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Remote Managed Care Jobs in Florida (NOW HIRING)

NTT DATA Services

BPO Senior Manager

Tampa, FL · Remote

$93K/yr

... in a healthcare, managed care, health plan, or utilization management environment preferred ... Remote employees must adhere to all technical support procedures and protocols. * Chronic ...

NTT DATA Services

BPO Senior Manager

Tampa, FL · Remote

$93K/yr

... in a healthcare, managed care, health plan, or utilization management environment preferred ... Remote employees must adhere to all technical support procedures and protocols. * Chronic ...

Aston Carter

Remote Medical Coder

Jacksonville, FL · On-site +1

$75/hr

Remote Medical Coder Assess and validate AI-generated content related to healthcare operations ... management, utilization management, patient access, compliance, or related healthcare ...

NationsBenefits, LLC

Teleaudiologist

Fort Lauderdale, FL · On-site +1

$90K - $110K/yr

Key Responsibilities Remote Clinical Care & Patient Management * Conduct patient evaluations, consultations, and follow-up care via video * Support and guide in-clinic staff through hearing ...

NationsBenefits

Teleaudiologist

Fort Lauderdale, FL · On-site +1

$90K - $110K/yr

Key Responsibilities Remote Clinical Care & Patient Management * Conduct patient evaluations, consultations, and follow-up care via video * Support and guide in-clinic staff through hearing ...

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Remote Managed Care information

What is a remote managed care?

A Remote Managed Care job involves overseeing healthcare services, cost management, and patient care coordination from a remote location. Professionals in this role work with insurance providers, healthcare facilities, and patients to ensure efficient and cost-effective care. Responsibilities may include reviewing treatment plans, managing claims, and ensuring compliance with healthcare regulations. Remote Managed Care positions are common in insurance companies, hospitals, and telehealth organizations, requiring strong communication and analytical skills.

What does a remote managed care do?

In a Remote Managed Care role, your primary daily tasks often include coordinating care plans, reviewing healthcare claims, ensuring members receive appropriate medical services, and communicating with providers, patients, and insurance companies. You may spend much of your day using online platforms to track cases, resolve billing issues, and document patient interactions. Collaboration with clinical teams, providers, and case managers is common to address patient needs and ensure the quality and cost-effectiveness of care. Working remotely requires a high level of self-motivation and strong organizational skills, as you’ll manage your caseload with minimal direct supervision.

What are the key skills and qualifications needed to thrive in remote managed care?

To thrive in a Remote Managed Care role, you need a solid understanding of healthcare administration, insurance processes, patient advocacy, and compliance — usually demonstrated by relevant experience or a degree in healthcare or business. Familiarity with managed care software platforms, claims management systems, and relevant certifications such as Certified Case Manager (CCM) or Certified Professional in Healthcare Management (CPHM) are often required. Strong communication, time management, and problem-solving skills set top performers apart in this position. These skills are critical for effectively coordinating patient care, ensuring regulatory compliance, and delivering excellent service while working remotely.

What are the most commonly searched types of Managed Care jobs in Florida?

The most popular types of Managed Care jobs in Florida are:

What are popular job titles related to Remote Managed Care jobs in Florida?

For Remote Managed Care jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Remote Managed Care jobs in Florida look for?

The top searched job categories for Remote Managed Care jobs in Florida are:

What cities in Florida are hiring for Remote Managed Care jobs?

Cities in Florida with the most Remote Managed Care job openings:

Remote Managed Care jobs near you
Infographic showing various Remote Managed Care job openings in Florida as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Clinical Documentation Integrity DRG Validator, REMOTE, Managed Care Network Development Med Mgmt...

Baptist Health South Florida

Coral Gables, FL • Remote

$33 - $44.50/hr

Full-time

Posted 4 days ago

Baptist Health South Florida rating

8.1

Company rating: 8.1 out of 10

Based on 99 frontline employees who took The Breakroom Quiz

1st of 24 rated health and beauty retailers

Job description

Responsible for improving the quality, completeness, and clinical accuracy of inpatient documentation and DRG assignment through targeted concurrent DRG validation. The Clinical Documentation Integrity Specialist II - DRG Validator reviews selected inpatient accounts generally more than 48 hours from admission that have not been DRG optimized, using integrated electronic health record workflows, technology-enabled review worklists, and analytics-informed prioritization to focus on cases with the highest documentation, clinical validation, and reimbursement risk. Focused review includes non-optimized DRGs, signs and symptoms DRGs, APR-DRGs with SOI/ROM of 1/1 where the clinical picture suggests higher acuity, local infection DRGs to evaluate for sepsis or systemic illness, sepsis DRGs without documented organ dysfunction or other required clinical indicators, and level-of-care versus DRG mismatch, such as ICU or step-down patients assigned minor DRGs or SOI/ROM 1/1.. Scope to include all inpatient payors. Uses analytics informed prioritization, AI assisted worklists, and DRG encoder logic including TruBridge where implemented. Supports Epic transition planning for CDI workflows with planned go live in July 2027.Degrees:
  • Doctor of Medicine / DO.
Licenses & Certifications:
  • ACDIS Certified Clinical Documentation Specialist.
  • AHIMA Certified Documentation Improvement Practitioner.
Additional Qualifications:
  • International medical school graduate required.
  • Five years of recent adult, pediatric, obstetric, inpatient medical, surgical, and critical care experience required.
  • Strong knowledge of Medicare MS-DRG and Medicaid APR-DRG assignment, severity of illness, risk of mortality, clinical validation, denial vulnerability, and documentation integrity required.
  • Experience in concurrent inpatient chart review, DRG validation, collaboration with coding professionals, and use of integrated electronic health records, web-based applications, and technology-enabled review/analytics tools required.
  • Knowledge of official coding guidelines, AHA Coding Clinic, CMS guidance, payer clinical validation expectations, and compliant documentation clarification consistent with AHIMA-ACDIS query guidance required.
  • Experience using integrated electronic health records and CDI workflows, including readiness for transition from CDEOne to Epic CDI with planned go live in July 2027.
  • Experience with analytics, reporting, and AI assisted review prioritization tools preferred.
  • Familiarity with DRG encoder and DRG validation tools including TruBridge preferred.
Minimum Required Experience: 5 Years

What Baptist Health South Florida employees say

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Benefits

Hours and flexibility

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About Baptist Health South Florida

Sourced by ZipRecruiter

Baptist Health South Florida is the largest healthcare organization in the region, with 12 hospitals, more than 27,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties. Baptist Health has internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences. A not-for-profit organization supported by philanthropy and committed to its faith-based charitable mission of medical excellence, Baptist Health has been recognized by Fortune as one of the 100 Best Companies to Work For in America and by Ethisphere as one of the World's Most Ethical Companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Miami, FL, US

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