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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 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.

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...

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...

Make it happen at Hopkins Provides disease case management oversight of chronic conditions (i.e CHF, COPD, Diabetes, asthma etc.) in adult population using remote patient monitoring as a tool. Responsible for all aspects of remote...

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...

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,...

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...

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 The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in...

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to...

About Us One Medical is a primary care solution challenging the industry status quo by making quality care more affordable, accessible and enjoyable. But this isn't your average doctor's office. We're on a mission to transform healthcare, which...

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...

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...

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,...

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...

Registered Nurse 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...

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...

Registered Nurse (Specialty Phone Triage) - Remote Opportunity 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...

Location: Avera McKennan Hospital Worker Type: PRN Work Shift: Rotating days/evenings ights/weekends/holidays (United States of America) Pay Range: The pay range for this...

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...

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families,...

About Pine Park Health Pine Park Health is a value-based primary care practice revolutionizing healthcare for residents of senior living communities across Arizona, California, and Nevada. We empower seniors...

Give Life in a Truly Rewarding Career with DaVita DaVita Kidney Care is bringing our industry-leading clinical quality to patients on-site at skilled nursing facilities (SNF) through a new team called DaVita Skilled Nursing Dialysis...

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...