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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 company, we reach millions...

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...

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 company, we reach millions...

Remote position, however, candidates must reside in the State of TX or State of IL. This position is a contract for about 9 months. Pay: $41/hour Job Responsibilities: RN working in the insurance or managed...

A national health organization is seeking a clinical professional to perform concurrent reviews and evaluate member health. This remote position requires a Nevada LPN or RN license and offers a pay range of $26.50 - $47.59 per hour, along with...

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...

Overview Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nations leading health care organizations and build your career at one of our 40+ locations throughout Houston.

Review provider post-service appeals for Medicare and Retirement. Gather clinical information including medical records and coverage criteria as it pertains to Medicare guidelines. Discuss cases with medical directors when applicable. Ability to...

This position is responsible for conducting face-to-face assessments of members who may need skilled nurse assessment services. The incumbent completes all assessments using a skilled care acuity tool and provides a recommendation for services...

A growing commercial insurance company is seeking a Clinical Review Nurse to assess medical necessity and appropriateness of treatments for Workers' Compensation claimants. This role involves collaboration with claims adjusters and conducting...

Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This position is remote. Candidates must be local...

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 company, we reach millions...

Utilization Review - Fully Remote This role involves performing precertification and medical necessity reviews for designated referrals and targeted outpatient procedures, services, and inpatient admissions. The position requires...

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

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: Aids patients in obtaining the correct level of care with the appropriate provider at...

Description RN Utilization Review at Providence Holy Cross Medical Center in Mission Hills, CA. This position is Part- time and will work 8-hour, Day shifts. Providence Holy Cross Medical Center is...

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's...

Description The on-call HEDIS Clinical Audit Coordinator is responsible for conducting clinical quality audits for the Quality Department. The auditor identifies and coordinates clinical audits to determine potential areas...

Become a part of our caring community and help us put health first The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental 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...

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...

A healthcare organization is seeking a Utilization Manager Registered Nurse to join their team in Massachusetts. The role involves conducting clinical reviews for service authorizations and ensuring compliance with regulatory standards. Candidates...

MSSI is seeking a travel nurse RN Utilization Review for a travel nursing job in Minneapolis, Minnesota. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 12/08/2025 Duration: 13 weeks 40 hours per week Shift:...

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 with the care, pharmacy benefits, data...

Job Details Job Location Orange, CA - Orange, CA Remote Type Fully Remote Position Type Full Time Salary Range $45.00 - $45.00 Hourly Travel Percentage None...