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Clinical Reviewer Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and...

Are you ready to bring your clinical competencies to a world‑class Medical Group known for the very highest clinical standards? Do you have a passion for the highest quality and patient satisfaction? Then please respond to this dynamic...

Virtual Care Nurse RN Virtually Integrated Care supporting CHI Health St. Elizabeth Hospital, in Lincoln, NE. As our Virtual Care RN, you will revolutionize patient care, leveraging cutting-edge technology to deliver expert nursing...

Job Description The RN Utilization Management (RN UM) functions as a support liaison for a variety of UM functions which may include the e‑TAR process, denials management, and the UM process.The RN UM coordinates care submission relating to the...

Air Combat Effectiveness Consulting Group, LLC in Monterey Park is seeking a Case Manager RN or LVN to join our Utilization Review Department. This per diem position involves coordinating care for patients, conducting admissions, and liaising with...

Your Role The Care Management team independently manages complex and high-risk care management cases by applying advanced clinical judgment to assess medical necessity, develop cost-effective care plans, and support...

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...

Clinical Services Supervisor, RN Under the direct supervision of the Health Center Manager and in-direct clinical supervision of Nursing Administration, the Clinical Services Supervisor (CSS) shall perform licensed nursing duties under...

Enloe Utilization Management Compensation range: $54.38 - $73.41. Your rate of pay will be based on applicable experience. Shift: Days. Days off: Variable. Hours per pay period: 0-24. Shift length: 12 Hours. Enloe Health is...

About Seen Health At Seen Health, we are revolutionizing the way senior care is delivered through the PACE (Programs of All-Inclusive Care for the Elderly) model. Backed by top VCs, Seen Health is a culturally-focused,...

Description Position at Healthmap Solutions Company Background Healthmap Solutions is the future of specialty health management that focuses on progressive diseases, with a particular expertise...

Hours: FT, Mon-Fri 8:30-5p Under the direction of the Care Management Manager, the Health Coach functions as the primary nurse to provide both health coaching and case management services to members across the continuum of...

Would you like to join an international team working to improve the future of healthcare? Do you want to...

When you work for us, we work for you With Titan Medical, you gain access to thousands of travel nursing and allied health jobs across the country. You also get unmatched service. From the moment you apply, your recruitment specialist...

Job Opportunity For Remote Nurse In Michigan This position is a remote role for nurses in Michigan. The following qualifications are required: A valid MI RN License Utilization management experience...

UM Review Nurse Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position, you will utilize your clinical judgement to approve or deny outpatient medical services for...

Description Providence is calling for Quality Assurance RN - Remote The Quality Assurance RN is responsible for facilitating and leading peer review strategies and initiatives to achieve clinical...

The RN Utilization Management (RN UM) functions as a support liaison for a variety of UM functions which may include the e‑TAR process, denials management, and the UM process. Coordinates care submission relating to the process of health care...

Case Management Nurse, Senior The Children's Services Program (CSP) team provides identification, referrals, and care management for all Medi-Cal members under 21 years old and collaborates within Promise Clinical Team. The Case...

Position Description Base pay is influenced by several factors including a candidate's qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and...

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:...

Overview The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in...

About Abby Care: Powering the Future of Care at Home for All of America Abby Care is building the leading AI-native platform for family-led care. America is facing a growing care crisis. Millions more people need care at home than ever.

Prime Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Santa Monica, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start...

Orbit Infusion Solutions is seeking a Home Infusion Registered Nurse (RN) to join their nurse-led team in Los Angeles, California. This independent contractor position allows you to choose your cases while delivering exceptional patient care in...