Work from Home Healthcare Jobs

Job Description Utilization management is the analysis of the necessity, appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures that an authorization for services is obtained from payer, if required, and that documentation supports the care delivered in such a way that minimizes the risk of denials after discharge. Community Health Systems, Inc. is one of the nation's leading operators of general acute care hospitals. The organization's affiliates own, operate or lease 89 hospitals in 16 states with approximately 15,000 licensed beds. Affiliated hospitals are dedicated to providing quality healthcare for local residents and contribute to the economic development of their communities. Based on the unique needs of each community served, these hospitals...

Looking for an internship program where you'll make a real difference - rather than just completing busy work? Then you've come to the right place. Cigna's Summer Internship Program is designed to assign you projects that have a lasting impact on our business - which touches millions of people across the globe. As an intern, you'll get an inside look at your desired field, while working next to some of the best in the industry. Program activities, including an executive speaker series, volunteer events, and career development workshops, give you the opportunity to network with employees across the organization and prepare you for a full-time career. Where You'll Work Come join our team as a Lab Management Intern next summer! As an intern, you will work as part of the Lab Management policy team. This is a project-oriented internship which will allow you the opportunity to assist in molecular laboratory test research and medical policy development. Using established research...

We Are Hiring Do you like leading a group to a common goal? Ascension is looking for a National Program Manager to join their Clinical Nursing Education team! Full-Time | Days | Virtual/Remote National Travel up to 30% What You Will Do Plan and manage the development and delivery of clinical education. Assist with determining clinical educational needs by participating in appropriate leadership/committee meetings and by direct communication with clinical management. Ensure the delivery of quality education that meets learning objectives. Develop and/or collaborate with department head to provide a fiscally responsible clinical education budget. Serve as clinical instructor, coordinator and/or subject matter expert for clinical educational offerings. What You Will Need Education: High school diploma/GED with 2 years of experience, or Associate's degree, or Bachelor's degree required. Work Experience: 3 years of experience required. 5 years of experience...

This is a unique opportunity to join an early-stage product development group, Transcatheter Mitral & Tricuspid Therapies (TMTT), focused on developing solutions for patients suffering from structural heart disease. The candidate will join a fast-paced, dynamic team and the individual who fills it will play a pivotal role in the development of new therapies and devices, from concept through to human use. Key Responsibilities include but are not limited to: Drive data standards implementation by ensuring technical quality compliance in alignment with industry standards (e.g., CDISC) and regulatory guidance, consistency in the adoption of data standards across clinical systems and provide technical guidance for study teams Provide functional expertise to clinical data standards solutions, and lead the activities clinical data standards solutions to support data collection, reporting, and submission Lead the maintenance of the clinical standards library components and...

Overview The Bilingual Spanish Virtual Medical Scribe ensures accurate and timely documentation of the medical chart under the supervision of the medical provider. The Scribe assists the provider by accompanying them during the patient exam recording detailed information into the electronic medical record (EMR). The Scribe performs other related medical record or clerical duties to increase provider effectiveness, efficiency, and productivity for improved patient flow and satisfaction. Responsibilities Preparing and assembling medical record documentation/charts for physician(s) Entering the patient room with the physician during patient visit to capture and transcribe medical record documentation utilizing electronic medical record applications Ensuring medical record compliance by self-documentation attestation to include: Scribe name, title and doctor working for as well as specific date and time entry Updating patient history, physical exam and other pertinent health...

Description Introduction Do you have the career opportunities as a(an) Virtual Patient Safety Attendant you want with your current employer? We have an exciting opportunity for you to join St. David's Medical Center which is part of the nation's leading provider of healthcare services, HCA Healthcare. Benefits We are committed to providing our employees with the support they need. At St. David's Medical Center, we offer eligible colleagues an attractive benefit package that includes medical, wellbeing, dental and vision benefits along with some unique benefits including: Student Loan RepaymentMedical, Dental, Vision, Life Insurance and Flexible SpendingPaid Time Off ( PTO ) and Personal Leave 401K (100% annual match - 3% to 9% of pay based on years of service) Academic Assistance and Reimbursements for Tuition and Student Loans Employee Discounts including Tickets, Retail, Mental Health Apps, Education Apps, Identity Theft Protection etc. Home , Auto , and Pet...

Please note that this position required UM and prior remote experience. Remote positions require that you live in Texas. About us: Morgan Stephens represents the nation's top healthcare systems offering the highest compensation and benefits to our top candidates. We are created and managed by experienced industry professionals in healthcare. As a leading provider of contract, contract to perm, and direct placement recruiting services to healthcare organizations throughout the United States, we have successfully served the needs of our employees and clients by placing thousands of quality healthcare professionals into organizations seeking top talent. Open Position: Utilization Management Nurses will work with members of the health plan to review medical requests and insure that proper care is being utilized. JOB RESPONSIBILITIES: Perform utilization management, utilization review, and/or concurrent review for the team Communicates with practitioners and members on cases...

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) The Community and State (C&S) Clinical Training team is currently recruiting a Senior Trainer (RN) to support the UnitedHealthcare Community Plan Care Management Programs. The Senior Trainer will be responsible for the effective delivery of training for new business initiatives, new and existing training programs that encompass training of clinical staff such as nurses, social workers, and medical directors as well as non-clinical staff. The Senior Trainer will be a self-starter with excellent communication and interpersonal skills who promotes optimal training outcomes through: If you are located in the state of New York, you will...

