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Resp & Qualifications PURPOSE: The Clinical Medical Review Nurse handles day-to-day review of professional and institutional claims and provider appeals that require medical review to determine if the claim...

**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 appropriate...

Overview Mount Carmel Behavioral Health is hiring Admissions RN's! Available Shift: Full Time Day (7a-7p) Full Time Night (7p-7a) Sign...

Description Utilization Review RN - Remote Providence Health Plan caregivers are not simply valued – they're invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of...

About Outpatient Clinics Corewell Health operates over 300 outpatient clinics across Michigan, bringing a multitude of care options to the communities that we serve. There are over 40 different types of primary care and specialty...

Description: Job Summary: Provides remote consultative and supportive nursing care to Intensive Care Units (ICU) to multiple medical centers utilizing in room camera and EPIC technology from a remote, centralized hub.

Join Our Caring Community: Help Us Prioritize Health As a Nurse Specialist focused on Authorization Review, you will be instrumental in facilitating the care patients need by diligently reviewing prior authorization requests. Your...

Description Location: UCHealth UCHlth Poudre Valley Hospital, US:CO:Fort Collins Department: PVH Cardiac Rehab Work Schedule: Part Time, 40.00 hours per pay period (2 weeks) Shift: Days Pay: $38.91 - $60.31 / hour. Pay is dependent on applicant's...

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...

Position Title: Registered Nurse II (100% REMOTE) Assignment Duration: 3 Months Work Schedule: M-F, 9-5:30pm EST with 30 min unpaid lunch Work Arrangement: Virtual Position Summary: Responsible for clinical criteria prior authorization setup to...

By clicking the “Apply” button, I understand that my employment application process with Takeda will commence and that the information I provide in my application will be processed in line with Takeda's Privacy Notice ( and Terms of Use ( . I...

Shift: Night Working Hours: 6:30p-7a Summary: The Admission/Discharge Registered Nurse (RN) is a member of the Nursing Care Team and is responsible for collaboration, communication & facilitation of optimal provision of...

Evenings, Weekend Only, Full-time & Part-time opportunities available (20hrs +) Hiring for evenings and weekends (*weekends and holidays are required) Incentives for Bilingual Spanish Telephone Triage RNs! Are you looking for an...

Overview: This position will work in our School Based Health Centers in Franklin County. Hours are between 7-4 depending on the site. Days are M-F depending on the site. More details will be discussed during the interview.

We are more than a health system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be...

Registered Nurse The VITAS Telecare RN is a member of the interdisciplinary team who is the pivotal person responsible for identifying the physical, psychological, social, and spiritual needs of those patients and families needing...

CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to...

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...

Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...

" The Utilization Review Specialist is responsible for the assessment and review of the healthcare delivery system with a concentration on tasks that promote cost-effective quality care and cost containment in accordance with various federal...

Job Type Full-time Description Gateway Rehab Center (GRC) has an outstanding opportunity for a Nurse Liaison Gateway Rehab who will be responsible for the pre-admission case management, ASAM level of care assessment, and...

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...

RELOCATE TO VIRGINIA OPPORTUNITY Join our esteemed team of healthcare professionals committed to advancing healthcare through cutting-edge research, comprehensive training, and compassionate care. UVA Health is an integrated...