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JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations...

Join Sedgwick and be a part of something truly meaningful. Our 33,000 colleagues work daily to support individuals facing unexpected challenges. Embrace the opportunity to grow your career with us while enjoying a culture of care and work-life...

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...

Registered Nurse Utilization Management (UM) Reviewer PeaceHealth is looking for a skilled and motivated Registered Nurse Utilization Management (UM) Reviewer to join our dedicated team in a Full Time, Day Shift (1.0 FTE) role. If you...

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...

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...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect...

Join a Meaningful Mission Maximus is a leading global organization dedicated to enhancing health and employment services for millions each year. In the UK, we employ around 5,000 passionate individuals who make a significant impact...

Who We Are At Entyre Care, our mission is to support caregivers by offering families both emotional and financial support throughout their caregiving journey. We ensure our caregivers have access to the right resources and...

Job Description Salary Range: $40 - $42/Hourly Why Hospice? Why VITAS? Have you ever considered hospice as a clinical specialty-one that blends clinical expertise with deep human connection?

For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of OH Case Manager RN will work in remote and field setting supporting Medicare and Medicaid l health...

$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...

This range is provided by Insight Global. Your actual pay will be based on your skills and experience talk with your recruiter to learn more. Base pay range $140,000.00/yr - $170,000.00/yr Direct message the job poster from...

Description Director of Nursing Location: Oakleaf Village and The Grove Columbus Job Type: Full time Pay Rate: up to $100k plus bonus Make a Difference—And Own Your Future At Wallick Senior...

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...

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care...

Current Employees and Students: If you are currently employed or enrolled as a student at any of the Universities of Wisconsin, log in to Workday to apply through the internal application process. Position...

Nurse Case Manager Position Type: Full-Time Contract Role Location: Work from home Work Type: Remote Est. Pay Range: $35.00/hour $38.46/Hour on W2 (USD) (all inclusive) Schedule: Mon-Fri 8am-5pm EST...

Fully Remote : Clinical Documentation Specialist Job Description Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers.

Capital City Hospice is proud to be Ohio-made. Every decision we make about hospice care is made with patients and families in mind. Our team is rooted in the communities we serve and are dedicated to delivering the highest quality of...

Benefits: 401(k) Bonus based on performance Employee discounts Flexible schedule Paid time off Wellness resources Benefits/Perks A...

Description Location: UCHealth UCHlth Leprino Building AMC, US:CO:Aurora Department: CTRC Outpatient FTE: Full Time, 0.9, 72.00 hours per pay period (2 weeks) Shift: Days Pay: $33.61 - $52.10 / hour. Pay is dependent on applicant's relevant...

Position Type: Student Support Services/School Nurse Date Posted: 1/20/2026 Location: District District: Jonathan Alder Local School District...

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...

Join Our Caring Community: Help Us Prioritize Health The Pre-Authorization Nurse Specialist is responsible for reviewing prior authorization requests to ensure appropriate care and settings, adhering to established guidelines and...