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Ochsner Health, a leading not-for-profit healthcare provider in the Gulf South, seeks an experienced RN for a remote case management role. You will coordinate care by liaising with patients, caregivers, multidisciplinary teams, and payers to...

Pride Health is seeking an experienced Registered Nurse (RN) with Utilization Management experience to support clinical quality review and AI model development for prior authorization use cases. The ideal candidate will review records, apply...

Become a part of our caring community The Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the...

Licensed Vocational Nurse - Home Health Excell Home Care is actively recruiting for LVN Case Manager. Our innovative company is focused on the best possible outcomes for our patients, outstanding and highly personalized patient care, and...

Join The BILH Team When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. LPN's encouraged to apply! Pay Range: $30.00 – $44.58 The pay range listed for this position is...

Utilization Management Nurse We are seeking a Utilization Management Nurse to join our team! As a Utilization Management Nurse on the team, you will be responsible for reviewing patient files and treatment methods with an eye for...

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...

Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team. Job Title: Nurse 3 Job Location: Redondo...

Home Health Nurse California, California, United States Or refer someone Job Openings Home Health Nurse About the Job Home Health Nurse These are just some of the reasons a Home Health RN role at our company is unlike any...

Utilization Review Nurse Auditor Fully Remote • Mount Laurel, NJ 08054 Salary Range $33.00 - $46.00 Hourly Position Type Full Time Travel Percentage 10% ExamWorks is looking for a Utilization Review Nurse Auditor to join...

Registered Nurse (RN) Are you a dedicated Registered Nurse (RN) seeking a meaningful role where your skills directly contribute to patient recovery? At Recovery Centers of America (RCA), we prioritize personalized, evidence-based...

Utilization Management Nurse Consultant (RN) 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...

Clinical Guide Part A The weekly schedule choice is either Monday - Friday 10am-7pm EST OR Tuesday - Saturday 9am-6pm EST A bit about this role: The Clinical Guide Part A will be part of the Utilization Management team,...

Utilization Management Nurse (RN) (Temporary) Remote in California We believe every candidate deserves thoughtful consideration. That's why we do not use AI or automated systems to review applications. Every application is reviewed...

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology...

The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring that medical services are used efficiently and appropriately. They review medical records, treatment plans, and patient information to determine the...

RN Care Coordinator Care Coordination Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest...

MAJOR RESPONSIBILITIES/ESSENTIAL FUNCTIONSThe primary job duties this position is responsible for achieving are listed in order of importance.Job Summary:To facilitate a safe discharge and/or transition of care for patients from hospital, lower...

Sagility is hiring an RN Utilization Management Reviewer for a fully remote, home-based role in the United States. You will perform day-to-day clinical and service authorization reviews for medical necessity and ensure compliance with CMS...

Elevate Patient Financial Solutions has an exciting career opportunity available as a Nurse Auditor. This position will be a remote based role. The Full Time schedule for this role will be Monday through Friday 8 AM to 5 PM.

Improve the lives of others while Caring. Connecting. Growing together. Job Description - HSS Clinical Coordinator RN - Telecommute in Texas (2391171) HSS Clinical Coordinator RN - Telecommute in Texas - 2391171 At...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing, and evaluating the care of patients. The staff RN utilizes the nursing process by use of...

Job Description Cedars-Sinai has been named to the Honor Roll for the ninth consecutive year and tied for #1 in California and Los Angeles in U.S. News & World Report's "Best Hospitals 2024-25" rankings, as well as placed...

Clinical Appeals Specialist The Clinical Appeals Specialist completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The Clinical Appeals Specialist utilizes...

Primary City/State: Virtual Arizona Category: Case Management Shift: Day Department: Case Management Seeking Applicants That Can Work at Least 8 Shifts per Month Great care starts...