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**Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

A leading healthcare provider in Winston-Salem is seeking a Telehealth Nurse to provide nursing services remotely. Applicants should have a valid RN license and at least 3 years of clinical experience, preferably in telephone triage. Strong...

Performing pre-service clinical coverage review of services (predetermination reviews), using applicable benefit plan documents, evidence-based medical policy and nationally recognized clinical guidelines and criteria. Managing clinical Out of...

A leading healthcare organization is looking for a Nurse Reviewer I to conduct preauthorization and appropriateness of treatment reviews for diagnostic imaging services. The role supports remote work and requires an associate degree in nursing...

Medical Review Nurse The Medical Review Nurse 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 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...

A state government agency in Florida is seeking a Registered Nurse Specialist to support foster children with complex medical needs. The role involves conducting assessments, home visits, and collaborating with caregivers and healthcare teams.

Schedule: Part-time, either 3 (10 hour) shifts or 4 (8 hour) shifts. Day/pm hours available. Every third weekend and holiday rotation. - - Candidate MUST have 2 years' acute care experience (ED, Urgent Care, ICU and some Med/ Surg will be...

A leading healthcare provider in Boston is seeking a Registered Nurse for a Triage Nurse role. The position involves providing direct patient care, performing nursing assessments, and coordinating care for patients and families. Candidates must...

What You'll Do... * Administers medication (e.g., oral intramuscular and intravenous) and monitors patient medication compliance * Performs treatments and performs or assists with nurse's sick call * Assists with doctor's sick call...

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...

What You Should Know About the RN Admission Care Liaison Role: * This is a part time DRIVING position serving the Central Ohio Region (Newark, Columbus, Marysville, Lancaster, etc.) * The hours are 11a-7p with any every 4th weekend and...

Take advantage of flexible schedules and get paid up to $68 an hour as a Registered Nurse (RN) in Westerville, Ohio, and surrounding areas. Nursing...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Company Overview: Join an innovative startup health plan based in Wisconsin that is revolutionizing healthcare and empowering companies to combat the relentless rise in healthcare costs. Our mission is to provide accessible, high-quality...

What You Should Know About the RN Admission Care Liaison Role: This is a part time DRIVING position serving the Central Ohio Region (Newark, Columbus, Marysville, Lancaster, etc.)The hours are 11a-7p...

Clinical Claims Review 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.

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

A leading healthcare company is seeking a Tele-Health Nurse to provide support to patients and caregivers through telephonic interactions. This remote position requires a Registered Nurse licensure and is ideal for those with a passion for...

This is a remote role. CircleLink Health is looking for passionate, tech savvy registered nurses to work remotely and serve patients enrolled in Medicare's Chronic Care Management Program. In this part time role...

A healthcare service provider is seeking a Registered Nurse - Case Review Specialist to provide remote support in reviewing cases for Federal Occupational Health. The ideal candidate will have at least 5 years of Nursing experience, a valid RN...