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Remote Jobs in the United States

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Jobs

Registered Nurse (RN) Software Galaxy Systems, LLC

Remote

$1,500–$2,000 / week
Full time
Quick Apply

A utilization management nurse’s job description includes examining medical treatments and interventions to avoid payment denial and optimizing reimbursements by assessing the treatment’s appropriateness, effectiveness, timing, and setting. Identifying areas to improve the cost-effectiveness of care while maintaining quality requires reviewing the utilization of health care resources, such as the length of hospital stay, medications, therapies, and diagnostic tests. .

1 day ago

Scrum Product Owner CareSource Management Services, LLC

Remote

Full time
Quick Apply

CareSource Management Services, LLC seeks a Scrum Product Owner: Req BS in IT, BioTech, IT Proj Mgmt, or related, & 5 yrs as a Test Lead in hlth care indstry. Email CV to ATTN: HR Shared Services, 1004391, hrsharedservices@caresource.com.

Today

Package Specialist IBM Corporation

NORTH CASTLE, NY

Remote

$193,461–$215,000 / year

One (1) year of experience must include utilizing Oracle Integration Cloud (OIC), Oracle Visual Builder Cloud Service (VBCS), Oracle Fusion ERP Cloud - Business Intelligence (BIP) Reports, Oracle SQL Database - PL/SQL programming, Electronic Data Interchange (EDI) file programming. Utilize: Oracle Integration Cloud (OIC), Oracle Visual Builder Cloud Service (VBCS), Oracle Fusion ERP Cloud - Business Intelligence (BIP) Reports, Oracle SQL Database - PL/SQL programming, Electronic Data Interchange (EDI) file programming.

Today

Clinical Pharmacist Software Galaxy Systems, LLC

Remote

$53–$55 / hour
Contractor
Quick Apply

You will be responsible for ensuring cases are accurately set up for our members, review clinical information for decisioning the request, performing outreach to providers for more information when needed, and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines. This is a great opportunity to initiate a career with a leading healthcare company by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, while promoting a best-in-class service experience.

30+ days ago

Front-End Tech Lead Developer Lateral Insights LLC

Birmingham, IA

Remote

Full time

Perform accessibility validation using automated testing tools, screen readers (JAWS, NVDA, VoiceOver), and manual keyboard/tabbing navigation. The position combines expert-level front-end engineering with formal accessibility certification, and provides both hands-on development and team leadership.

1 day ago

Locum Physician (MD/DO) - Psychiatry - General/Other in Boston, MA LocumJobsOnline

Boston, MA

Remote

Doctor of Medicine | Psychiatry - General/Other Location: Boston, MA Employer: Weatherby Healthcare Pay: Competitive weekly pay (inquire for details) Shift Information: 4 days x 10 hours Start Date: ASAP. Weatherby Healthcare is part of the CHG Healthcare family of staffing companies, which leads the locum tenens industry in size and quality.

30+ days ago

Senior Manager, Medical Loss Ratio Centene

Florissant, MO

Remote

$107,700–$199,300 / year

Leads cross-functional forums and working sessions with Finance, Actuarial, Legal/Compliance, Government Affairs, and operations to drive decisions, resolve issues, and ensure clear ownership of actions that impact MLR results and regulatory posture. See Centene Terms & Conditions at https://www.centene.com/terms-conditions.html and Privacy Policy at https://www.centene.com/privacy-policy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.

30+ days ago

Remote Medical Director, Appeals Centene

White Salmon, WA

Remote

$236,500–$449,300 / year

See Centene Terms & Conditions at https://www.centene.com/terms-conditions.html and Privacy Policy at https://www.centene.com/privacy-policy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/privacy and Terms of Use at https://www.sonicjobs.com/terms. Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and medical necessity appeals.

1 day ago

Remote Behavioral Medical Director, Central Region Centene

Carlton, TX

Remote

$236,500–$449,300 / year

1 day ago

iValua Consultant Collabera

Dallas

Remote

$70–$73 / hour
Quick Apply

Hands-on iValua platform experience — configuration, development, and/or integration (non-negotiable). Experience supporting procurement or supply chain technology integrations.

7 days ago

Psychologist Reviewer Centene

WILMINGTON, NC

Remote

$87,700–$157,800 / year

Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care. For ABA Reviewers only, working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence-based practices designed for individuals with Autism Spectrum Disorder.

