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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...

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...

Job Type Contract Description Clinical Nurse Consultant-RN Engage Consulting is seeking an experienced Clinical Nurse Consultant-RN for a 1099 contract to support an interim project in the post-acute care...

A healthcare organization in Washington, DC, is seeking a qualified nurse for clinical review and care coordination. This role requires evaluating medical services and ensuring effective patient care while maintaining communication with various...

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...

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 of...

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...

A healthcare management firm is seeking a detail-oriented Utilization Management Reviewer for a fully remote position. The role includes reviewing care based on evidence-based guidelines, ensuring quality and compliance while upholding medical...

Job Type Contract Description Job Type Contract Description Clinical Nurse Consultant-RN Engage Consulting is seeking an experienced Clinical...

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.

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...

A leading healthcare organization is seeking a Utilization Management Nurse RN to review clinical data and support patient care from a remote setting. This role requires critical thinking and clinical expertise to ensure proper hospital admissions...

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...

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...

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...

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...

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...

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...

Additional Information About the Role Part time position (2) 12 Hour Day Shift - 6:00 am to 6:30pm Located at BJC Commons Minimum of 2 -5 plus years of RN experience needed Recent bedside RN experience in Acute Med/ Med Surg needed We are seeking...

Job Description: Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained from clinical records or systems to apply...

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...

A leading health solutions company is seeking a Care Manager-Registered Nurse in Connecticut. This role requires developing and coordinating care plans for members with multiple chronic conditions while ensuring effective telephonic engagement.

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...

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...