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General Information Press space or enter keys to toggle section visibility Work Location: Los Angeles, CA, USA Work Schedule Monday - Friday, 8AM - 5PM ...

MCMC is seeking an RN/LPN/LVN with a clinical background to join as a Clinical Quality Assurance Coordinator, performing QA reviews of peer reports from home. You will ensure evidence-based rationales, accurate client instructions, and standards...

OverviewJobs for Humanity is partnering with CEDARS‑SINAI to build an inclusive and just employment ecosystem. We prioritize individuals from diverse communities including Refugee, Neurodivergent, Single Parent, Blind or Low Vision, Deaf or Hard...

Job Title: Clinical RN Job ID: 90637 Location: North Hollywood, California Overview: Are you a dedicated Registered Nurse who excels in outpatient clinical care and thrives in a...

About Carisk Partners, Inc. Carisk Partners, a Best Places to Work award winning organization, is a specialty risk transfer, care-coordination company servicing insurers, government entities, self-insured plan sponsors...

Join the dynamic journey at Vynca, where we're passionate about transforming care for individuals with complex needs. We're more than just a team; we're a close-knit community. Our shared commitment to caring for each other and those we...

This Job at a Glance Job Reference Id: ORD-224258-NP-CATitle: NPDates Needed: ASAP - OngoingShift Type: Day ShiftAssignment Type: OutpatientCall Required:...

Behavioral Health Utilization Reviewer The Behavioral Health Utilization Reviewer is responsible for conducting clinical reviews of behavioral health service requests, claims, and appeals to confirm medical necessity and appropriateness...

Novant Health is seeking an RN Coach for telephonic virtual care to help patients navigate their healthcare journey through chronic-care management, self-management support, and acute triage, collaborating with physicians and care teams to deliver...

Job Summary and Responsibilities As our Utilization Review RN, you will meticulously review medical records to confirm appropriate admission status and continued hospitalization, utilizing established criteria and critical...

Job Opportunity Our client is a private health management company devoted to providing an exceptional clinical team in the comfort, and privacy of a patient's own home. We are seeking dynamic, experienced, and compassionate Registered...

Job Title Location: 100% Remote – Any US State Shift: Fri-Sat-Sun-Mon 8:30 am – 6 pm CST Overtime may be required and Holidays are required Duration: 12months Job Profile Summary: Will be working with the IL and MI Medicaid...

CorVel Corporation is seeking a Utilization Review Case Manager for a fully remote role in the United States. The position requires current nursing licensure and 4+ years of clinical experience with preferred exposure to utilization review.

Join Our TeamJoin an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! La Palma Intercommunity Hospital, a member of Prime Healthcare, offers incredible opportunities to expand your...

Utilization Management Admissions Liaison RN II Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) L.A. Care Health Plan is an independent public agency created by the state of California to provide health...

Registered Nurse Care Coordinator Company: Merrimack Health Work Type: Remote Employment: Temporary Location: US Seniority: Mid Level Technologies: InterQual Requirements: BSN preferred; Massachusetts RN license; minimum 5 years clinical nursing;...

Clinical Nurse Professional Development Educator Advanced How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At...

Department: 11200 Atrium Health Pineville - Case Management Status: Part time Benefits Eligible: Yes Hours Per Week: 20 Schedule Details/Additional...

Clinical Appeals Nurse (RN) | Remote | Contract Walker Healthforce is seeking a Clinical Appeals Nurse (RN) with 2+ years of clinical nursing experience to provide clinical review and...

CVS Health is seeking a Telephonic RN Case Manager to support members across the United States from a remote work setup. You will coordinate care with patients and their care teams, applying guidelines and reviewing medical necessity to optimize...

Facilitates, in collaboration with the Manager of Quality Management accurate, timely and consistent clinical data to public reporting databases and agencies, including The Joint Commission (Oryx), and CMS. Reviewing paper and electronic medical...

Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team. In this role, you'll perform both inpatient and outpatient...

Availity, a leader in healthcare technology, is hiring a UM Nurse Analyst (Clinical Informaticist) to interpret payer medical policies and build AI-enabled decision trees for automated prior authorization. You'll collaborate with Product,...

Clinical Reviewer, Precertification RN The Clinical Reviewer, Precertification RN, is a licensed Registered Nurse that is expected to function independently in her / his role and is responsible for managing a clinically complex caseload...

RN CDI Specialist As one of the Top 8 Most Innovative Healthcare Systems in Becker's Hospital Review, we're working to create a national model for improving health. Today, we're focused on bringing our region services that improve every...