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Job DescriptionJoin Cedars-Sinai Cedars-Sinai has been named to the Honor...

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...

Molina Healthcare in Illinois seeks a licensed RN Case Manager to support Medicare members. This telephonic position may require occasional face-to-face visits; 25–40% travel may be needed depending on state requirements. You will assess, plan,...

Job Description & Requirements Family Medicine Nurse Practitioner or Physician Assistant(NP) StartDate: ASAP Available Shifts: Day 8 Pay Rate: $72.75 - $78.75 This facility is seeking a Family Medicine Nurse Practitioner or...

Description: FAMILY NURSE PRACTITIONER JOB SUMMARY Provides continuous and comprehensive services necessary for the promotion of optimal health, prevention and treatment, in an underserved community clinic. To perform a variety of advanced clinical...

University Hospitals is seeking a Registered Nurse to collaborate with the health care team to coordinate admissions, continued stays, and level-of-care decisions. You will communicate with patients and families to ensure timely care and proper...

Telephonic After-Hours Call - Evenings, Nights & Rotating Weekends Required Part-Time (20 Hours) Active Nurse Practitioner license in Connecticut or Rhode Island Required Optum Home & Community Care, part of the Optum family...

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...

Trillium Health Resources is seeking a Registered Nurse to join our Utilization Management team in North Carolina. The UM reviews, coordinates care, and supports discharge planning to improve outcomes and ensure appropriate utilization of...

Utilization Management Nurse Join us in our mission to transform healthcare! NirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees at every stage...

Description: FAMILY NURSE PRACTITIONER JOB SUMMARY Provides continuous and comprehensive services necessary for the promotion of optimal health, prevention and treatment, in an underserved community clinic. To perform a variety of advanced clinical...

Job Title: Nurse, Clinical Medical Review Location: Columbia, MD (Primarily remote, but hybrid) Duration: 6 Months Contract PURPOSE: We are seeking a qualified RN or LPN with experience supporting HEDIS reporting and abstraction processes in a...

Healthcare Management Solutions, LLC is seeking experienced CHSD Audit reviewers to conduct independent medical record reviews for the STS CHSD program. This remote, part-time role focuses on data accuracy, source verification, and adherence to...

Registered Nurse Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Part-Time Shift: Evenings Job Description Join a team that's shaping the...

About This Role The Preservice Review RN position at UnitedHealth Group involves assessing customer needs, identifying solutions to complex issues, and conducting clinical research to support medical determinations. This role is ideal for...

Abbott is seeking a per-diem RN trainer in the Durham, NC area to deliver Face-2-Face training for home testing customers. You will guide finger stick collection, explain PT/INR device use, and assist with reporting responsibilities. The...

Overview TEEMA is partnering with a leading organization supporting a large-scale federal healthcare program to identify a Clinical Quality Reviewer. This role focuses on reviewing clinical cases, identifying potential quality or safety...

Nursing Assistant PositionUnder the direction of a Registered or Licensed Vocational Nurse, provides basic nursing care and implements selected aspects of the patients nursing plan of care.This position requires providing care/service to an...

Prolific is seeking Registered Nurses to train and evaluate AI models. If successful, you'll be invited to join Prolific as a Domain Expert participant, where you'll get paid to train and evaluate powerful AI models. Researchers paying up...

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...

Supports the values of service excellence, teamwork, and integrity while managing patient care. Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers. Qualifications: Requires a...

Humana is seeking an Utilization Management Nurse to support the coordination, documentation and communication of medical services and benefit determinations. This role requires interpreting criteria and policies to determine the best care and to...

Mass General Brigham Health Plan Holding Company, Inc. seeks a Nurse for utilization review to assess medical necessity and benefit coverage for ACO/HMO/EPO members. Remote with occasional on-site team meetings in Somerville, MA. Strong...

Job Description Utilization Review RN - Remote. This position is Per Diem and will work 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA...

Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in accordance with established standards of care, policies, and procedures. Demonstrates performance...