Remote Senior Clinical Appeals QA (LPN)
NTT Data
- Remote job
NTT DATA is seeking a BPO Clinical Review Senior Specialist in Tampa, FL to conduct quality audits of clinical appeal reviews, ensuring compliance with NCQA, Medicaid regulations and medical necessity guidelines. The role demands strong analytical and communication skills and the ability to coach staff while supporting quality improvements. The position is remote within Florida, requiring residency in the state, and offers comprehensive benefits including 401k with company match and paid time #J-18808-Ljbffr NTT DATA, Inc.
- A healthcare solutions company seeks a Manager of Clinical Appeals in New York. The role involves overseeing clinical appeals operations with... ...appeals and team leadership, particularly in managing remote teams. The position requires strong writing skills and a thorough...Remote workSenior
$70k - $80k
...Piper Companies is seeking a Remote Clinical Appeals Analyst to provide clinical expertise in reviewing and resolving complex member and provider... ...must hold an active North Carolina licensure as an RN, LPN, PT, or OT and have significant clinical experience. The salary...Remote workFull timeContract workMonday to Friday- St. Luke's University Health Network is seeking a Clinical Triage Specialist (LPN/RN) for the PA & NJ regions to support Primary Care & Senior Care. This role involves triaging calls, applying nursing protocols, and coordinating care to ensure timely access and quality...Remote jobSenior
- ...Senior Clinical Support LPN SRMH Orthopedics and Spine Center is seeking a Senior Clinical Support LPN to join our team in Harrisonburg, VA.... ...-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states...Remote workSeniorFull timeTemporary workWork at office
$81.1k - $116.48k
Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist - 100% Remote Join to apply for the Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist - 100% Remote role at Healthfirst . Position Summary: The Appeals & Grievances (A&G) unit...Remote jobFull timeMonday to FridayShift work$81.1k - $116.48k
Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst... ...of or delivery of clinical and non-clinical services. A&G... ...providers. This position is 100% Remote. We are hiring for the following... ...Minimum Qualifications: RN, LPN OR Dental Hygienist Preferred...Remote jobContract workTemporary workWork experience placementLocal areaMonday to FridayShift work- Everest Clinical Research invites applications for a Senior Clinical Data Manager role based in Bridgewater, New Jersey, with on-site duties and work-from-home... ...data management activities, CRF design, timelines, QA, and client audits. You will train personnel, manage...Remote jobSeniorWork from home
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- ...This position reports to the Head of Clinical Quality Assurance at Gan & Lee Pharmaceuticals... ...(Gan & Lee) or designee.. The Senior Manager, Clinical Quality Assurance supports... ...risks to address and complete risk-based QA assessments to support the implementation...Remote workSenior
$137.8k - $206.8k
Job DescriptionGeneral Summary:The Senior Manager, Clinical Study Quality Lead provides study-level quality... ...candidate brings direct, hands-on GCP QA experience supporting clinical trials... ...hybrid and is not eligible for a fully remote work arrangement.Key Duties and...Remote workSeniorFull timeSummer workFlexible hours2 days per week- MES Solutions is seeking a self-driven RN or LPN to join as Clinical Quality Assurance Coordinator. This 100% remote role focuses on reviewing peer reports, ensuring accuracy, and aligning with client agreements, regulatory standards, and state and federal mandates. You...Remote jobMonday to FridayWeekend work
$165k - $180k
...Description Summary The Senior Manager, Clinical Quality Assurance is responsible for working... ...accountable for participating in day-to-day QA Compliance operations in conformance... ...Hayward, CA location (preferred) or can be remote based. The anticipated salary range for...Remote workSeniorWork at officeShift work- MES Solutions, LLC is seeking a Clinical Quality Assurance Coordinator to maintain... ...peer review reports in a fully remote setup. The role requires an active RN or LPN license with at least two years of... ..., and support management with QA insights. #J-18808-Ljbffr MES Solutions...Remote job
$89k - $109k
