Remote RN: Medical Policy & Claims Strategy Lead
PVH (Tommy Hilfiger/Calvin Klein)
- Remote job
Blue Cross and Blue Shield of Nebraska is seeking a remote Nursing Policy Leader to drive medical policy development, coding strategy, and operational excellence. You will partner with executives and IT teams to translate clinical needs into policy and system configurations. The role requires an RN license, BSN, and 5–7 years of clinical nursing plus 3+ years in medical policy or related health-insurance operations. #J-18808-Ljbffr PVH (Tommy Hilfiger/Calvin Klein)
- ...is seeking a senior Clinical Analyst to lead medical policy development, coding strategy, and complex claims configuration initiatives. This remote nursing role partners across Medical... ...enhancements. The ideal candidate will have RN licensure, BSN (Master's preferred), 5-...Remote jobPolicyMedicalClaims
- Recruiting for P&C Claims Legal, Property Center... .... Position may be remote within the United... ..., insurance policies and contracts. Experience leading complex or strategic... ...managing risk‑mitigation strategies. Optional... ...small team. Benefits Medical, dental, vision, life...Remote workPolicyMedicalClaimsTemporary workCasual workWork at office
$115.2k - $158.4k
...Description The Communications Lead, Insurance and Content Strategy is a strategic advisor... ...pillars. ~Implements policies and programs to increase employee... .... Benefits ~Medical, dental and vision benefits... ...role. ~While this is a remote position, occasional travel...Remote workPolicyMedicalFull timeTemporary work$220k - $275k
...Description This is a remote position, but must reside... ...VP & Head of Payer Strategy is the enterprise payer... ..., and coding/billing policies. ~Lead escalation management:... ...contract, payer mix, claims denial rates, and financial... ...relations, or medical management. ~CMS or...Remote workPolicyMedicalClaimsFull timeContract workLocal area$183.55k - $275.32k
...Regulatory Labeling Strategy, Advertising, and... ..., and Medical, as well as other... ...labeling documents. Lead regulatory strategy... ...teams on appropriate claim substantiation, fair... ...maintain internal policies, SOPs, and guidance... ...ability to be either remote in the US or...Remote workPolicyMedicalClaimsTemporary workLocal areaWork from homeFlexible hours3 days per week$150k
...hiring Loula's founding Payer Strategy & Partnerships Lead! This is someone who... ...credentialing requirements, claims processes, and payment timelines... ...package Unlimited PTO Medical, dental, and vision coverage... ...or New York preferred but remote is welcome. Loula is an Equal...Remote workMedicalClaimsContract workTemporary work$115k - $145k
Associate Director, Medical Strategy At Real Chemistry, making... ...or San Francisco) or remotely within the US, depending... ...leadership - Lead, shape and execute strategy... ...Learning. Remote Work Policy Since the pandemic, we... ...any unverified sources claiming to be connected to Real...Remote workPolicyMedicalClaimsWork at office2 days per week- ...Credit Card, and Mortgage)—including credit strategies/policies for new account origination and... ...including pregnancy, childbirth and related medical conditions, breastfeeding, and... ...coverage issues, we are unable to accommodate remote work from Hawaii or Alaska at this time...Remote workPolicyMedicalWork experience placementWork at office
$195k - $215k
...Equally. Our Advisory, Medical, and Marketing... ...our Fertility Policy, enhanced parental... ...research and evidence strategy and tactical... ...new business, and lead projects in a leadership... ...data knowledge of claims, EHR, and other... ...including hybrid and remote work, along with...Remote workPolicyMedicalClaimsTemporary workSummer workWork at officeImmediate startWork from homeFlexible hours- ...searching for a Director of Data Strategy to lead the development and... ...with key strategic leaders in Claims, Finance, Analytics, Actuarial... ...Committee. Develop and implement policies for data roles, stewardship,... ...Group Health Insurance (Medical, Dental, and Vision) Life...Remote jobPolicyMedicalClaimsImmediate startWork from homeWork visaFlexible hours2 days per week
$126k - $170k
...Director, Product Strategy - Commercial Lines... ...business. This role leads product strategy... ...Underwriting, Actuarial, Claims, Product... ...disability insurance Medical, dental and vision... ...and hybrid/remote options for eligible... ...Employer. It is our policy to recruit, hire,...Remote workPolicyMedicalClaimsTemporary workWork at officeHome officeFlexible hours$193k - $240k
...Director, Contracting Strategy and Administration... ...Disease markets Lead the design of... ...respond to federal policy shifts, specifically... ..., ensuring claims are valid and paid... ...3 days per week - remote considered for qualified... ...benefits such as medical, dental, vision, flexible...Remote workPolicyMedicalClaimsContract workTemporary workWork at officeFlexible hoursShift work2 days per week3 days per week- American Medical Association is seeking a Sr. Manager Claims for a remote role within the AMA Insurance team. Lead the claims department, establish policies, and ensure timely, accurate processing in line with carrier requirements and state/federal regulations. You will...Remote jobPolicyMedicalClaims
$79.5k - $100k
...Location : This is a hybrid remote/in‑office role.... ...follows a hybrid office policy in which employees who... ...Medidata offers industry‑leading expertise, analytics‑powered... ...Team The Global Sales Strategy & Enablement group,... ...provides benefits, including medical, dental, life and...Remote workPolicyMedicalWork at officeLocal areaFlexible hours$28.76 - $62.3 per hour
