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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...

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

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...

Responsibilities: How you'll change lives ...

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...

Program Integrity Clinical Compliance AuditorOptum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers.

Prime Staffing is seeking a travel nurse RN Research / Clinical Research for a travel nursing job in Fullerton, California. Job Description & RequirementsSpecialty:...

About the job Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark , General Catalyst , Peter Thiel , Adam D'Angelo , Larry Summers , and Jack Dorsey .

To support client care authorization processes, the part-time Temp Clinical Letter Writer will gather and review medical records, draft letters of medical necessity, and communicate with team members regarding client authorizations and...

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management) .Candidate must be authorized to work in USA without requiring sponsorshipLocation: 100% Remote for California...

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...

Molina Healthcare is hiring a remote RN Care Manager. Preference for candidates in Washington State. This role will be working Pacific Standard Time hours. This role supports Medicare members through telephonic case management and...

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

Overview Talent Staffing Solutions Inc. DBA Mendrix Agency Group is a fast-growing, nurse-first staffing agency serving Skilled Nursing Facilities (SNFs) and Nursing Homes across Los Angeles County. We are hiring on CNAs,...

Job OverviewPay Range: $46.76hr - $51.76hrRequirement/Must Have5+ years Clinical nursing experience.2+ years Care Management.Bachelor's Degree in Nursing.In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required...

As a Clinical Documentation Review Specialist (RN), you will help medical staff clarify patient records to ensure appropriate reimbursement and reflect care complexity.You will perform concurrent reviews and engage with physicians to resolve...

Trustaff is seeking a travel nurse RN Clinic for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: ClinicDiscipline:...

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 consistent...

8 Hours POSITION SUMMARY The Clinical Staff Nurse is a skilled and experienced professional Registered Nurse (RN) responsible for excellence in the clinical practice of nursing and the management of patient care.

WORK REMOTELY after training! CANDIDATE MUST RESIDE IN THE METROPOLITAN NEW YORK AREA! !! Process all requests for services in accordance with Medicare and NYS Medicaid guidelines as well as departmental criteria and...

Explore opportunities with Amedisys, part of the Optum family of businesses. We provide home health, hospice and community-based services that help people receive quality care where they feel most comfortable: at home. Rooted in personalized care,...

Utilization Review Specialist (RN) – Work From Home (Florida-Based Candidates Only)Concierge Home Care | Work From Home Opportunity – Must Reside in FloridaAt Concierge Home Care, we are growing and looking for an experienced Utilization...

TRISTAR Company is seeking an experienced Utilization Review Nurse for a fully remote role across all states. The job focuses on workers' compensation utilization review—prospective, concurrent, expedited, and retrospective reviews—to...

Clinical Documentation Integrity Specialist IIThe Clinical Documentation Integrity Specialist II (CDI) is responsible for utilizing independent clinical judgement in facilitating the integrity, overall quality, accuracy, and completeness of...

GQR Healthcare is seeking a travel nurse Correctional for a travel nursing job in Commerce, California. Job Description & RequirementsSpecialty:...