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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...

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...

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.

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...

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

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...

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...

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...

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...

Review and abstract medical record data into appropriate application(s)Support chart chase processes by requesting/obtaining records as needed. Primary source verify abstracted medical record data. Analyze chart data, evaluate for possible data...

Cabell Huntington Hospital is seeking a full-time Virtual Integrated Care Coordinator (RN) for our CHH Virtual Integrated Care Department. This job is responsible for supporting and driving...

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...

We are more than a health system. We are a belief 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...

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...

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...

Job Summary: The Intake Nurse - RN is responsible for assessing potential new members for eligibility for the program and for explaining the program to them and their families. Responsible for knowing required outreach activities...

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...

CareHarmony's Care Coordinators (LPN) (LVN) work comprehensively with providers to deliver value-based care management initiatives for their patients. CareHarmony is seeking an experienced Licensed Practical Nurse to work 100% Remote –...

Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris™ revolutionizes the path from life...

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...

Job Summary This is a work on site position located in Danville, Pennsylvania. The Clinical Documentation Improvement Program (CDI) is designed to improve the physician's documentation in the patient's medical record, supporting the appropriate...

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...

The Admissions Nurse is responsible for the overall direction and coordination of activities related to admission of residents to the facility while providing superior customer service. Position: Admissions Nurse - Remote...