...— talk with your recruiter to learn more. JOB TITLE: Senior Clinical Quality Associate LOCATION: Remote - candidates based in the following states will be considered... ...in support of clinical study conduct and provide QA expertise to ensure adherence with applicable...Remote workSeniorFull timeDay shift- ...Salary Type AnnuallyIndustry PharmaceuticalsSelling Points Drive clinical quality excellence in a hybrid executive role. Lead impactful... ...issues and develop effective corrective action plans.Supervise remote vendor audits, ensuring thorough follow-up actions and compliance...Remote workSenior
- We are seeking a senior QA specialist who will play a critical role in driving compliance... ...Lead or contribute to risk assessments for clinical projects, software systems, and vendor... ...Assistance Program Location This is a remote position, and we are open to candidates...Remote workSeniorWork at office
- Omada Health, Inc. is seeking a Senior Director, Clinical Quality to oversee program quality, accreditation, and clinical quality analytics. This... ...and clinical programs is essential. Omada offers a remote-first culture with competitive compensation and bonuses. #J...Remote jobSenior
- A clinical-stage biotechnology firm is seeking a Senior Clinical Quality Associate to lead quality assurance activities in clinical research. This remote role requires strong knowledge of FDA regulations and... ...Bachelor’s degree and relevant QA experience, along with...Remote jobSenior
- 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
$68.97k - $113.31k
## Senior Clinical Consultant (Remote)Applyremote type: Fully Remotelocations: Work From Home - PAtime type: Full timeposted on: Posted Todayjob requisition... ...subject matter expert in all lines of business (STD/LTD/Appeals) and products, action planning management, and Guardian...Remote jobSeniorWork from homeFlexible hours- WORK ARRANGEMENT: Remote, with occasional travel as needed for meetings, audits, training... ...Management, Pharmacy Utilization Management, and Appeals and Grievances.Reporting to the Chief... ...assigned functions.Works closely with clinical and operational leaders to translate...Remote workSenior
$26.34 - $40.82 per hour
...Inpatient Pavilion, Aurora - CO Department: Clinical Care Annex Work Schedule: Full Time, 7... ...role and does not offer a hybrid or remote option Work nights, earn more - our... ...State licensure as a Practical Nurse (LPN) or Vocational Nurse (LVN). BLS through...Remote workFull timeTemporary workLocal areaFlexible hoursShift workNight shift- ...Senior Clinical Quality Performance Specialist The Senior Clinical Quality Performance Specialist is responsible for overseeing, designing... ...(QI) tools in decision-making. Work Arrangement: Remote - This position is fully remote; however, the associate must...Remote workSeniorWork experience placement
$165k - $180k
...applications and next steps. Our partner is looking for a Senior Manager, Clinical Quality Assurance based in the United States. This role... ...be based at a designated California location or performed remotely within the United States. How Jobgether works: We...Remote workSeniorWork at officeShift work- ...Job Title: Senior Manager, Clinical & Coding Location: Remote Employment Type: Full‑Time Position Summary Health Business Solutions (HBiz) is seeking... ...outcomes. Partner with clinical, coding, and appeals teams to support rebuttals, appeals, and education initiatives...Remote workSeniorPermanent employmentFull time
$124.5k - $236.5k
...studies and projects across one or more clinical programs to drive proactive quality management... ...a requirement). Prefer 1+ years of GCP QA auditing experience ~ Successful and... ...-based but can occasionally be performed remotely. Employees who are site/office-based and...Remote workSeniorWork at officeLocal areaImmediate startMonday to Friday- ...Quantenalgorithmen für die Wirkstoffforschung (w/m/d) Mathematiker*in / Bioinformatiker*in (m/w/d) Senior Statistiker*in klinische Studien Facharzt für Endokrinologie als Clinical scientist (m/w/d) Münster, North Rhine-Westphalia, Germany Be an early applicant 3 days ago...Remote workSenior
- A leading clinical research organization is seeking a Senior Project Manager to oversee and execute clinical trials. This fully remote position requires strong project management skills, relevant academic qualifications, and a minimum of 8 years' experience in clinical...Remote workSenior
- ...Reference26-00485 Job Description: Design, build, and configure clinical study databases in EDC/CDM platforms. Ensure systems meet... ...integrations & data transfers with vendors. Deliver client workshops (remote/on-site). Manage timelines, budgets & project deliverables....Remote workSenior
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