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We believe everyone should have confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care...

Remote Clinical Review Nurse - Prior Authorization Location: Must be located in Central or Eastern time zones Employment Type: Full-Time About the Role We are seeking an experienced Registered Nurse to join our team within...

A leading healthcare organization is seeking a Prior Authorization RN to join its team. This role entails reviewing prior authorization requests to ensure medical necessity and compliance with Medicare and Medicaid guidelines. Applicants should...

A healthcare company is hiring a Utilization Review Nurse, RN, in California. This role involves managing inpatient utilization efficiently by reviewing admissions, applying medical necessity criteria, and collaborating with healthcare teams.

Description 1 years of recent ED, ICU, or IR experience strongly preferred. Fast paced minimally invasive procedural department. RNs are responsible for care of the patient during interventional radiology procedure, including assessment, sedation,...

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic...

Location: Avera McKennan Hospital Worker Type: PRN Work Shift: Rotating days/evenings ights/weekends/holidays (United States of America) Pay Range: The pay range for this...

$40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical...

Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The...

Requirements Qualifications / Experience Current multi-state RN license with no restrictions; nurses currently holding a single-state RN license must obtain a multi-state license prior to being made a job...

Registered Nurses are encouraged to consider a part-time remote Nurse Reviewer position with Liberty Healthcare Corporation. Liberty Healthcare operates a statewide program in Idaho which assesses children and adults who are living with...

Job Description Critical Care Virtual Registered Nurse - located in Big Flats, NY! This position is per diem night shift. Position Details: The Virtual Critical Care Registered Nurse works from the...

Enjoy what you do while contributing to a company that makes a difference in people's lives. Shady Grove Fertility, one of the premier fertility centers in the United States, seeks experienced, compassionate, and dynamic team players who are...

JOB DESCRIPTION Job Summary Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically...

Scope of Work With principal investigator oversight, prepares, evaluates and implements research studies to enhance the advancement of clinical practice. Serves as primary coordinator / project manager on a variety of...

A leading health organization is seeking a Utilization Review Nurse to manage inpatient care efficiently. In this role, you will be responsible for reviewing admission criteria and ensuring high-quality patient care. The position offers...

We are looking for a Procedural Registered Nurse to join our collaborative team at Memorial Health! What You'll Do: Deliver patient care using the nursing process: assessment, analysis, diagnosis, planning, implementation, and evaluation. Assist...

A health insurance company is seeking a Prior Authorization RN to review requests for health services and ensure compliance with Medicare and Medicaid guidelines. This remote role involves clinical decision-making and documentation for...

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to...

Overview The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in...

Description RN Utilization Review at Irvine, CA. This position is Part- time and will work Remote 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: Aids patients in obtaining the correct level of care with...

Facility: CoxHealth South: 3801 S National Ave, Springfield, Missouri, United States of America, 65807 Department: 1651 Virtual Care Command Center Scheduled Weekly Hours: 24 Hours:...

A leading medical institution in Columbus, Ohio, is seeking a Cardiovascular Procedure RN to manage and provide care to patients and their families. The position is responsible for directing nursing care and collaborating with healthcare teams to...

A leading pharmacy company is seeking a Clinical Outcomes Quality Assurance Nurse to ensure the quality of documentation and implement clinical best practices. Responsibilities include managing outcomes forms and communicating with patients and...