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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...

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...

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 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.

A healthcare service provider is seeking a Registered Nurse - Case Review Specialist to provide remote support in reviewing cases for Federal Occupational Health. The ideal candidate will have at least 5 years of Nursing experience, a valid RN...

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...

Remote Rn Care Coach This is a remote role. CircleLink Health is looking for passionate, tech savvy registered nurses to work remotely and serve patients enrolled in Medicare's Chronic Care Management Program. In this part time role...

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...

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,...

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...

Remote position, however, candidates must reside in the State of TX or State of IL. This position is a contract for about 9 months. Pay: $41/hour Job Responsibilities: RN working in the insurance or managed...

A talent marketplace for AI research is seeking experienced Registered Nurses to work remotely on innovative projects. You will create and review deliverables that contribute to advancing AI research. Ideal candidates should have over 4 years of...

A leading health company is seeking a Telephonic Nurse Case Manager II responsible for managing care for members with chronic needs. The position requires a BA/BS in a health-related field, a current RN license, and five years of clinical...

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...

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...

A leading home health care provider is seeking a Compliance RN Home Health Clinical Partner in Nashville, TN. This full-time position involves conducting clinical audits, performing HIPAA checks, and providing compliance education. Ideal...

A leading healthcare company is seeking a Tele-Health Nurse to provide support to patients and caregivers through telephonic interactions. This remote position requires a Registered Nurse licensure and is ideal for those with a passion for...

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...

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...

Unit Description: The Primary Nurse in Ambulatory Oncology serves as a pivotal member of the patients' multidisciplinary team, coordinating care across the continuum. Key aspects of this role include telephone triage of acute illness, ongoing...

A leading insurance firm is seeking a Medical Bill Review Senior Nurse in Schaumburg, IL. The role involves reviewing complex medical bills for compliance, managing litigation issues, and ensuring customer satisfaction. Candidates must have at...