30+ days ago

staff - Registered Nurse (RN) - Case Management - $27-46 per hour Perm Staff Jobs

Lansing, MI

Remote

$60,522–$129,615 / year

The LTSS RN Case Manager is responsible for comprehensive assessment, care planning, coordination, implementation, and monitoring of Long-Term Services and Supports (LTSS) for dual-eligible Medicare and Medicaid members. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs.

4 days ago

staff - Registered Nurse (RN) - Case Management - $42-48 per hour Perm Staff Jobs

Warren, MI

Remote

$60,522–$129,615 / year

4 days ago

Junior NextGen Developer DCS Corp

California, Maryland

Remote

$73,160–$100,000 / year

Pay Range and Benefits : There are a variety of factors that can influence salary at DCS Corp, including but not limited to, geographic location, Federal Government contract labor categories and wage rates, relevant prior work experience, specific skills and competencies, education, and certifications. DCS is seeking an experienced Junior Developer to join its teams developing exciting and modern Navy next-generation mission planning software on an Agile/SAFe team.

22 days ago

staff - Registered Nurse (RN) - Case Management - $27-48 per hour Perm Staff Jobs

Clinton Township, MI

Remote

$60,522–$129,615 / year

3 days ago

staff - Registered Nurse (RN) - Case Management - $34-43 per hour Perm Staff Jobs

Detroit, MI

Remote

$60,522–$129,615 / year

4 days ago

Air Operations Center & Technology Program Manager DCS Corp

Bedford, Massachusetts

Remote

$90,220–$200,000 / year

You will help translate battle-tested commercial concepts such as Collaborative Decision Making (CDM), real-time disruption management, automated flight dispatch, and predictive resource allocation into modern, cloud-native command and control (C2) software capabilities for the warfighter. In this role, you will leverage deep commercial airline industry expertise—specifically from Airline Operations Control Centers (OCC / NOCC)—to advise and guide software product teams, operational leaders, and system architects.

3 days ago

Medical Director (Remote) Securian

Birmingham, MI

Remote

$211,000–$287,000 / year

Provide decisions for UW and claims based on solid medical knowledge consistent with current guidelines, demonstrate ability to incorporate new medical knowledge into guideline updates and enhancements, includes advanced proficiency in ECG interpretation. Demonstrated ability to work collaboratively in a team-based environment, valuing diverse expertise and perspectives while maintaining professionalism and mutual respectPreferred Qualifications: 5+ years experience in insurance medicine, Board of insurance medicine candidate and/or working towards DBIM.

3 days ago

Senior Compliance Corrections Specialist Centene

JEFFERSON CITY, MO

Remote

$70,100–$126,200 / year

Develops, implements and continually refines corrections reporting that provides meaningful trend analysis for business stakeholders and senior leadership on new, in progress and closed issues as well as regulatory sanctions. Supports management in the development and maintenance of corrections processes and tools designed to effectively remediate compliance issues in a timely manner, ensure timely escalation and sustainable resolutions.

Today

Senior Director, Claims Workforce Management Centene

WEST PALM BEACH, FL

Remote

$146,000–$269,600 / year

Education/Experience: Requires a Bachelor's degree and 10+ years of related experience, including prior management experience or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Analyzes operations and influences key performance criteria to influence staffing model strategies based on trends and forecasted results to create the most effective and efficient support models for contact center.

Today

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Remote Jobs in the United States

Registered Nurse (RN) Software Galaxy Systems, LLC

Scrum Product Owner CareSource Management Services, LLC

Package Specialist IBM Corporation

Clinical Pharmacist Software Galaxy Systems, LLC

Front-End Tech Lead Developer Lateral Insights LLC

Locum Physician (MD/DO) - Psychiatry - General/Other in Boston, MA LocumJobsOnline

Senior Manager, Medical Loss Ratio Centene

Remote Medical Director, Appeals Centene

Remote Behavioral Medical Director, Central Region Centene

iValua Consultant Collabera

Psychologist Reviewer Centene

staff - Registered Nurse (RN) - Case Management - $27-46 per hour Perm Staff Jobs

staff - Registered Nurse (RN) - Case Management - $42-48 per hour Perm Staff Jobs

Junior NextGen Developer DCS Corp

staff - Registered Nurse (RN) - Case Management - $27-48 per hour Perm Staff Jobs

staff - Registered Nurse (RN) - Case Management - $34-43 per hour Perm Staff Jobs

Air Operations Center & Technology Program Manager DCS Corp

Medical Director (Remote) Securian

Senior Compliance Corrections Specialist Centene

Senior Director, Claims Workforce Management Centene

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