Job Title: Medical Director, Oncologist (US Remote-Based) Job Location: United States (Remote/ Home Based) Job Overview: Primary responsibilities include medical and safety oversight of clinical trials as well as corporate support for business opportunities. The Medical Director provides Medical Monitoring services to clinical trials with the aim to monitor the safety and wellbeing of study participants, integrity of the project data in accordance with the clinical trial protocol/clinical study protocol (or equivalent documents), standard operating procedures (SOPs), good clinical practice (GCP), and all other applicable directives and regulatory requirements. Responsibilities include medical supervision of assigned projects from both a medical and scientific perspective. The Medical Director provides and/or oversees medical monitoring activities including protocol development, development and/or review of project-specific Medical Monitoring Plan (MMP),...

Careers that Change Lives The Medical Surgical Portfolio strives to enable earlier diagnosis, better treatment, faster complication-free recovery, and enhanced patient outcomes through less invasive surgical solutions. The Patient Monitoring business includes technologies that provide insights and intelligence to help clinicians reduce dangerous and costly patient complications in acute care. The Sr. Principal Platform & Services Manager is a critical team member within our Patient Monitoring Operating Unit who will fill experience gaps in the team and the organization. To be successful in the future Continuous Connected Care (CCC) platform we must gain critical marketing software as a service experience. The Sr. Principal Platform & Services Manager is responsible for developing and leading the global feature and services roadmap for the Continuous Connected Care platform. This role will work closely with the regional marketing and cross functional teams to gather...

Job Summary: The Sr. Clinical Account Executive (CAE) position is an exciting opportunity for a pharmacist who is looking to leverage their pharmacy and healthcare expertise to meet the Health Plan client's strategic goals and drive improved clinical and financial outcomes for their membership. In this role the CAE will use their deep understanding of the pharmacy/healthcare landscape and pipeline, as well as strong clinical, analytical, financial, and business skills to develop and present a comprehensive strategy aligning and supporting to the client's strategic goals. The strategic plan should address critical business metrics such as member and client satisfaction, clinical support and clinical solution program adoption - with a goal to deliver lower healthcare costs and optimal clinical outcomes. This role requires the CAE to think forward into the future as the healthcare landscape continues to evolve, be comfortable with a wide variety of data elements, have an ability...

Current Employees: If you are a current employee at the University of Miami, please exit this websiteand log into Workday toapply using the internal application process.To learn how to apply for a faculty position using the Career worklet, please review thistip sheet. Where Excellence Meets Purpose The University of Miami is among the top research universities and academic medical centers in the nation, and one of the largest private employers in South Florida. With more than 16,000 faculty and staff, the University strives for excellence, and is driven by a powerful purpose to transform and impact the lives of its students, patients, members of the community, and people across the globe. The University is committed to fostering a culture of belonging, where everyone feels valued and has the opportunity to add value. Through values of Diversity, Integrity, Responsibility, Excellence, Compassion, Creativity, and Teamwork (DIRECCT) the U community works together to create an...

Edwards' has an exciting opportunity in the Transcatheter Heart Valve (THV) group, focused on developing minimally invasive solutions for patients suffering from structural heart disease. This is an exciting opportunity within a company that leads the heart valve market, not only in terms of market share but also in cutting edge technology. As the Senior Specialist, Medical Writer supporting the THV division, you will serve as a medical writer working with subject matter experts to create abstracts, manuscripts, and presentations that effectively and clearly describe clinical trial methodology, data, product use, and relevance. You will ensure that publications and presentations comply with Quality Systems Regulations and applicable regulatory, journal, and other guidelines in terms of content, format, and structure. Key Responsibilities: Ensure timely and successful development of high-quality manuscripts, abstracts, and posters, including medical writing, editing,...

Description The Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Pre-Authorization Nurse work assignments are often straightforward and of moderate complexity. Responsibilities The Pre-Authorization Nurse completes medical necessity and level of care reviews for requested services using clinical judgment along with MCG Criteria and state guidelines, and refers to internal stakeholders for review depending on case findings. Educates providers on utilization and medical management processes. Enters and maintains pertinent clinical information in various medical management systems. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent...

Description As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! JOB SUMMARY Responsible for all aspects of billing, follow up and collection activity. Billing responsibilities include manual re-bills as well as electronic submission to payers. Follow-up includes telephone calls to payers and/or...

The Clinical Transformation Consultant (CTC) is responsible for the ongoing clinical management of physician practices participating in UnitedHealthcare's (UHC) Accountable Care Organizations (ACO), Value Based Programs, Patient Centered Medical Homes (PCMH), or Population Health Management programs such as Patient Centered Care Model. The CTC will lead multi-disciplined practice transformation and practice performance improvement initiatives. The selected candidate will guide practices in achieving targeted goals that include improved quality, efficiency and utilization. The CTC is accountable for driving practice progress toward desired transformational change and performance improvement, while meeting savings goals set for the practice. As the single point of clinical contact for a practice, the CTC will be responsible for communicating progress towards achievement of targeted goals to Senior Leadership both within UnitedHealthcare and at the practice. If you are located in...

Description As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! JOB SUMMARY Responsible for providing assistance, coaching and training to staff members, including new hires. They support and assist the Team, the Supervisor and Management with complex inventory and issue resolution. Responsible...