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Remote Clinical Validation Lead – Appeals & IRE Oversight
Remote / Online - Candidates ideally in
Johnson City, Washington County, Tennessee, 37614, USA
Listed on 2026-07-14
Johnson City, Washington County, Tennessee, 37614, USA
Listing for:
Stryker Corporation
Remote/Work from Home
position Listed on 2026-07-14
Job specializations:
-
Healthcare
Healthcare Management, Healthcare Compliance
Job Description & How to Apply Below
United Healthcare in the United States seeks a clinical professional to oversee appeal submissions and perform quality reviews across CMS IRE processes, Home Health PPS, and cost outlier audits. You will verify medical record evidence, coding accuracy, and policy references to support defensible determinations.
Reporting to the Chief Medical Officer for Payment Integrity, this role offers remote work options and requires strong clinical judgment, written communication, and collaboration with
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