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A health services organization is seeking a Prior Authorization RN to join their Wisconsin Medicaid Market team. This role involves reviewing clinical appropriateness of prior authorization requests in accordance with Medicare/Medicaid guidelines.

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...

A leading healthcare provider is seeking a Clinic Registered Nurse (RN) for their urology team in Omaha, Nebraska. This hybrid role allows for remote work after training. The RN will collaborate with a multidisciplinary team to provide...

A leading health insurance company is seeking a Utilization Management Nurse 2 to coordinate care and communicate with providers and members. The role requires a licensed RN, 3-5 years of critical care nursing experience, and a passion for...

JOB DESCRIPTION Job Summary Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically...

Requirements Qualifications / Experience Current multi-state RN license with no restrictions; nurses currently holding a single-state RN license must obtain a multi-state license prior to being made a job...

Explore opportunities with [agency name], a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best,...

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...

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic...

Salary range: $95,139 - $130,811 annually, based on qualifications. This exempt remote-hybrid position is eligible for a comprehensive benefits package which includes medical, dental, vision, a 403(b) retirement account, and a generous...

A leading healthcare organization is seeking a Prior Authorization RN to join its team. This role entails reviewing prior authorization requests to ensure medical necessity and compliance with Medicare and Medicaid guidelines. Applicants should...

The Registered Nurse provides professional nursing care to patients within assigned areas utilizing the nursing process to assess, plan, implement and evaluate patients. What you will do Provides nursing...

A healthcare organization in Washington, DC, is seeking a qualified nurse for clinical review and care coordination. This role requires evaluating medical services and ensuring effective patient care while maintaining communication with various...

Explore opportunities with [agency name], a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best,...

Receives inquiry calls and assists the caller with scheduling a face-to-face assessment to triage to the appropriate community referral. Assesses or ensures assessment by a qualified mental health professional of patients who present for assessment.

Overview Registered Nurse (RN), Clinical Decision Unit Rockville Centre, NY Explore a career with Mercy Hospital, a 375-bed not-for-profit hospital and member...

A telehealth organization is seeking a compassionate Registered Nurse (RN) for a part-time Telemedicine RN position based in Honolulu, HI. You will support patient care by assessing needs, offering medical advice, and ensuring optimal health...

Remote Clinical Review Nurse - Prior Authorization Location: Must be located in Central or Eastern time zones Employment Type: Full-Time About the Role We are seeking an experienced Registered Nurse to join our team within...

Description RN Utilization Review at Irvine, CA. This position is Part- time and will work Remote 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our...

Job Summary: The Registered Nurse (RN) is accountable for providing competent nursing care. Responsible for coordination of the patient's plan of care through assessment, planning, implementation, and evaluation of nursing...

GoTo Telemed seeks experienced, certified CRNAs for remote anesthesia consultation, patient education, and post-operative follow-up services. This 1099 independent contractor position provides flexibility while supporting surgical teams across...

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture,...

ABOUT AUSTIN REGIONAL CLINIC: Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years! We are one of central Texas' largest professional medical groups with 35+ locations and we...

Registered Nurse Endocrinology - Albany, NY If you are looking for a Hybrid RN II position, full time, this could be your opportunity. Here at St. Peter's Health Partner's, we care for more people in more places. This position will be...

Baptist Health is the regions largest not-for-profit healthcare organization, with 12 hospitals, over 28,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward...