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

Job Type Full-time Description Gateway Rehab Center (GRC) has an outstanding opportunity for a Nurse Liaison Gateway Rehab who will be responsible for the pre-admission case management, ASAM level of care assessment, and...

Utilization Management Nurse Job Description Responsible for reviewing and documenting prior authorization and concurrent stay requests, as well as member case histories, in compliance with...

Job Description Job Summary Join our team as a Clinical Review Nurse, where you will play a crucial role in supporting the review of medical claims and appeals. You will ensure compliance with state and federal...

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 Location: US Remote Base Pay Range: $36.00 - $43.00 per hour plus bonus Estimated Travel: Up to 10% for training Must be a US...

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...

Summary The Remote Patient Monitoring- Home Telehealth (RPM-HT) Registered Nurse (RN) Care Coordinator executes position responsibilities that demonstrates leadership, experience, and creative approaches to the management of complex...

SUMMARY: Reports to the Director of Care Management or designee. Conducts surveillance over medical necessity of patient care records. In collaboration with the physician of record and the Utilization Review Committee physician ensures the...

Description Home Search Jobs Job Description RN Utilization Management (REMOTE butNV License) Remote: Las Vegas, Nevada, US Salary Range: 42.00 - 43.00 | Per Hour...

remote within one of our plan states, IL, TX, NM, OK, MT or TN Registered Nurse responsible for collaborating with healthcare providers, members, and business partners, to optimize member benefits, evaluate medical necessity and promote...

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...

Duration: 3+ Months (Possible contract to hire) Job Description: Onsite training - will last up to six weeks but could be extended. A typical day would like in this role: Process prior...

To apply you must live in the following States: MA, NH, RI, IA, CO, FL, SC, NC, RI, CT, VA, MD, UT Our Intake Manager is responsible for the day-to-day operations of the Intake department. This includes directly supervising...

A Brief Overview Collaborates and coordinates with all members of the health care team, patient and family (or significant others) to coordinate and ensure timely and efficient delivery of required workflow, services and...

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.

Job Type Full-time Description About Us Hines is a nationwide, independent leader in personalized managed health care, focused on what's important to you-comprehensive services with the program...

The Utilization Review Specialist is responsible for the assessment and review of the healthcare delivery system with a concentration on tasks that promote cost-effective quality care and cost containment in accordance with various federal and/or...

Where You'll Work With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world...

JOB DESCRIPTION Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member...

THIS IS A REMOTE POSITION Part Time/Contract Position DUTIES: -Assess patient health problems over the phone and via secure video -Schedule appointments and refer patients -Advise and monitor...

Job Description Summary The Utilization Review Registered Nurse is responsible for reviewing medical services to ensure they meet evidence-based guidelines and member benefit plans. This includes...

As our Telephonic Nurse Care Manager, you will coordinate all aspects of patient care for high-risk individuals. You will evaluate each patient while directing treatment plans, discuss claims, benefits, and eligibility, and manage resources while...

Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately...

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 appropriate clinical...