...Job Summary Provides lead level support for medical claim and internal appeals review... ...regulatory requirements, Molina policies and procedures, and... ...Contributes to overarching strategy to provide quality and cost... ...experience. Registered Nurse (RN). License must be active...Remote workPolicyMedicalClaimsHourly payWork experience placementWork at office$111.8k - $216.6k
...important and impactful work lead to the same place. Job... ...to established firm policies and procedures. KEY... ...implement the overall strategy, process, procedures, and... ...time personnel include: Medical/Prescription Drug... ...Illness Insurance Hybrid/Remote Work Opportunities Hospital...Remote workPolicyMedicalFull timeTemporary workLocal areaRelocationFlexible hours- ...PMG leverages business strategy and transformation, creative... ...with clients, media leads, analytics teams, and... ...and support for everyday medical expenses and routine... ...NY I'm seeking a fully Remote role In which city and... ...Employment Opportunity policy,we do not discriminate...Remote workPolicyMedicalContract workFor contractorsWork experience placementFor subcontractorWork at officeLocal areaRelocationVisa sponsorshipShift work
$219k - $285k
...: San Diego, USA- Remote Be a part of a global... ...of becoming a leading biopharmaceutical... ...Metabolic Market Access Strategy & Marketing is... ...with Commercial, Medical Affairs, HEOR, Legal... ...: Monitor payer policy changes, reimbursement... ..., such as Komodo claims, MMIT, and Policy...Remote workPolicyMedicalClaimsTemporary workWork experience placement- ...Partners Group is seeking a Head of Claims Intake and Strategy to lead claims processes with clarity and strategic... ...direction. This role can be fully remote or hybrid for candidates based in... ...should have a strong background in medical professional liability, with...Remote jobMedicalClaims
$47.89 - $55.76 per hour
...As a BlueCard/ITS Claims Specialist, this role... ...escalation point, leads cross-functional... ...ITS/BlueCard policies and procedures.... ...support operational strategy. ~Act as a liaison... ...Company-subsidized medical, dental, vision, and... .... ~Remote work and continuing...Remote workPolicyMedicalClaimsFull timeSummer workWork at officeNight shift- ...Senior Integrated Accumulations Manager to lead the strategy and implementation of enterprise-wide accumulations... ...on optimizing benefit administration and claims processing while collaborating with cross-functional teams in a remote environment. The ideal candidate will have...Remote jobClaimsFull time
$102.4k - $170.6k
...enterprise level requirements for policy controls and data... ...EDG Policy(ies) and industry leading Maturity models and their respective... ...of the Enterprise Data Strategy and Management organization... ...with data management (medical, provider, claims, clinical, pharmacy, eligibility...PolicyMedicalClaimsFull timeWork from home- ...includes continuous remote monitoring,... ...operator to build and lead the revenue cycle... ...Director, Revenue Cycle Strategy, Partnerships &... ..., translate policy changes into action... ...authorization, coding, claims submission, denial... ...or children for Medical, Dental, and Vision...Remote workPolicyMedicalClaimsFull timeTemporary workPart timeWork at officeRelocationFlexible hours
$143.32k - $273.93k
...spouses. USAA roles may offer remote or hybrid flexibility for... ...consistent with applicable policy and business needs. The Opportunity... ...As a dedicated Fraud Strategy Analyst Lead, you will be accountable for... ...include comprehensive medical, dental and vision plans, 40...Remote workPolicyMedicalTemporary workH1bWork at office- The Compliance Lead will help lead the organization's compliance strategy and operations, ensuring adherence to federal... ...knowledge of operations in claims, call centers, and/or medical management. Privacy... ...leadership on necessary changes. Policies & Procedures: Oversee the...Remote jobPolicyMedicalClaimsFor contractors
- ...managing insurance claim denials and leading the appeals process... ...organized, knowledgeable in medical billing and payer... ...in office then remote Benefits offered Key... ...develop effective appeal strategies. Obtain necessary... ...in accordance with HIPAA and company policies....Remote workPolicyMedicalClaimsWork at officeMonday to Friday
$77.5k - $87k
...Join to apply for the Lead Claims Examiner role at AmTrust... ..., claimants and medical providers. Maintains a... ...This position will start remotely with an expectation to... ...Responsibilities: Follows AmTrust policies and procedures in... ...return to work strategies and treatment plans. Obtains...Remote workPolicyMedicalClaimsFlexible hours- ...an experienced leader to manage a specialty casualty claims team. This role involves guiding strategy on complex claims while ensuring adherence to regulatory... ...to enhance team performance. The position allows for remote work across the US, along with a comprehensive...Remote jobClaims
$126.1k - $168.13k
...house opportunity? The Senior Claims Counsel position with First... ...loss under the title policy, assess defenses for the insured... ...outside counsel on litigation strategy through the course of claim administration... ...benefits package including medical, dental, vision, 401k, PTO/...Remote workPolicyMedicalClaims- ...site, hybrid, or fully remote for California‑based attorneys... ..., developing strategy, and/or evaluating staff... ...attorneys, adjusters, claims professionals and support... ...current and possible future policies, practices, trends and... ...develop. Benefits Medical, dental, vision, life,...Remote workPolicyMedicalClaimsTemporary workWork at officeLocal areaImmediate startWork from homeShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN: Medical Policy & Claims Strategy Lead. Be the first to apply!



