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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...

JOB DESCRIPTION Job Summary The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for overseeing delegated activities to ensure compliance...

We are hiring for a Registered Nurse. $7,500 Sign-On Bonus available At Caretenders Home Health, a part of LHC Group, we embrace a culture of caring, belonging, and...

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...

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.

Take advantage of flexible schedules and get paid up to $68 an hour as a Registered Nurse (RN) in Westerville, Ohio, and surrounding areas. Nursing...

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 leading healthcare organization is looking for a Nurse Reviewer I to conduct preauthorization and appropriateness of treatment reviews for diagnostic imaging services. The role supports remote work and requires an associate degree in nursing...

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,...

Provide support to all units within Claims to ensure all clinical components are met for CMS, NCQA, URAC, DOL, DOI, and all other State and Federal entities. Identify business priorities and necessary processes to triage and deliver work. Use...

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...

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.

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...

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...

Take advantage of flexible schedules and get paid up to $68 an hour as a Registered Nurse (RN) in Westerville, Ohio, and surrounding areas. Nursing...

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...

Performing pre-service clinical coverage review of services (predetermination reviews), using applicable benefit plan documents, evidence-based medical policy and nationally recognized clinical guidelines and criteria. Managing clinical Out of...

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...

Nurse Navigator 1 - Site Disease - Full Time/Remote page is loaded## Nurse Navigator 1 - Site Disease - Full Time/Remotelocations: Miami, FLtime type: Full timeposted on: Posted Todayjob requisition id: R100091779## **Current Employees:**If you...

A prominent medical institution is seeking a Nurse Rev II to conduct clinical assessments and evaluations for individuals in nursing facilities. This hybrid role includes statewide travel and offers flexible scheduling with no weekends or...

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...

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...