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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 regulations...

Employer Industry: Healthcare Services Why consider this job opportunity Opportunity for career advancement and growth within the organization Work remotely, with flexibility in scheduling Engage in...

Fully Remote: Clinical Documentation Specialist Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

A leading healthcare provider in Winston-Salem is seeking a Telehealth Nurse to provide nursing services remotely. Applicants should have a valid RN license and at least 3 years of clinical experience, preferably in telephone triage. Strong...

A state government agency in Florida is seeking a Registered Nurse Specialist to support foster children with complex medical needs. The role involves conducting assessments, home visits, and collaborating with caregivers and healthcare teams.

Clinical Claims Review At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better.

Nurse Navigator 1 - Site Disease - Full Time/Remote page is loaded## Nurse Navigator 1 - Site Disease - Full Time/Remotelocations: Miami, FLtime type: Full timeposted on: Posted Todayjob requisition id: R100091779## **Current Employees:**If you...

Overview Contract role - 8/8/23-12/31/23, with possible extension Pay rate: $50-$65 Hourly Location: Remote IL Required License: RN, LCSW, LCPC Basic function: This position is responsible for discharge care...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Join to apply for the RN Call Assist Remote in PST role at Optum 1 day ago Be among the first 25 applicants Join to apply for the RN Call Assist Remote in PST role at...

A telehealth practice is seeking a Virtual Registered Nurse for a 6-month contracted position to provide high-quality patient care through EMR communications and triage. Candidates should have a BSN and an active nursing license, along with...

A nationwide home infusion company is seeking a Quality Assurance Chart Review Nurse. This role involves reviewing clinical records for compliance and accuracy. Candidates should have a nursing degree, an active license, and experience in home...

HonorVet Technologies is seeking a local contract nurse RN PACU - Post Anesthesia Care for a local contract nursing job in Columbus, Ohio. Job Description &...

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record...

The Patient Care Assistant (PCA) II performs duties to enhance patient experience while maintaining patient comfort and a safe patient environment. All care is provided based on the concepts inherent in the model of care for TCH which promotes an...

A leading healthcare company seeks a Remote Tele-Health Nurse to provide telephonic support to patients and caregivers. This role involves coordinating clinical data, ensuring compliance, and applying behavior modification techniques to enhance...

CVS Health Remote Telephonic Case Manager At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading...

Mercy East Region Throughput Center Rn Find your calling at Mercy! The East Region Throughput Center RN serves as the clinical expert for the unit. There are three main focuses of this position: to be the first point of contact for...

A national health organization is seeking a clinical professional to perform concurrent reviews and evaluate member health. This remote position requires a Nevada LPN or RN license and offers a pay range of $26.50 - $47.59 per hour, along with...

A fast-growing insurance company is seeking a Clinical Review Nurse to assess medical necessity for Workers' Compensation claims. This role offers a remote or office location option and requires an active RN license along with 5+ years of related...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Registered Nurse (RN) Outpatient Clinic- Float Team - Hybrid/Partially Remote The RN is responsible for providing clinical support to providers and patients in Clinical Practice Group (CPG) office. These duties may include: patient care,...