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Reviews hematology and medical oncology cases, including stem cell transplant cases, on a flexible telework schedule.
Behandelt psychiatrische und psychotherapeutische Patientinnen und Patienten, mit Schwerpunkt auf ADHS im Erwachsenenalter, in einer Online-Klinik.
Audits utilization management operations, investigates regulatory findings, analyzes healthcare data, and prepares compliance responses and corrective action plans.
The Senior Utilization Management Audit & Compliance Analyst serves as the subject matter expert for external customer audits, regulatory inquiries, and utilization management oversight activities. This position is responsible for reviewing audit requests, performing detailed analyses of utilization management data, researching findings within the UM system, Essette, and related systems, and preparing professional, evidence-based responses for health plans, clients, regulators, accreditation organizations, and other external stakeholders.
The ideal candidate possesses extensive Utilization Management experience across Medicare, Medicaid, Commercial, and Dual Eligible populations and maintains a strong understanding of applicable UM regulations, accreditation standards, and delegation requirements. This role requires exceptional analytical, writing, and communication skills, along with advanced Excel proficiency to analyze large data sets, identify trends, validate findings, and support audit responses.
JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES
The Senior Utilization Management Audit & Compliance Analyst’s responsibilities include but are not limited to:
Audit Management & Customer Response
UM System Review & Investigation
Data Analysis & Reporting
Utilization Management Compliance
Process Improvement & Audit Readiness
EDUCATION:
EXPERIENCE:
SALARY: $90,000/Annually
Benefits Offered
Remote Opportunities
We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington.
Our Story
Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits.
With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you.
Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.
Conducts clinical quality audits, evaluates GCP compliance, reviews corrective actions, and advises teams on regulated clinical processes.
About AbbVie
AbbVie’s mission is to discover and deliver innovative medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people’s lives across several key therapeutic areas including immunology, oncology and neuroscience - and products and services in our Allergan Aesthetics portfolio. For more information about AbbVie, please visit us at www.abbvie.com. Follow @abbvie on LinkedIn, Facebook, Instagram, X and YouTube.
Primarily responsible for the execution of the Clinical audit program, including scheduling, planning, reporting and resolution of Clinical audits. Ensuring alignment with RDQA policies and procedures wherever possible and contributing to the development and implementation of the Clinical QA quality system. Provision of advice and support on GCP and quality topics to business partners to ensure compliance with worldwide requirements and expectations.
Responsibilities:
Applicable only to applicants applying to a position in any location with pay disclosure requirements under state or local law:
Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, incentive, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company’s sole and absolute discretion unless and until paid and may be modified at the Company’s sole and absolute discretion, consistent with applicable law.
AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives and serving our community. Equal Opportunity Employer/Veterans/Disabled.
US & Puerto Rico only - to learn more, visit https://www.abbvie.com/join-us/equal-employment-opportunity-employer.html
US & Puerto Rico applicants seeking a reasonable accommodation, click here to learn more:
https://www.abbvie.com/join-us/reasonable-accommodations.html
Conducts clinical quality audits, evaluates GCP compliance, reviews corrective actions, and advises teams on clinical regulations and quality systems.
About AbbVie
AbbVie’s mission is to discover and deliver innovative medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people’s lives across several key therapeutic areas including immunology, oncology and neuroscience - and products and services in our Allergan Aesthetics portfolio. For more information about AbbVie, please visit us at www.abbvie.com. Follow @abbvie on LinkedIn, Facebook, Instagram, X and YouTube.
Primarily responsible for the execution of the Clinical audit program, including scheduling, planning, reporting and resolution of Clinical audits. Ensuring alignment with RDQA policies and procedures wherever possible and contributing to the development and implementation of the Clinical QA quality system. Provision of advice and support on GCP and quality topics to business partners to ensure compliance with worldwide requirements and expectations.
Responsibilities:
Applicable only to applicants applying to a position in any location with pay disclosure requirements under state or local law:
Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, incentive, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company’s sole and absolute discretion unless and until paid and may be modified at the Company’s sole and absolute discretion, consistent with applicable law.
AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives and serving our community. Equal Opportunity Employer/Veterans/Disabled.
US & Puerto Rico only - to learn more, visit https://www.abbvie.com/join-us/equal-employment-opportunity-employer.html
US & Puerto Rico applicants seeking a reasonable accommodation, click here to learn more:
https://www.abbvie.com/join-us/reasonable-accommodations.html
Adjusts complex allied health insurance claims by investigating losses, evaluating coverage and liability, negotiating resolutions, and presenting strategies to executives.
About Integrated Specialty Coverages
Integrated Specialty Coverages, LLC (ISC) is a growth stage technology and data-driven commercial MGA and insurance wholesaler leading innovation in the market.
