Remote Clinical Data & Audit Consultant
Centene Management Company LLC
- Remote job
Centene Management Company LLC is seeking a Clinical Data and Audit Consultant for its Medical Management/Health Services team. The role focuses on clinical data collection, audits, workflow design, and regulatory reporting to support HEDIS/URAC/NCQA compliance. The consultant analyzes data, creates processes, trains staff, and drives performance improvements across clinical service teams. The position requires RN licensure in CA, a clinical background, and experience in data analysis and #J-18808-Ljbffr Centene Management Company LLC
$33.71 - $60.67 per hour
...everything for our 28 million members as a clinical professional on our Medical Management... ...Position Purpose: The Clinical Data and Audit Consultant is responsible for the clinical content... ...and a flexible approach to work with remote, hybrid, field or office work schedules...Remote workHourly payFull timePart timeWork at officeFlexible hours$122 per hour
...Licensed Clinical Social Worker (LCSW) Up to $122/hour Fully Remote or In-Person Flexible Schedule Pay & Flexibility Hourly Rate: Up to $122 per hour... ...Full Compliance: Stay protected with built-in audit support and ongoing compliance resources. Broad...Remote workBi-weekly payHourly payExtra incomeFull timePart timePrivate practiceFlexible hours$122 per hour
...Licensed Clinical Social Worker (LCSW) Up to $122/hour Fully Remote or In-Person Flexible Schedule Pay & Flexibility Hourly Rate: Up to $122 per hour... ...Full Compliance: Stay protected with built-in audit support and ongoing compliance resources. Broad...Remote workBi-weekly payHourly payExtra incomeFull timePart timePrivate practiceFlexible hours$60k - $145k
...communities.The RoleThe Migration Consultant will be a leading member of... ...by providing expertise with data and document content... ...and in the future.This is a remote, full-time permanent role with... ...sciences industryExperience with Clinical, Regulatory, Quality, or Safety...Remote workPermanent employmentFull timeWork at officeLocal areaWork from home3 days per week- ...modeling. You will apply deep expertise in data science, machine learning, AI techniques,... ...stakeholders. As an advisor, you will partner across Audit, Technology, Enterprise AI, data science,... ...unless the job is noted as open to remote.Fannie Mae is an equal opportunity...Remote workFull timeWork at office
- ...relationships with respected organizations across all 50 states, we offer opportunities at leading health systems, hospitals, specialty clinics, and post-acute facilities. Thanks to our direct client partnerships and national MSP programs, you'll have the flexibility to work...Remote work
- ...committed to "ending cancer for life" through toptier clinical care, ambitious research programming, and ongoing... ...clinical trials. Job Title: InterSystems HIE / Epic Data Conversion Consultant Job Location: Remote Duration: 1 Month Job Type: Temporary...Remote workTemporary workWorldwide
- ...license in good standing to join the Medicaid Team as a Clinical Auditor. The role may offer remote work flexibility, but the candidate must reside in... ...based guidelines. The incumbent will support clinical auditing activities, align compliance with corporate standards,...Remote work
$60k - $145k
...The Role The Migration Consultant will be a leading member of the... ...by providing expertise with data and document content migration... ...in the future. This is a remote, full-time permanent role with... ...industry Experience with Clinical, Regulatory, Quality, or Safety...Remote workPermanent employmentFull timeWork at officeLocal areaWork from homeFlexible hours$90k - $185k
...by providing expertise with data and document content migration... ...practices. The Senior Migration Consultant is a customer advocate... ...in the future. This is a remote, full-time permanent role with... ...industry Experience with Clinical, Regulatory, Quality, or Safety...Remote workPermanent employmentFull timeWork at officeLocal areaWork from homeFlexible hours- ...focused on medical reasoning. The role involves designing complex clinical scenarios, evaluating AI responses, and providing expert... ...certification in Internal or Emergency Medicine. This is a fully remote position requiring a commitment of 20-40 hours per week, with a...Remote workTemporary workFor contractors
$75k - $115k
...Description Join the PPD™ clinical research business of Thermo... ...complex internal and external audits to help ensure compliance... ...facility audits. Provide GCP consultation and quality support to project... ...(25-50%). Location: Remote United States. Relocation assistance...Remote workFull timeWork at officeWork from homeRelocation package- ...medicine to refine large language models. The role involves designing clinical scenarios, evaluating AI responses, and collaborating with... ...experience, and strong communication skills. This is a fully remote contractor position requiring 20-40 hours per week, with a commitment...Remote workTemporary workFor contractors
