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Compliance Nurse Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders,...

Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team. In this role, you'll perform both inpatient and outpatient...

Clinical Documentation Integrity Specialist Evaluates the day to day documentation practices of the Medical Staff and healthcare team on a complex patient population, and offers education and recommendations in accordance with the...

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...

Be part of a soul-hearted approach to healing Alsana is a national leader in eating disorder treatment, offering a holistic, soul-hearted approach to recovery for adults and adolescents of all genders. We exist to be a source of hope...

Details Client Name Providence Little Company of Mary Medical Center Torrance Job Type Travel Offering Nursing Profession...

Clinical Documentation Integrity Specialist II The Clinical Documentation Integrity Specialist II (CDI) is responsible for utilizing independent clinical judgement in facilitating the integrity, overall quality, accuracy, and completeness...

Elevance Health is seeking a Nurse Case Manager I to provide care management for members with complex and chronic conditions. The role can be performed virtually with required in-person training sessions, and some on-site work may be needed in St.

Job Title Employment Type: Full time Shift: Rotating Shift Description: This is a remote position but will need onsite training in Mishawaka Indiana. Shift: Days - 8 hr shift LOCAL CANDIDATES ONLY! Why Choose Saint...

100% REMOTE PAY: $47-$52/hr REQUIRED: Must have current RN licensing Post market medical device experience in either medical assessment, complaint handling, post market reporting – preference is actual medical device assessment Highly prefer...

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...

Clinical Appeals and Grievances Specialist Will this role be fully remote? Yes. Are there any specific locations the candidates should be in (i.e., do they need to live in IL)? No but must have CA license. Work Schedule/Shift & Time Zone:...

*This role will require the successful candidate to work the shift of Monday to Friday, 1pm to 10pm Central (2pm to 11pm Eastern). The Utilization Review Clinician is responsible for reviewing medical records to determine medical necessity. This...

Habitat Health empowers older adults to experience more good days in their homes and communities. Through the Program of All-Inclusive Care for the Elderly (PACE), we provide comprehensive medical care along with support for daily needs such as...

Central Intake Nurse Job Type: Full-Time Remote possible Benefits Offered: Healthcare Dental Vision PTO 401K Your Job Summary The Central Intake Nurse...

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...

RN Care Manager *F/T Day* Torrance, California Full Time he case manager performs the primary functions of assessment, planning, facilitation and advocacy, which are achieved through collaboration with...

Nurses - are you looking for a change? Want to work no nights, no weekends, and no holidays? Check out Hines & Associates! Experience in both medical and behavioral health and/or substance use disorder settings is...

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...

Parenteral Services Clinical RN Specialist The Parenteral Services Clinical RN Specialist provides clinical support to the Parenteral Services team through advanced nursing expertise, education, care coordination, and operational...

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...

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...

Utilization Management Team Member Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk...

Clinical Review Rn/Pt/Ot Adventist Healthcare seeks to hire an experienced Clinical Review RN/PT/OT for our Home Health Services Team who will embrace our mission to extend God's care through the ministry of physical, mental, and...

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...