Clinical Guidelines Jobs

Lead the development and clinical review of Osmosis educational scripts and materials as a Senior Medical Content Editor, applying your terminal medical degree and U.S. clinical experience to ensure clinically accurate, learner-focused content.

Provide accurate, compassionate patient billing and research-related claims support as a Patient Accounting Representative II at Westwood Medical Pavilion.

The Ohio State University Health Plan is hiring a Registered Nurse Patient Care Resource Manager to perform retrospective claims reviews, support utilization management, and contribute to clinical policy and process improvements for its member population.

Experienced board-certified physician needed to lead medical necessity determinations, utilization management, and clinical policy for Presbyterian Health Plan, helping drive quality, cost-effective care for New Mexico members.