Remote Senior Manager, Clinical Review & Utilization
Remote
- Remote job
Luminare Health is seeking a Senior Manager, Clinical Review to lead the daily operations of the Clinical Review Department within Healthcare Management, overseeing Utilization Management and Claims Medical Management, and supporting the Utilization Review Program. Remote position; candidates must reside in the continental United States, excluding Alaska, New York, California, or Hawaii. The role requires a Bachelor’s degree and an active RN license, with 7+ years in direct clinical care or #J-18808-Ljbffr Remote
- ...Medical Oncology (or Hematology/Oncology) for a remote role across the USA. You will perform chart review and utilization review for health plan companies with... ...certified with active license and 5+ years of clinical work. No patient contact; start ASAP. Role...Remote jobSeniorFull timeImmediate start
- ...Behavioral Health Utilization ReviewSaint Luke's... ...Health Utilization Review to join our team.... ...Department, Case Management and Reception teams... ...nursing supervisors and senior administration are... ..., 9am -5pm. Remote work not preferred... ...care provider.Review clinical charts in order to...Remote workMonday to FridayDay shift
- ...our lab network. The Senior Program Manager will drive the end-to... ...through the analytical review of tests and their... ...RegionalizationThis is a Remote opportunity however... ..., or a related field.Clinical laboratory or Health... ...to senior leadership, utilizing detailed Cost of...Remote workSeniorFull timeTemporary workPart timeWork experience placementFlexible hours
- WORK ARRANGEMENT: Remote, with occasional travel as... ...policy and procedure management, corrective action oversight... ...Physical Health Utilization Management, Behavioral... ...functions.Works closely with clinical and operational... ...operational and clinical reviews. Establish...Remote workSenior
- ...About The Role The Senior Manager of Medical and Clinical Claim Policy and Configuration is... ...Management, and Legal. *This is a remote role. Primary Responsibilities Review, update, evaluate and... ...to promote quality, optimize utilization and cost to make them...Remote workSeniorLocal areaFlexible hours
- ...Job Description Job Description: Manager of Clinical Utilization Management - Denial ComplianceLocation... ...Burbank, CAPosition Type: Hybrid (85% remote, 15% onsite in Northridge, CA); Full-... ...staff, managing daily tasks, performance reviews, and any necessary disciplinary...Remote workPermanent employmentFull timeTemporary workFlexible hours
$136.4k - $181.4k
...partner company, who manages all applications and... ...partner is looking for a Senior Manager, Clinical Site Payments,... ...amendments, forecasted spend, utilization, and closeout... ...invoice management: Review and validate vendor invoices... ...benefits . ~ Remote work environment in the...Remote workSeniorFull timeWork at office$80 - $120 per hour
...Remote | Utilization Management & Case Management Clinical Review Consultant We are sharing a specialised part-time consulting opportunity for United States-based healthcare professionals experienced in utilization management, case management, medical necessity review...Remote jobHourly payWeekly payContract workPart timeFor contractorsFlexible hoursNight shift- A leading healthcare organization seeks a Medical Director in Jackson, Mississippi. This role involves conducting clinical reviews of inpatient records and ensuring accurate decision-making based on national guidelines. Candidates should hold an MD or DO and have over...Remote job
$223.8k - $313.1k
...Director to conduct inpatient medical necessity reviews and support high-quality decision-making.... ...an MD or DO and have at least 5 years of clinical experience. The position promotes... ...within a structured environment. This is a remote position with occasional travel to...Remote job$39.4 - $53 per hour
...technology-enabled revenue cycle management solutions for health systems... ...We are seeking Virtual Utilization Review Specialists to join our... ...admissions. Utilizes approved clinical review criteria to determine... ...Abilities Required: This is a remote role which requires access...Remote workSeniorTemporary workWork at officeLocal areaMonday to FridayWeekend work$87.7k - $157.8k
...for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is... ...Centene is Hiring: Manager, Clinical Review Remote Clinical Leadership Opportunity... ...integrity and appropriate utilization of services Make an impact across...Remote workFull timePart timeWork at officeFlexible hours$280.84k - $393.18k
...Health Services, the Senior Medical Director... ...Policies and clinical leadership around... ...including quality management, grievance and appeals... ...connections to utilization management,... ...as well physician reviewers, working in the domains... .... (Mon & Fri - remote, Tues - Thurs...Remote workSeniorTemporary workLocal area- ...strategy and execution of clinical studies. The Senior (Clinical Study Manager 4) role will develop and... ...biostatisticians to review and interpret results of... ...or PMA submissions) and utilizing resources to research and... ...compliancePerform on-site and remote site qualification...Remote workSeniorInterim roleLocal areaWorldwideFlexible hoursShift work
$275k - $325k
...9 million patients, including clinical trials, transfusions, and other... ...oncology for the better. Utilization Management Medical Director OncologyWork Location: REMOTE (work from home)California Nevada... ...utilization management for case review and clinical decision making....Remote workWork from home$110.7k - $200.9k
