6 clinical review auditor jobs found in Remote, remote

AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology. Join us in improving health care outcomes for all!  We promise to do what’s right, always. Position Summary: The Compliance Paralegal supports the legal and compliance team by conducting research, preparing documentation, and ensuring adherence to regulatory requirements. This role assists in monitoring company policies, maintaining compliance records, and drafting reports for internal and external audits. The Compliance Paralegal also helps coordinate regulatory filings and communicates with relevant agencies as needed, including...

We are looking for an HR Analyst to play a critical role in enabling data-driven People decisions across the employee lifecycle. This role sits at the intersection of HR systems, analytics, compensation, workforce planning, and operational execution, and partners closely with People Ops, Compensation, Payroll, Finance, and HRBPs. This is not a reporting-only role. You will be responsible for building trusted data foundations, translating complex people data into actionable insights, and supporting high-impact initiatives such as compensation cycles, workforce planning, HRIS transformation, and compliance reporting. There will be a lot of opportunities to learn along the way, so the ideal candidate should have the confidence, curiosity, and executive presence to engage with senior stakeholders, be a trusted SME, and drive meaningful change. You're excited to adapt and grow alongside a fast-paced, high-growth business that's scaling globally. If you're ready to roll up your...

AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology. Join us in improving health care outcomes for all!  We promise to do what’s right, always. Position Summary: The Director of Utilization Management (UM) is a senior clinical and operational leader responsible for strategy, design, execution, and continuous improvement of Prior Authorization and utilization management programs. This role owns UM outcomes across clinical quality, regulatory compliance, operational performance, financial impact, and client experience. The Director will build and lead a high-performing UM organization,...

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 Claims Supervisor position at Golden State Claims Adjusters reports...

Grow With Us! At Hilb Group, we recognize that our associates are our greatest asset. We promote a service-driven culture of high performance that encourages career and professional development. The Hilb Group is currently seeking a motivated and ambitious ­­­­­Commercial Lines Account Manager to join our team. This position will report to our agency located in Baltimore, MD. The ideal candidate will be motivated to succeed, is well organized, able to prioritize, and able to work well with a team. This is a virtual position. Responsibilities: Support assigned producers by placing and processing new business, account development, and renewal retention. Pre-Qualify new business. Review, analyze, and submit applications following agency marketing guidelines Review and order renewals according to agency procedures. Investigate company non-renewals and coordinate with insured and Producer(s) to re-market Prepare proposals and applications, submit to insureds and carriers (or...

Counterpart is an insurtech platform reimagining management and professional liability for the modern workplace. We believe that when businesses lead with clarity and confidence, they become more resilient, more innovative, and better prepared for what's ahead. That's why we built the first Agentic Insurance™ system --- where advanced AI and deep insurance expertise come together to proactively assess, mitigate, and manage risk. Backed by A rated carriers and trusted by brokers nationwide, our platform helps small businesses grow with confidence. Join us in shaping a smarter future, helping businesses Do More With Less Risk®. Counterpart is entering a new chapter of growth with strong backing from world-class investors, a growing network of distribution partners, and a passionate team of industry veterans and innovators. As Controller, you will serve as the operational backbone of our finance function, ensuring accurate, timely, and compliant financial reporting while building...