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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...

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...

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...

Registered Nurses are encouraged to consider a part-time remote Nurse Reviewer position with Liberty Healthcare Corporation. Liberty Healthcare operates a statewide program in Idaho which assesses children and adults who are living with...

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...

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...

Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The...

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...

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...

A health insurance company is seeking a Prior Authorization RN to review requests for health services and ensure compliance with Medicare and Medicaid guidelines. This remote role involves clinical decision-making and documentation for...

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...

Registered Nurses are encouraged to consider a part-time remote Nurse Reviewer position with Liberty Healthcare Corporation. Liberty Healthcare operates a statewide program in Idaho which assesses children and adults who are living with...

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,...

RN - Utilization Review Nurse | 3+ Years of Experience | Remote in IL | Contract Walker Healthforce is seeking a RN - Utilization Review Nurse with 3+ Years of Experience to support a Healthcare Payor Client based out of IL.

Carries out communicable disease surveillance, prevention, and control measures for the City of Boston. Investigates reports of communicable diseases including pathogens of public health importance, reported outbreaks, or other...

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.

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,...

Job Summary: The Clinical Nurse Specialist is an advanced practice nurse who functions in the role of expert clinician, educator, leader, consultant and researcher. In collaboration with the healthcare team, the CNS...

Facility: CoxHealth South: 3801 S National Ave, Springfield, Missouri, United States of America, 65807 Department: 1651 Virtual Care Command Center Scheduled Weekly Hours: 24 Hours:...

Job Description: • Participates in the development and ongoing implementation of QM Work Plan activities. • Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet...

In order to have an accurate count of participants, we need you to register for the Recruitment Fair on the District's website. Please select "apply for this position" under the heading to the right labeled "Apply Now". Interviews slots will fill up...

Description & Requirements Be part of something great Maximus is a global organisation that specialises in providing health and employment services to millions of people every year. Here in the UK we employ...

A leading health organization is seeking a Utilization Review Nurse to manage inpatient care efficiently. In this role, you will be responsible for reviewing admission criteria and ensuring high-quality patient care. The position offers...

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...