- ...people in lifelong health, one step at a time. Omada’s Clinical Quality Team is seeking a Senior Data Analyst to advance our mission of delivering high-... ...through data and analytics. Working Conditions Remote first environment Travel may be up to 8% Benefits...Remote workWork from homeFlexible hours
- ...Coral Connect, LLC is hiring a Senior Clinical Compliance Manager to guide healthcare organizations on compliance with laws, regulations and accreditation standards. You will lead audits, develop policies, and educate stakeholders to improve quality and regulatory readiness...Remote work
- ...measures. You will guide care plans, collaborate with clinical and operations teams, and mentor staff while ensuring audits and improvements across markets. The role requires PA residency, up to 10% travel in PA, and remote flexibility for PA. Competitive salary and...Remote work
$210k - $235k
Jade Biosciences is seeking a Director, Clinical Compliance who will lead compliance oversight for clinical trials and ensure adherence to ICH-GCP regulations. This remote role includes significant collaboration with study teams and vendors. The successful candidate will...Remote job- ...the accuracy of AI models. The role involves designing complex clinical scenarios, evaluating AI responses, and providing feedback to improve... ...recent active practice and board certification. This fully remote position requires 20-40 hours per week, with flexibility in...Remote job
- Mosaic Health, LLC. is seeking a Manager, Clinical Quality to lead a team focused on clinical quality measurement, reporting, audit support and improvement activities. You will set priorities, manage resources, and partner with clinical leaders to address gaps in quality...Remote job
- KORE1 is seeking a Solutions Consultant (Oncology Real-World Data) for a fully remote, full-time role. The position supports pre-sales, scientific solution development... ...-paced environment. The ideal candidate combines clinical or scientific expertise with strong communication...Remote jobFull time
$80k - $90k
..., untangles healthcare data to deliver industry-leading... ...k The Medical Review Clinical Appeals Auditor (RN) is... ...from medical review audit work completed by the... ...business insights. Consults with internal resources... ...work independently in remote setting with minimum supervision...Remote workFor contractorsImmediate startWork from homeHome officeFlexible hoursShift work- UnitedHealth Group is hiring a Clinical DRG RN auditor to apply MS-DRG/APR-DRG knowledge, ICD-10 guidelines, and AHA Coding Clinic guidance in inpatient claim audits. You will validate codes, DRG assignments, and discharge status to identify overpayments and compose rationales...Remote job
- Elevance Health is seeking a Diagnosis Related Group Clinical Validation Auditor-RN to audit inpatient medical records, ensuring clinical documentation supports DRGs billed and reimbursed. The role emphasizes ICD-10 coding expertise and DRG validation across multiple DRG...Remote job
- ...in internal or emergency medicine. The role involves designing clinical scenarios for AI systems, evaluating diagnostic accuracy, and collaborating... ...the last three years. The position offers a flexible, fully remote role of 20-40 hours per week, ideal for professionals looking...Remote jobFlexible hours
- ...enhance AI language models. Responsibilities include designing clinical scenarios, evaluating AI diagnostics, and collaborating with researchers... ...communicate complex medical concepts clearly. This position is remote, requiring 20-40 hours/week, with an initial duration of 1...Remote job
$69.3k - $78k
Overview Medical Review Nurse II - Clinical Validation At Performant, we’... ...performs medical claims audit reviews. As a MR Nurse, you will... ...Commercial Payers. You will work remotely in a fast paced and dynamic... ...Proprietary, Confidential and/or Public data. As such, all employees and...Remote workFor contractorsWork at officeWork from homeHome officeShift work- UnitedHealth Group is seeking a M&R Coding Clinical Analyst to verify the accuracy of... ...by comparing medical records to submitted data. This role requires independent judgment... ...compliance with state and federal guidelines. Remote work is available within the U.S. The position...Remote job
$64.5k - $92.2k
Gainwell Technologies LLC is seeking a Clinical Quality Nurse Reviewer, Sr. Specialist to perform ongoing quality assurance audits on clinical staff. This full-time remote position requires an active RN license and clinical experience in healthcare. Responsibilities include...Remote jobFull time- ExlService Holdings, Inc. is seeking a Clinical Validation Auditor to review inpatient records... ...fairness in claims coding while working remotely. Ideal candidates are licensed nurses... ...overpayments, contributing to quality patient data and compliant billing practices. #J-1880...Remote job
- UnitedHealth Group is seeking a Clinical DRG RN auditor to apply expert MS-DRG/APR-DRG coding knowledge and ICD-10 guidelines in inpatient claims audits. This remote role allows telecommuting from anywhere in the U.S. with a sign-on bonus for external applicants. Responsibilities...Remote jobRelocation package
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