Top 1001 Remote work from home Jobs in Maitland, Fl

Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Orlando, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Florida
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
Remote Sales Specialist
HSS Careers —Orlando, FL
- $69,000 - $150,000 a year
- Full-time
- Remote
- Computer literacy
- Computer skills
- Leadership
- Health insurance
- Dental insurance
Quick Apply
13d
Medicare Sales Independent Contractor (1099) - Remote
MyPlanAdvocate —Florida
- $65,000 - $85,000 a year
- Contract
- Remote
- Mid-level
9d
Medicare Sales Agent - Independent Contractor (1099) Opportunity
MyPlanAdvocate —Florida
- $65,000 - $85,000 a year
- Contract
- Remote
- Mid-level
13d
Customer Service Representative (Remote FL)
Oscar Health —Orlando, FL
- $19 - $21 an hour
- Remote
- Writing skills
- High school diploma or GED
- Analysis skills
- Paid parental leave
- Paid holidays
Quick Apply
Remote Client Agent – Work From Home | Training Provided
The Gainey Agency —Orlando, FL
- Remote
- Sales
- Customer service
- Computer literacy
- Opportunities for advancement
- Flexible schedule
Quick Apply
Customer Support Agent
Motus —Orlando, FL
- $20 an hour
- Weekends as needed
- Remote
- English
- Communication skills
- Entry level
- Health savings account
- AD&D insurance
Quick Apply
1d
Billing Specialist (Remote)
Champion Tax Relief, Inc. —Orlando, FL
- $23 an hour
- Full-time
- Remote
- Google Workspace
- Mid-level
- Administrative experience
Quick Apply
Part Time Customer Service Representative/Call Center Rep (Remote)
Automated Health Systems —Orlando, FL
- $14 - $15 an hour
- Part-time
- Remote
- Bilingual
- Mid-level
- High school diploma or GED
- Wellness program
- Health insurance
Quick Apply
Remote Inbound Sales Agent (9.14 Start)
Grand Circle LLC —Orlando, FL
- $19 - $21 an hour
- Call employer
- Remote
- Mid-level
- Travel
- 1 year
- Paid holidays
- Disability insurance
Quick Apply
Medical Scheduler - Winter Garden/Remote After 90 Days
Community Health Centers, Inc. —Winter Garden, FL
- Full-time
- Remote
- Spanish
- Medical office experience
- HIPAA
- Paid holidays
- Health insurance
Customer Service Representative
North American Learning Institute —Orlando, FL
- $41,600 - $52,000 a year
- Weekends as needed
- Remote
- Spanish
- English
- Communication skills
- AD&D insurance
- Dental insurance
Quick Apply
Patient Advocate (Part Time, Remote 1099)
Understood Care —Orlando, FL
- $25 an hour
- Part-time
- Remote
- Spanish
- 3 years
- Older adults
Quick Apply
Remote Call Center Representative
TechOp Solutions International —Orlando, FL
- Full-time
- Remote
- Research
- Mid-level
- High school diploma or GED
Quick Apply
5h
Customer Service Representative
Sunshine 811 —DeBary, FL
- $18.50 an hour
- Overtime
- Remote
- Bilingual
- Background check
- Pass drug screening
- Paid holidays
- Disability insurance
Quick Apply
Patient Disability Advocate
HCA Florida Osceola Hospital —Kissimmee, FL
- Full-time
- Remote
- Entry level
- Employee stock purchase plan
- Disability insurance
Quick Apply
2d
Clinical Service Desk-Helpdesk-REMOTE-US
NTT DATA —Orlando, FL
- $20 - $25 an hour
- Weekends as needed
- Remote
- Writing skills
- English
- Mid-level
- Health savings account
- AD&D insurance
Quick Apply
2d
Contact Center Representative
Systems Integration, Inc. —Orlando, FL
- Seasonal
- Remote
- Background check
- Computer literacy
- High school diploma or GED
- Paid training
Quick Apply
Client Advocate
greenpath, inc. —Orlando, FL
- $15.00 - $17.57 an hour
- Weekends as needed
- Remote
- Residential
- Organizational skills
- Typing
Quick Apply

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remote work from home jobs near maitland, fl

Care Review Clinician (RN) - Remote in FL

Molina Healthcare, Inc. -
Orlando, FL

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Job Details

Full-time
$26.41 - $51.49 an hour

Benefits

Health insurance

Qualifications

Inpatient experience
RN License
Managed care organization experience
Acute care facility experience
Pre-authorization review for utilization management
Productivity software

Full Job Description

JOB DESCRIPTION

Must reside in Florida

Job Summary

Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.
Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members.
Processes requests within required timelines.
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner.
Requests additional information from members or providers as needed.
Makes appropriate referrals to other clinical programs.
Collaborates with multidisciplinary teams to promote the Molina care model.
Adheres to utilization management (UM) policies and procedures.

Required Qualifications

At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
Registered Nurse (RN). License must be active and unrestricted in state of practice.
Ability to prioritize and manage multiple deadlines.
Excellent organizational, problem-solving and critical-thinking skills.
Strong written and verbal communication skills.
Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

Certified Professional in Healthcare Management (CPHM).
Recent hospital experience in an intensive care unit (ICU) or emergency room.

Utilization Management (UM) experience highly preferred.

#PJHS3

#LI-AC1

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Apply Now

Refine Your Search

remote work from home jobs in maitland, fl

Care Review Clinician (RN) - Remote in FL

Care Review Clinician (RN) - Remote in FL

Remote Sales Specialist

Medicare Sales Independent Contractor (1099) - Remote

Medicare Sales Agent - Independent Contractor (1099) Opportunity

Customer Service Representative (Remote FL)

Remote Client Agent – Work From Home | Training Provided

Customer Support Agent

Billing Specialist (Remote)

Part Time Customer Service Representative/Call Center Rep (Remote)

Remote Inbound Sales Agent (9.14 Start)

Medical Scheduler - Winter Garden/Remote After 90 Days

Customer Service Representative

Patient Advocate (Part Time, Remote 1099)

Remote Call Center Representative

Customer Service Representative

Patient Disability Advocate

Clinical Service Desk-Helpdesk-REMOTE-US

Contact Center Representative

Client Advocate

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