Location: Remote, United States Category: Clinical Trial Services Division: Precision for Medicine... ...invoicing and variance management of clinical budget... ...conducting investigator meetings Review and/or approve of IP... ...Generate and utilizes metric reporting (e.g., CTMS...Remote workSeniorContract workWork experience placementWork at officeLocal areaFlexible hoursNight shift$248k - $287.1k
...providing guidance to the utilization team leaders to... ...research and overseeing the review of niche drugs (i.e.,... ...packaging of the clinical evidence summaries from... ...planning; sets performance management guidelines and... ...roadblocks and providing senior consultative support to...SeniorFull timeWork experience placementInternshipLocal areaWork from homeFlexible hoursShift work- Arcadis is seeking a Utility Coordinator to join our Atlanta transportation team, embedded... ...installations for transportation projects, with remote work 1-2 days per week. You will oversee multiple utility coordination projects, review plans, prepare analyses, and ensure GDOT...Remote jobSeniorWork at officeRelocation2 days per week1 day per week
$166k - $209k
...peptide drugs. We are advancing a clinical‐stage pipeline of... ...location.Position Summary:The Senior Manager, Clinical Business Systems is... ...releases.Perform audit trail reviews and user access reviews.IT GxP... ...company.Travel:Remote employees will need to be present...Remote workSeniorContract workWork at office$120k - $200k
Team: Product Management & AlliancesCity: BostonState: MA Veeva... ...communities.The RoleA Senior Product Manager for Veeva Clinical Operations will own the product... ..., our team will review your full application package... ...and/or stock bonus.#LI-Remote#LI-MidSeniorVeeva’s headquarters...Remote workSeniorWork at officeLocal areaWork from home3 days per week$248.5k - $373k
...73,000.00Job Area: Medical & Clinical OperationsCompany: UnitedHealth... ...Oncology will provide utilization review determinations and support case and disease management teams to achieve optimal clinical... ...enjoy the flexibility to work remotely * from anywhere within the U....Remote workMinimum wageWork experience placementLocal area$248.5k - $373k
...00Job Area: Medical & Clinical OperationsCompany: UnitedHealth... ...and medical claims reviews. Our role is to... ...seamless experience, and manage health care costs.The... ...knowledge in various utilization management activities... ...the flexibility to work remotely * from anywhere within...Remote workMinimum wageWork experience placementLocal area$150k - $175k
...offering flexibility to work remotely. You’ll partner with... ..., and execution of clinical trials in... ...role combines people management with hands-on contribution... ...provide regular updates to senior leadership.Manage clinical... ...of Institutional Review Board (IRB) approvals...Remote workSeniorMinimum wageOngoing contractFull timeContract workTemporary workWork at officeLocal areaWorldwideNight shift3 days per week- Spectrum Healthcare Resources seeks a Utilization Manager Registered Nurse (UMRN) to work entirely from home in a fully remote role. The nurse will review cases, educate patients on appropriate care, and manage health care costs for dependents of active duty and eligible...Remote jobWork from homeMonday to Friday
- ...Job Title: Senior Manager, Clinical & Coding Location: Remote Employment Type: Full‑Time Position Summary Health Business Solutions (HBiz) is seeking... ...g., RAC, MAC, CERT, PERM, TPE, and commercial payer reviews). Direct audit intake, medical record review,...Remote workSeniorPermanent employmentFull time
$180k - $205k
...Description We are looking for a Senior Product Manager to own scheduling and the... ...work runs through our core clinical operations platform, the... ..., lab turnaround, staffing utilization, and care quality. ~Work... ...Requirements ~This remote opportunity based out of the...Remote workSeniorFull timeTemporary workWork at officeImmediate startWork visaFlexible hours- ...strategy and execution of clinical studies. The Senior (Clinical Study Manager 4) role will develop and... ...biostatisticians to review and interpret results of... ...or PMA submissions) and utilizing resources to research and... ...compliance Perform on-site and remote site qualification...Remote workSeniorInterim role
$75k - $150k
...success, and growth.The Product Marketing Manager / Senior Manager - Clinical Operations will be responsible for... ...the assessment, our team will review your full application package and follow... ...bonus and/or stock bonus.#LI-Remote#LI-MidSeniorVeeva’s headquarters is located...Remote workSeniorWork at officeLocal areaWork from home3 days per week$116k - $157k
...seeking a mission-driven Senior Consultant to join the Energy & Utilities team. In this role, you... ...contribute to the execution and management of decarbonization... ...regulatory, and policy reviews Conduct building energy... ...standards Desire to work in a remote environment with...Remote workSeniorWork experience placementFor subcontractorLocal areaImmediate start- Moderna Services, Inc. is seeking a Sr. Manager, Clinical Data Management in Cambridge, MA. Lead data management activities for studies and... ...deliverables for regulatory submissions. You will drive EDC setup, data review, and database lock across studies, ensuring TMF readiness and...Remote jobSenior
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