Backed by one of the leading private equity firms, Onex Partners, and led by a forward-thinking management team, ISC is combining the worlds of insurance and technology to create an Insurtech powerhouse. As a leading online distributor of insurance products for a range of industries and “Main Street USA”, we are looking for the right people to help us in our mission of achieving exponential growth. We strive to be the number one place to go for brokers and agents to source insurance. To accomplish this, we’re building a digitally focused team that deeply understands the intersection between user experience, data, and AI/ML to optimize the way we engage with our customers and partners.
Job Summary
The Complex Loss Specialist position at Golden State Claims Services reports to a Claims Supervisor or Claims Manager and will specialize in Allied Health claims. The chief duty of the Complex Loss Specialist for Allied Health claims is to adjust the most time-intensive, complex, and high exposure losses that require a higher level of technical expertise, knowledge, and negotiating ability, for the program(s) to which is assigned. The Complex Loss Specialist will have a high level of ability to provide analysis and presentations to Senior Executives and Program Executives for these complex matters and will be well-versed in leading strategic roundtable discussions to determine optimal resolution strategy.
Position Responsibilities
Core Technical Duties
Investigation & Documentation
Minimum Qualifications
The starting annual pay scale for this position is listed below. Actual starting pay will be based on factors such as skills, qualifications, training, and experience. In addition, the company offers comprehensive benefits including medical, dental and vision insurance, 401(k) plan with match, paid time off, and other benefits.
ISC’s salary ranges are determined by role and level. The range displayed on each job posting reflects the minimum and maximum target for new hire salaries for the position across all US locations and could be higher or lower based on a multitude of factors, including job-related skills, experience, and relevant education or training.
National Pay Range
$87,000—$109,000 USD
Benefits of Working at ISC
Applicants may contact the ISC HR department via e-mail or phone to request and arrange for an accommodation that will allow the applicant to successfully complete the application process. Applicants needing assistance may request accommodation at any time. Please contact ISC at HR@ISCMGA.com or 760-599-7242.
ISC believes in creating long-term relationships by being responsive and relevant and by consistently delivering value to our community of customers. Specifically, we focus on attracting, developing, and retaining the best talent for our business, challenging our people, demonstrating a “can-do” attitude, and fostering a collaborative and mutually supportive environment.
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, gender, gender identity, sexual orientation, marital status, medical condition, genetic information, mental or physical disability, military or veteran status, or any other characteristic protected by local, state, or Federal law.
**Must be legally authorized to work in the United States.**
**ISC participates in the Federal E-Verify program**
Manages clinical trial data processes, databases, quality checks, documentation, reporting, and regulatory data reconciliation.
We are hiring a Clinical Data Manager II or Senior Clinical Data Manager to join our global team. We can consider candidates based in the Poland, Hungary, Romania, Serbia or Slovakia.
Position Summary:
The Clinical Data Manager II/Senior Clinical Data Manager is responsible and manages all aspects of the clinical trial data management process from study start up to post database lock for assigned projects. Standard Operating Procedures / Work Instructions (SOPs/WIs); regulatory directives; study specific plans and guidelines will be followed. This position will also oversee and/or perform database development and testing.
Essential functions of the job include but are not limited to:
Qualifications:
Precision is required by law in some states or cities to include a reasonable estimate of the compensation range for this role. This compensation range takes into account the wide range of factors that are considered in making compensation decisions including but not limited to: skill sets, experience and training, licensure and certifications, and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Precision, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. This role is also eligible for a discretionary annual bonus, private medical insurance, MultiSport Card, life insurance, pension, home working allowance, vacation, among other benefits.
Reasonable estimate of the current range for Poland:
190200 PLN gross per annum to 285400 PLN gross per annum
Any data provided as a part of this application will be stored in accordance with our Privacy Policy. For CA applicants, please also refer to our CA Privacy Notice.
Precision Medicine Group is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status or other characteristics protected by law.
If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact Precision Medicine Group at myHR@precisionmedicinegrp.com.
Recruitment Fraud Warning: Please be aware that fraudulent individuals and websites may impersonate Precision Medicine Group or its affiliates and attempt to obtain personal, financial, or banking information through fake job postings or employment offers. Precision Medicine Group will never request payment, banking details, or other sensitive financial information as part of the recruitment process. If you believe you have been targeted by a recruitment scam, we encourage you to report the incident to your local law enforcement authorities, consumer protection agency, or relevant cybercrime reporting organization in your country. Please also notify us at myHR@precisionmedicinegrp.com so we can investigate and take appropriate action.
Candidates must be legally authorized to work in the country of employment without employer sponsorship.
Manages clinical trial data processes, databases, quality checks, reporting, medical coding, and regulatory documentation across assigned studies.
We are hiring a Clinical Data Manager II or Senior Clinical Data Manager to join our global team. We can consider candidates based in the Poland, Hungary, Romania, Serbia or Slovakia.
Position Summary:
The Clinical Data Manager II/Senior Clinical Data Manager is responsible and manages all aspects of the clinical trial data management process from study start up to post database lock for assigned projects. Standard Operating Procedures / Work Instructions (SOPs/WIs); regulatory directives; study specific plans and guidelines will be followed. This position will also oversee and/or perform database development and testing.
