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AHMC HealthCare is seeking a Denials Case Manager, RN in San Gabriel, CA. This role involves appealing denials, working with revenue cycle teams, and ensuring compliance with medical necessity standards. Requires a graduate of an accredited RN...

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...

Job Summary: The LVN Case Manager works under the direction of an RN following assessment, planning, facilitation and advocacy, which are achieved through collaboration with the client and other health care...

RN Care Manager The Registered Nurse Care Manager provides case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare...

Case Management Nurse II Under supportive supervision, the Case Management Nurse II position supports the physician and interdisciplinary team in the provision of patient care, with the underlying objective of enhancing the quality of...

Nurse Reviewer 1 Nurse Reviewer 1 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes...

Working remotely, the full-time RN Utilization Management will review and document member case histories and prior authorization requests, utilizing clinical judgment to determine coverage eligibility while ensuring compliance with policies and...

Summary We are currently hiring for an Appeals Analyst to join BlueCross BlueShield of South Carolina. In this role as Appeals Analyst, you will research the substance of complex appeal or retrospective review requests...

Physicians Choice Home Health is seeking an experienced RN Clinical Coordinator to help support high-quality patient care across our home health team. In this role, you will partner closely with the Director of Patient Care Services, your RN...

JOB DESCRIPTION - REGISTERED NURSE (A) Job Summary: The Registered Nurse provides patient care on a supplemental basis to our client facilities. With the delivery of safe, quality patient care as...

Job Title : Registered Nurse (Navy Nurse Corps) Category / Component : Officer • Both Overview Navy Nurse Corps officers deliver professional nursing care to service members, families, and global communities in leading edge military medical...

Job Description Job Summary: Seeking an experienced in-patient Case Manager with Utilization Review expertise to assess and coordinate patient care, ensuring appropriate utilization and discharge planning. This role requires strong...

Note: We are seeking a highly motivated, skilled and experienced nurse educator for an ‘sweat equity' ownership position in a new allied health ursing program in Redondo Beach. This is a once-in-a-lifetime opportunity for the right person.We...

Clinical Nurse Coordinator (LPN) Compensation: $58,000 - $68,000 annual salary, plus annual potential for bonus and merit increases Employment Type: Full-Time, Salaried, Exempt Reports to: Director of Oncology and Infusion...

Medical Review RN IV – Commercial Appeals & Grievance Nurse Location: Remote – Candidate Must Reside in California Duration: 6+ Months Contract-to-Hire Schedule: Monday-Friday | 9:00 AM – 5:00 PM Pay Range:...

Position SummaryThe individual in this position is responsible for coordinating patient care activities to conform to evidence-based practice and/or regulatory/payor requirements. This position integrates functions typically considered to be case...

Position Title: Behavioral Health Nurse - Contract Position, Ventura, Ca Department: Clinical Services / Recuperative Care Reports To: Director of Nursing / Nursing Manager...

RN Care Manager The RNCM manages a panel of rising and high intensity members to support integrated chronic disease and behavioral health care for the members. The RNCM collaborates with members to create a care plan and oversees progress...

myPlace Health is built around a simple but powerful belief: older adults deserve the support they need to live safely, independently, and with dignity in their own communities. As a PACE (Program of All Inclusive Care for the Elderly)...

Quality Assurance Nurse The Quality Assurance Nurse is responsible for case management quality assurance and mentorship of operations staff, providing tools and calibrating processes, while ensuring consistent delivery of CorVel's case...

At Caregenix, we are committed to delivering exceptional, value-based care. Our team lives by the iCARE values-Integrity, Compassion, Accountability, Respect, and Excellence-in everything we do. If you are passionate about improving patient...

Note : This is an educational program, not a job. Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market. Looking to start a rewarding career...

Health And Social Services Coordinator 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...

Overview Join 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...

Please contact: To discuss this amazing opportunity, reach out to our Talent Acquisition Specialist Nikhil Jhajharia at email address [email protected] can be reached on # 630-576-1935. We have...