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A company is looking for a Utilization Management RN to ensure efficient healthcare resource use while promoting quality patient care.Key ResponsibilitiesCoordinate with healthcare teams to assess and monitor the delivery of healthcare...

New York Licensed Practical Nurse Coordinator is a full-time remote position responsible for managing patient care coordination, communication with healthcare providers, and ensuring high-quality care services.Key ResponsibilitiesComplete...

Seeking a part-time Licensed Peer Reviewer to work remotely in the United States, who will review medical records for standard of care determinations and provide quality improvement recommendations based on clinical expertise in an outpatient...

Leading a team of Utilization Management Nurses, the full-time California Licensed Utilization Management Nurse Lead will review inpatient and prior authorization requests, ensuring timely processing and high-quality medical outcomes while working...

Overseeing hospice intake compliance, the full-time remote Hospice Clinical Compliance & Audit Associate Director will manage clinical audit activities to ensure documentation accuracy, regulatory compliance, and claim readiness while...

Ohio RN Clinical Finance Specialist is a full-time remote position responsible for implementing clinical finance strategies, securing pre-authorizations, and managing clinical denials.Key ResponsibilitiesImplement and support clinical finance...

Managing project-related activities, the full-time Operations Manager - Medical will oversee medical and non-medical appeals decisions, develop standardized project information sharing methods, and facilitate team meetings while working remotely...

To support a 24/7 Occupational Health triage call center, full-time Telephonic Registered Nurses will manage a high volume of incoming calls, provide assessments using proprietary algorithms, and document interactions while working remotely during...

A company is looking for a Clinical Review Nurse - Concurrent Review.Key ResponsibilitiesPerform concurrent reviews to assess member health and appropriate care levelsReview quality and continuity of care, including discharge planning and resource...

Providing remote patient monitoring and support, the full-time Telehealth Nurse (LPN/LVN) will conduct regular phone visits to educate members on managing chronic conditions such as hypertension and diabetes while ensuring accurate documentation...

Bilingual Nurse Patient Access Specialist (RN), a full-time remote position responsible for facilitating patient access to therapy by conducting benefit investigations, verifying insurance eligibility, and providing ongoing patient support and...

To support patient care initiatives, the full-time Bilingual LPN Care Coordinator will manage outbound phone calls to patients, addressing healthcare needs and facilitating access to resources in a fully remote environment.Key...

Seeking a remote California RN/LVN Utilization Management professional, the full-time nurse will review prior authorization requests for medical necessity across inpatient and outpatient services, applying CMS guidelines and Milliman Care...