Essential functions of the job include but are not limited to:
Qualifications:
Any data provided as a part of this application will be stored in accordance with our Privacy Policy. For CA applicants, please also refer to our CA Privacy Notice.
Precision Medicine Group is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status or other characteristics protected by law.
If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact Precision Medicine Group at myHR@precisionmedicinegrp.com.
Recruitment Fraud Warning: Please be aware that fraudulent individuals and websites may impersonate Precision Medicine Group or its affiliates and attempt to obtain personal, financial, or banking information through fake job postings or employment offers. Precision Medicine Group will never request payment, banking details, or other sensitive financial information as part of the recruitment process. If you believe you have been targeted by a recruitment scam, we encourage you to report the incident to your local law enforcement authorities, consumer protection agency, or relevant cybercrime reporting organization in your country. Please also notify us at myHR@precisionmedicinegrp.com so we can investigate and take appropriate action.
Candidates must be legally authorized to work in the country of employment without employer sponsorship.
Provides psychological expertise in Marathi for an innovative customer project as a remote contractor.
Provides psychiatric evaluation and treatment in Japanese for patients through a remote contractor engagement.
Provides psychological expertise to support an innovative customer project as a bilingual Indonesian contractor.
Provides psychiatric care and expertise in Indonesian and English for a customer-focused remote project.
Provides psychological expertise in Gujarati for an innovative customer project as a remote contractor.
Provides remote psychiatric assessments, medication management, and brief psychotherapy for adult clients while collaborating with therapists.
Why Choose Two Chairs?
Compensation: Hourly rate of $62–$96/hr (determined by experience, qualifications, and place of residence).
AI-Assisted Documentation: Spend less time on administrative notes and more time on client care with our optional built-in AI documentation tools.
True Work-Life Balance: Set your own schedule up to 8 hours/week (with the potential to increase) within M-F, 8am-8pm. No late nights, no weekends, no on-call obligations.
Paid Non-Clinical Time: Get paid for administrative tasks, clinical team consultations, required training, and client no-shows.
Safety & Coverage: Enjoy 24⁄7 crisis line support for client risk assessments and seamless coverage support when you take time off.
Additional W-2 advantages you won’t find with 1099 contract work:
About You
About the Role
About Two Chairs
Two Chairs is setting a new standard in mental health care with seamlessly integrated therapy and psychiatry delivered by highly trained clinicians, powered by smart technology, and measured for real impact. By combining timely access, personalized care, and proven outcomes — we’re creating a system that works — for patients, providers, health plans, and clinicians alike. With that, we’re excited and honored to have been recognized as a 2025 Great Place to Work and 2025 Fortune’s Best Workplaces in Healthcare .
One of our company values is “Embrace Differences,” and diversity, equity, inclusion, and belonging are the principles guiding how we build our business and teams. We encourage interested candidates from all backgrounds to apply, even if they don’t think they meet some expectations of the role.
Important Notes:
#LI-REMOTE #ZR
Provides remote psychiatric assessments, medication management, and brief psychotherapy for adults while collaborating with an integrated care team.
Why Choose Two Chairs?
Compensation: Hourly rate of $62–$96/hr (determined by experience, qualifications, and place of residence).
AI-Assisted Documentation: Spend less time on administrative notes and more time on client care with our optional built-in AI documentation tools.
True Work-Life Balance: Set your own schedule up to 8 hours/week (with the potential to increase) within M-F, 8am-8pm. No late nights, no weekends, no on-call obligations.
Paid Non-Clinical Time: Get paid for administrative tasks, clinical team consultations, required training, and client no-shows.
Safety & Coverage: Enjoy 24⁄7 crisis line support for client risk assessments and seamless coverage support when you take time off.
Additional W-2 advantages you won’t find with 1099 contract work:
About You
About the Role
About Two Chairs
Two Chairs is setting a new standard in mental health care with seamlessly integrated therapy and psychiatry delivered by highly trained clinicians, powered by smart technology, and measured for real impact. By combining timely access, personalized care, and proven outcomes — we’re creating a system that works — for patients, providers, health plans, and clinicians alike. With that, we’re excited and honored to have been recognized as a 2025 Great Place to Work and 2025 Fortune’s Best Workplaces in Healthcare .
One of our company values is “Embrace Differences,” and diversity, equity, inclusion, and belonging are the principles guiding how we build our business and teams. We encourage interested candidates from all backgrounds to apply, even if they don’t think they meet some expectations of the role.
Important Notes:
#LI-REMOTE #ZR
Provides psychological expertise to support an innovative customer project as a bilingual Japanese-speaking contractor.
Provides telemedicine fertility and family-care consultations as a registered nurse.
Provides telemedicine consultations and clinical guidance for fertility and family care patients.
Provides remote physician case reviews for occupational medical exams, clearances, surveillance, accommodations, and medical review boards.
Provides clinical data quality and informatics expertise as a CDQI nurse specialist for healthcare data programs.