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Job Title: Remote Prior Authorization Registered NurseJob Description We are seeking experienced Registered Nurses (RNs) to join a remote Prior Authorization team supporting Dual Eligible (Medicare and Medicaid) populations. In...

Job DescriptionJob Summary Provides support for clinical facility site reviews. Under the supervision of leadership, uses clinical judgement within appropriate scope to independently conduct reviews and other monitoring activities...

CVS Health is seeking an experienced Registered Nurse (RN) for Utilization Management in a remote, work-from-home role. You will review clinical data, apply guidelines and collaborate with care teams to ensure appropriate, high-quality,...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. **This position is remote. Candidates must be local to New England States for consideration** The Clinical...

JOB DESCRIPTION Must reside in Florida Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established...

Building Location: Building B - St Marys Medical Center Department: 2003910 SMMC 10-CRITICAL CARE - SMMC HOSP Job Description: Responsible for organizing and providing nursing care to patients through the process of assessment, planning,...

Building Location: Building B - St Marys Medical Center Department: 2003900 SMMC 9-CRITICAL CARE - SMMC HOSP Job Description: Education Qualifications: Responsible for organizing and providing nursing care to patients through the process of...

Clinical Documentation Improvement Specialist-RN- Remote The Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) assists with the identification of diagnoses, conditions, and procedures that are representative of the...

Home Health Clinical Referral NurseOrganization: SCAH-Sutter Care at Home - UTPosition Overview: The Home Health Clinical Referral Nurse serves as the initial point of contact for potential home health patients, working closely with our clerical...

Tele-ICU Critical Care Physician AdventHealth is a faith-based healthcare organization dedicated to extending the healing ministry of Christ. We offer whole-person care that addresses the physical, emotional, and spiritual needs of...

Physicians East seeks a QEC Pre Procedure Screening Nurse for a part-time remote role based in Greenville, NC. The nurse will review patient charts, screen for procedural eligibility, and coordinate with physicians to ensure proper evaluation and...

Get AI-powered advice on this job and more exclusive features. This range is provided by Medix. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $37.00/hr...

Job Summary and Responsibilities As our Educator in Critical Care in accordance with our mission and core values of integrity, compassion, collaboration, and excellence, this position is established to serve as a...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Job Description The VITAS Telecare RN is a member of the interdisciplinary team who is the pivotal person responsible for identifying the physical, psychological, social, and spiritual needs of those patients and families needing...

Find your calling at Mercy! Overview Provides professional nursing care to patients within the medical practice in support of, and as directed by, the physicians. Assists the physician in the treatment of patients and completes...

Job Summary And ResponsibilitiesAs our Critical Care/Emergency Educator, and in accordance with our mission and core values of integrity, compassion, collaboration, and excellence, you will serve as a consultant and resource professional by acting...

Description Location: UCHealth Anschutz Pavilion - Aurora Department: Critical Care Metro Float Pool - Either ICU or PCU Metro Denver Critical Care Float Pool RNs will support patients and teams at University of Colorado Hospital, Highlands Ranch...

Evry Health seeks an RN Integrated Care Coordinator (UM) to provide comprehensive care coordination and drive quality outcomes for members across the care continuum. This remote role requires rotating weekend hours for utilization review and...

Job Summary and ResponsibilitiesAs our Educator in Critical Care Emergency, In accordance with our mission and core values of integrity, compassion, collaboration, and excellence, this position is established to serve as a consultant/resource...

Guidehealth is seeking a Registered Nurse (RN) for a remote Telehealth Medicare Annual Wellness Visit Specialist - PRN. The role conducts AWVs via telehealth under physician supervision, focusing on preventive care and patient education.

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Pay Range: $35.92 - $53.88 A successful candidate's actual pay rate will be based on several factors including relevant experience, skills, training, certifications and education. This position is responsible for the coordination of patients...

Building Location: Building B - St Marys Medical Center Department: 2004150 FLOAT POOL - CRIT CARE - SMMC HOSP Job Description: Education Qualifications: Responsible for organizing and providing nursing care to patients through the process of...

Case Manager Utilization RNWorks collaboratively with an MD to coordinate and screen for the appropriateness of admissions and continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the...