) to lead nursing care for residents in a supportive, team-based environment. The role includes administering medications, creating care plans, and ensuring documentation meets regulatory standards. Qualified...SeniorFull time
- ...MES Solutions is seeking a self-driven RN or LPN to join our remote Clinical Quality Assurance team. You will oversee peer review reports, ensure alignment with client agreements and regulatory standards, and maintain high-quality documentation while protecting confidentiality...Remote workMonday to Friday
- Elevance Health, Inc. seeks a Medical Management Clinician based in Florida to support virtual work with required in-person training sessions. This... ..., 4+ years clinical/utilization review experience, and active RN/LPN license with #J-18808-Ljbffr Elevance Health, Inc.Remote job
- LanceSoft is seeking a Healthcare - Care Review Clinician II for a remote role in the United States. The position involves medical necessity reviews and prior authorization work... ...plan or IPA prior authorization and a CA RN or LVN license. Travel to client offices or hospitals...Remote jobShift work
$70k
...Are you an RN or LPN looking for an opportunity in focused wound care... ...is full time, and is fully remote. Candidates must reside in the... ...States. Assistant to the Medical Director - RN or LPN ~ Full... ...coordinate corrective actions, and manage risk ~#IND102...Remote workFull timeFor contractorsWork at office- ...MES Solutions is seeking a self-driven RN or LPN to join our remote Clinical Quality Assurance team. You will review peer review reports, ensure evidence-based rationales, and maintain compliance with client specifications, regulatory standards, and federal/state mandates...Remote workMonday to FridayAfternoon shift
- ...Precertification Nurse - LPN/RN Medlogix, LLC delivers innovative medical claims solutions through a seamless collaboration... ...: Monday to Friday Location: Remote. Will need to be in Hamilton NJ... ...- Preferred InterQual/Review Manager/CERME CPT and ICD-9/ICD-10...Remote jobFull timeWork at officeMonday to Friday
- Elevance Health seeks a Medical Management Clinician Associate in Florida. The role supports virtual work with in-person training sessions, requiring residence in Florida and compliance with hybrid/virtual work policies. License and licensure in-state are required, with...Remote job
$80k - $85k
About LakeHouse Senior Living LakeHouse Senior Living operates... ...of licensed nurses, care managers, and support staff to... ...wellness checks, medication management, and service plan... ...Qualifications: Registered Nurse (RN) or Licensed Practical Nurse (LPN) license in good standing...SeniorFull timeWork at officeLocal area- ...Solutions is seeking a Clinical Quality Assurance Coordinator to review peer reports remotely and ensure accuracy, citations, and regulatory compliance. The role requires an active RN or LPN license and at least two years of clinical experience. You will verify client...Remote jobMonday to Friday
- ...Clinical Coordinator - LPN or RN role at Paradigm 2... ...accountable specialty care management organization focused... ...seeking a full-time remote Clinical Coordinator (... ...and manage a range of medical and health care related... ...protected class. Seniority level ~ Seniority level...Remote workFull timePart timeFor contractorsReliefLive inLocal areaMonday to FridayFlexible hoursWeekend work
- Maximus is seeking a Lead Coordinator - Clinical Review, an LPN or RN, to support the California Independent Medical Review (CA IMR) team. This fully remote, non-bedside role involves reviewing medical records, extracting key clinical information, and preparing clear summaries...Remote job
$60.2k - $107.4k
...and support of members about management of their health and well-being... ...the flexibility to work remotely from anywhere within the U.S.... ...customer service setting addressing medical/health questions Own... ...~ Current and unrestricted RN compact license ~4+ years of...Remote jobSeniorMinimum wageFull timeWork experience placementLocal areaMonday to Friday- ...Summary Provides education to medical providers as warranted.... ...Location: This a full-time remote position . You will work an 8-... ...: Required Education: If LPN, graduate of accredited School... ...Licensed Vocational Nursing; If RN, graduate of approved School of...Remote workSeniorFull timeFor contractorsWork experience placementWork at officeLocal areaShift work
- ...and logging of chronic care management activities, and provider and... ...area as well as working from remote depending on training and productivity... ...Review and organize patient medical records in preparation for... ...CMA) or licensed nurse (i.e. LPN or RN). Must be licensed in the...Remote workFull timeMonday to FridayFlexible hours
- ...specialized healthcare organization is seeking a dedicated Assistant to the Medical Director, requiring an active RN or LPN license and significant wound care knowledge. This full-time remote role involves supporting the Clinical Director through administrative and clinical...Remote jobFull time
$725 per month
...Health and Wellness Director Bench - LPN or RN at Brookdale Senior Living, Chandler, AZ. Through on‑the... ...Director role, including people management, clinical management, quality care and... ...electronic documentation. Benefits Medical, dental, vision insurance. 401(k) with...SeniorHourly payTemporary workWork at officeFlexible hours- ArchWell Health in Tampa, FL is seeking a Nurse Care Manager to coordinate and evaluate care for patients with acute and chronic conditions across the care continuum. You will work closely with the care team to develop and execute individualized care plans, ensuring regulatory...Remote jobSenior
$160k - $180k
...About the Role: The Senior Director of Clinical... ...every workflow it asks clinicians to follow is protocol-based... ...Planned Parenthood's medical leadership across the... ...themselves. This role is remote, with periodic travel... ...clinical background (RN, NP, PA, or equivalent)...Remote workSeniorLocal areaWork from home
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