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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 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...

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...

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...

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...

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.

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...

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 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...

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...

$40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical...

A leading healthcare company is seeking a Utilization Management Nurse 2 to provide care coordination and clinical oversight. The ideal candidate will have a Registered Nurse license and 3-5 years of relevant experience in critical care or...

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...

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...

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position. ESSENTIAL...

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...

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...

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...

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,...

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...

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...

A leading pharmacy company is seeking a Clinical Outcomes Quality Assurance Nurse to ensure the quality of documentation and implement clinical best practices. Responsibilities include managing outcomes forms and communicating with patients and...

Job Type Full-time Description WESTSIDE IS LOOKING FOR A NURSE / RN TO JOIN THE VIRTUAL NURSE TEAM! SIGN ON BONUS OFFERED! LOAN PAYOFF PROGRAMS...