Top 487 Remote healthcare Jobs in Miami, Fl

Care Review Clinician (BH Licensed) - Remote in FL
Molina Healthcare, Inc. —Miami, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Health insurance
Care Review Clinician (BH Licensed) - Remote in FL
Molina Healthcare, Inc. —Florida
- $26.41 - $51.49 an hour
- Full-time
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Health insurance
Care Review Clinician (RN) - Remote in FL
Molina Healthcare, Inc. —Miami, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- RN License
- Mid-level
- Critical & Intensive Care
- Health insurance
Licensed Health Insurance Agent | Remote Work
Alexandre Agency —Miami, FL
- $75,000 - $150,000 a year
- Full-time
- Remote
- Communication skills
- Entry level
- Work from home
- Flexible schedule
Quick Apply
Patient Services Specialist - Nurse
Serva Health LLC —Florida
- From $65,000 a year
- Weekends as needed
- Remote
- Background check
- Spanish
- Nursing
- Health insurance
- Dental insurance
Quick Apply
Intake Coordinator
House of Hearts Florida —Hollywood, FL
- $20 - $25 an hour
- Part-time
- Remote
- Administrative experience
- Children
- Entry level
- Flexible schedule
Quick Apply
7h
Contact Center Associate 1 - UHealth Connect (Remote)
University of Miami —Medley, FL
- Full-time
- Remote
- Spanish
- Computer literacy
- HIPAA
- Health insurance
- Dental insurance
Insurance Verification Representative - Remote (Tri-County Area)
University of Miami —Medley, FL
- Full-time
- Remote
- Bilingual
- Computer literacy
- Mid-level
- Health insurance
- Dental insurance
Coordinator,Credentialing
Pediatric Associates —Plantation, FL
- Full-time
- Remote
- Research
- Mid-level
- High school diploma or GED
Referral & Authorization Care Coordinator
Oshi Health —Miami, FL
- $47,000 - $52,000 a year
- Email
- Remote
- Nursing
- Data analysis skills
- Mid-level
- Paid holidays
- Health insurance
Quick Apply
Master Scheduler
University of Miami —Medley, FL
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Computer skills
- Health insurance
- Dental insurance
Patient Benefits Advisor 2, Full Time
University of Miami —Miami, FL
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Medical terminology
- Health insurance
- Dental insurance
Customer Service Representative (Temporary)
Convey Health Solutions —Miami, FL
- Up to $16 an hour
- Temporary
- Remote
- Spanish
- Computer literacy
- HIPAA
Quick Apply
3d
Clinical Business Operations Specialist - Remote
University of Miami —Hialeah, FL
- Full-time
- Remote
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance
Chest Pain MI Data Abstractor: Part Time
Carta Healthcare —Miami, FL
- Part-time
- Remote
- US work authorization
- 1 year
- Entry level
- Flexible schedule
Quick Apply
Sr. Insurance Verification Representative (H)
University of Miami —Medley, FL
- Full-time
- Remote
- Mid-level
- Health insurance
- Dental insurance
2d
Remote ABA Therapy Medical Billing Specialist
House of Hearts ABA —Hollywood, FL
- $20 - $28 an hour
- Part-time
- Remote
- Bachelor's degree
- Children
- Organizational skills
Quick Apply
14d
Oncology Data Specialist - FT - Days - Remote Eligible
Memorial Healthcare System —Pembroke Pines, FL
- Full-time
- Remote
- Anatomy knowledge
- Customer service
- Research
Member Engagement Specialist (EST)
Tuesday Health —Miami, FL
- Remote
- Spanish
- Mid-level
- 3 years
- Paid holidays
- Health insurance
Quick Apply
9d
Accounts Receivable Specialist
Oshi Health —Miami, FL
- $47,000 - $52,000 a year
- Email
- Remote
- HIPAA
- Research
- Mid-level
- Paid holidays
- Health insurance
Quick Apply

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remote healthcare jobs near miami, fl

Care Review Clinician (BH Licensed) - Remote in FL

Molina Healthcare, Inc. -
Miami, FL

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Job Details

Full-time
$26.41 - $51.49 an hour

Benefits

Health insurance

Qualifications

Productivity software

Full Job Description

JOB DESCRIPTION Job Summary

Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations, and 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 - ensuring 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 and presents cases 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 Molina care model.
Adheres to utilization management (UM) policies and procedures.
May work collaboratively with appropriate departments to provide applied behavior analysis (ABA)/behavioral health therapy (BHT) services to Molina members with autism spectrum disorder (ASD) and other related disorders.
May approve requests for BHT by reviewing behavioral assessments and treatment plans for medical necessity and BHT best practice guidelines. This includes but is not limited to: psychological evaluation requests, comprehensive diagnostic evaluations, functional behavioral assessments, and progress reports.
May perform ongoing monitoring of BHT treatment plans to evaluate effectiveness and treatment efficacy.
May provide peer to peer consultation BHT in-network providers to support treatment planning and maximize member progress.
May work collaboratively with ABA providers to ensure best service practices for members.
May create and develops forms, recommendations and guidelines and training for BHT service delivery.
May collaborate and coordinate with behavioral health medical directors, and senior medical directors to ensure proper management of the BHT benefit.

Required Qualifications

At least 2 years health care experience, including experience in behavioral health and/or hospital acute care, or equivalent combination of relevant education and experience.
Licensed Clinical Social Worker (LCSW), Licensed Master Social Worker (LMSW), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), Licensed Marriage and Family Therapist (LMFT) or equivalent behavioral health licensure. License must be active and unrestricted in state of practice.
May require behavioral analyst experience, and/or board certification/licensure as a behavioral analyst (BCBA and/or LBA).
Demonstrated knowledge of community resources.
Ability to operate proactively and demonstrate detail-oriented work.
Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
Ability to work independently, with minimal supervision and demonstrate self-motivation.
Responsive in all forms of communication, and ability to remain calm in high-pressure situations.
Ability to develop and maintain professional relationships.
Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
Excellent problem-solving, and critical-thinking skills.
Strong verbal and written communication skills.
Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

Recent hospital behavioral health experience in an intensive care unit (ICU) or emergency room.

#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 healthcare jobs in miami, fl

Care Review Clinician (BH Licensed) - Remote in FL

Care Review Clinician (BH Licensed) - Remote in FL

Care Review Clinician (RN) - Remote in FL

Licensed Health Insurance Agent | Remote Work

Patient Services Specialist - Nurse

Intake Coordinator

Contact Center Associate 1 - UHealth Connect (Remote)

Insurance Verification Representative - Remote (Tri-County Area)

Coordinator,Credentialing

Referral & Authorization Care Coordinator

Master Scheduler

Patient Benefits Advisor 2, Full Time

Customer Service Representative (Temporary)

Clinical Business Operations Specialist - Remote

Chest Pain MI Data Abstractor: Part Time

Sr. Insurance Verification Representative (H)

Remote ABA Therapy Medical Billing Specialist

Oncology Data Specialist - FT - Days - Remote Eligible

Member Engagement Specialist (EST)

Accounts Receivable Specialist

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