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Medical Solutions is seeking a local contract nurse RN Case Management for a local contract nursing job in Burbank, California. Job Description & Requirements Specialty: Case Management Discipline: RN ...

Piper Companies is seeking a Clinical Appeals Nurse to join a leading health insurance organization for a contract remote opportunity located in North Carolina. The Clinical Appeals Nurse will serve as a clinical...

Company : Highmark Inc.Job Description : JOB SUMMARY New Castle County territory - Registered Nurse This community-based Case Manager position is responsible for...

Job Requirements Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the patient's need...

Nurse Case Mgr II (RN) This position will service members in different states: Multi-State RN Licensure will be required upon hire. Location: Virtual - This role enables associates to work virtually full-time, except for required...

Our Utilization Management RN (Registered Nurse) evaluates efficiency, appropriateness, and medical necessity for medical services, and procedures for our Health Plan. This role uses clinical knowledge to provide judgment to...

Concurrent Utilization Review (UR) Nurse The Concurrent Utilization Review (UR) Nurse is responsible for conducting real-time clinical reviews to ensure the medical necessity and appropriateness of healthcare services provided to members...

Nurse Care Manager Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Days Job Description Join a team that's shaping the...

Outpatient Case Manager (RN/LVN) Recruiting on behalf of a leading healthcare organization in Southern California About the Opportunity Vivo HealthStaff is proud to partner with our client, a...

Boys & Girls Clubs of Metro Los Angeles in Los Angeles, CA, is seeking a Peaceful Connections Case Manager for the Watts/Willowbrook Club to meet with youth, set goals, and track progress to prevent violence involvement. You will also engage...

Join Gainwell It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career...

Clinical File Assessments Position Position Purpose: Responsible for clinical file assessments. Identifies monthly insights for improvement and participates in Interrater Reliability meetings. Aids in efforts to continuously develop...

Details Client Name PIH Health Hospital - Downey Job Type Travel Offering Nursing Profession Registered Nurse (RN)...

RN Case Manager This is a 13-week contract position. Monday - Friday, 8:00 AM - 4:30 PM The RN Case Manager coordinates management of care and ensures optimum utilization of resources, service delivery, and compliance with...

Public Health Nurse The County of Los Angeles Department of Public Health is seeking qualified candidates to fill emergency Public Health Nurse vacancies related to the homelessness crisis. Under the emergency order, applicants who...

Telephonic Nurse Case Manager: California RN License (Remote) Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location:...

Newport News, Virginia Hiring Range $41.00 - $56.38/HourlyActual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs. This...

Description The UM Denial Nurse Reviewer supports high-quality, cost-effective care by applying clinical knowledge, policies, and regulatory guidelines to the review and processing of adverse organization determinations. This role...

Summit provides independent insurance agents and their clients with market-leading workers' comp insurance and elite customer service. We're growing and currently serve more than 7,000 independent agents and 31,000 policyholders across the South,...

UM Review Nurse - Texas Astrana Health is looking for a Utilization Review Nurse with a Texas LVN license to assist our Health Services Department in reviewing a high volume of outpatient and inpatient cases. This position will require...

description: Provides excellent patient care by assisting in the collaboration, development, implementation, revision and reporting of the case management program. Acts as a liaison between the patient, family, nurse, physicians,...

Utilization Management RN - Prior Authorization Immediate need for a talented Utilization Management RN - Prior Authorization. This is a 12+ Months Contract opportunity with long-term potential and is located in US (Remote). Please review...

Full-Time Hospice Intake & Admissions RN Are you an RN who values meaningful connections and wants to make a difference at one of life's most important moments? Join The Community Hospice as part of our Central Intake & Admissions Team,...

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...

Optumcare Medical Behavioral Integration Nurse Case Manager For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care.