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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 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...

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 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...

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...

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...

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...

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...

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...

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.

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,...

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:...

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'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...

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...

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...

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...

Overview The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in...

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...

*Quality Assurance Registered Nurse - 100% Remote* Contract duration: 520 hour contract to hire Training Schedule: M-F, 4-6 weeks *Contract Details* * *Contract Duration:* 520-hour contract-to-hire, long term opportunity *...

$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...

Description 1 years of recent ED, ICU, or IR experience strongly preferred. Fast paced minimally invasive procedural department. RNs are responsible for care of the patient during interventional radiology procedure, including assessment, sedation,...

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,...