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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...

Provide high-quality clinical services within scope of practice and infection control standards. Coordinate care with other members of the patient/client's care team from admission to discharge. Complete clinical nursing assessments per federal/state...

Overview Contract role - 8/8/23-12/31/23, with possible extension Pay rate: $50-$65 Hourly Location: Remote IL Required License: RN, LCSW, LCPC Basic function: This position is responsible for discharge care...

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...

By joining Sedgwick, you'll be part of something truly meaningful. Its 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, and...

Description Location: UCHealth UCHlth Med Ctr of the Rockies, US:CO:Loveland Department: MCR Care Management Work Schedule: Full Time, 80.00 hours per pay period (2 weeks) Shift: Days Pay: $38.91 - $60.31 / hour. Pay is dependent on applicant's...

A healthcare consulting firm is seeking a Clinical Reimbursement Consultant for a unique remote opportunity. The ideal candidate will be a Registered Nurse with at least five years of experience in MDS completion within a Skilled Nursing Facility.

Urgent Hiring for "Remote Clinical Review Nurses" Job Description: Review approximately 20 cases a day for medical necessity. Advocate for and protect members from unnecessary hospital...

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...

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...

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...

Clinical Nurse Liaison, RN 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...

As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for...

Care Advocate (RN) - Florida Papa is a new kind of care built on human connection. Across the country, health plans and employers look to Papa to provide vital social support by pairing older adults and families with Papa Pals, trained...

A leading risk and claims administration partner seeks a part-time RN Clinical Consultation specialist in Salt Lake City, Utah. This role involves triaging calls and providing care advice, supporting employees' recovery from injuries in a remote...

A leading health solutions company is seeking a fully remote Case Manager - Registered Nurse (RN) to join their National Medical Excellence team. The position involves assessing and coordinating care for members to enhance overall wellness.

A healthcare provider is seeking a Utilization Management Clinical Manager for analyzing medical service requests. The ideal candidate will possess an RN license and extensive experience in prior authorization in managed care. Responsibilities...

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

Workers' Compensation Case Manager - RN - Fully Remote in the US WorkCare, Inc. is seeking a full?time RN to serve as Workers' Compensation Case Manager, supporting our occupational health initiatives across the United States.

Description Location: UCHealth UCHlth Anschutz Inpt Pavilion, US:CO:Aurora Department: IP Behavioral Unit Work Schedule: Full Time, 80.00 hours per pay period (2 weeks) Shift: Flex Pay: $42.90 - $66.50 / hour. Pay is dependent on applicant's...

A telehealth organization is seeking a compassionate Registered Nurse (RN) for a part-time Telemedicine RN position based in Honolulu, HI. You will support patient care by assessing needs, offering medical advice, and ensuring optimal health...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: The Virtual Mental Health Intake RN is a Registered Nurse who provides competent and...

Telephonic Case Manager At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions...

RN Clinical Appeals Nurse Job Summary: The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory...

Description Location: UCHealth Anschutz Inpatient Pavilion - Aurora Department: Virtual Health Center - Quality program This position is an onsite role and does not offer a hybrid or remote option Work Schedule: Full Time, 72.00 hours per pay...