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Job Description Registered Nurse (RN)- Torrance,CA Local Pay: $56.75/hour - (W2) Join our team and make a meaningful impact by delivering exceptional care in a professional...

This is a remote role. CircleLink Health is looking for passionate, tech savvy registered nurses to work remotely and serve patients enrolled in Medicare's Chronic Care Management Program. In this part time role...

Job Title: Clinical Quality Assurance Nurse Pay: see below Registered Nurse - $28.50/hr (Non-negotiable) LPN/LVN- $26.50/hr (non-negotiable) Regular Schedule after...

Clinical Research Nurse-BSN Clinical Research Nurse Join the transformative team at City of Hope, where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of...

Clinical Review Nurse - Prior Authorization Various, NV Clinical Review Nurse - Prior Authorization Various, NV All On-site Location: Fully Remote – Prefer Candidates reside in NV, but can reside elsewhere if they...

RN Care Manager *F/T Variable* Santa Monica, California Full Time RN Care Manager with our Care Management Team at our Cedars-Sinai Tarzana Medical Center in Tarzana, CA. This is a full-time position that will work 8-hour...

Utilization Management Clinical Quality Nurse Reviewer RN II Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) L.A. Care Health Plan is an independent public agency created by the state of California to...

Job Title Utilization Management Team Leader Job Description The Utilization Management team independently manages complex utilization and retrospective clinical reviews across multiple lines of business, assessing medical...

Supports the values of service excellence, teamwork, and integrity while managing patient care. Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers. Qualifications: Requires a...

PIH Health in Los Angeles is seeking an RN Peer Review Analyst responsible for retrospective medical record reviews, data compilation to validate quality and accuracy of documentation, and auditing charts for admission/continued stay. You will...

Overview Facilitates, in collaboration with the Manager of Quality Management accurate, timely and consistent clinical data to public reporting databases and agencies, including The Joint Commission (Oryx), and CMS.

The Registered Nurse is responsible for overseeing the health, wellness, and psychiatric stability of patients receiving Full-Service Partnership (FSP) and broader outpatient behavioral health services. The position is primarily...

Company : Allegheny Health NetworkJob Description : GENERAL OVERVIEW: Responsible for obtaining insurance precertification/recertification, functioning as a liaison with...

IV Infusion Specialist Assessment Nurse The IV Infusion Specialist Assessment Nurse is responsible for identifying current and future patient care needs; being able to recognize normal versus abnormal body physiology. The role requires...

Hospice Admissions Nurse Peoples Health Services is the only family-owned, locally governed Hospice and Home Health provider in the Florida Panhandle. We believe that when we take care of the people who care for our patients, everyone...

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure...

Randstad USA is seeking a hybrid RN Case Manager in the greater Arlington, VA area. This role blends home-based and field work, covering Falls Church, Annandale, Springfield, Arlington, Alexandria; mileage reimbursed. The ideal candidate...

Job Title: Clinical Prior Authorization Reviewer Job Description This role focuses on reviewing prior authorization requests to determine medical necessity and appropriate level of care in alignment with national standards,...

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

Job Title Day to Day Responsibilities Research and design treatment/care plans to promote quality of care, cost-effective health care services based on medical necessity complying with contract for each appropriate plan type.

Responsible for reviewing medical records and preparing clinical appeals in response to medical necessity denials and diagnosis-related groups (DRG) reassignments Responsibilities Prepare and submit clinical appeals...

Your job is more than a job You overthink every care option and scenario because, as a Care Manager, you're the hub of your patient's case management and care plan. You assure quality through the continuum of care, collaborate with members...

Are You Ready to lead in Healthcare? We are currently seeking a Full-Time Case Manager(LPN/LVN) to join our outstanding healthcare team! Salary Range: $83,203-$93,936 per year We are passionate...

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...

Sensorum Health Patient Monitoring and Triage Nurse Job Description ABOUT SENSORUM HEALTH Sensorum Health (sensorum.ai) enables better proactive and preventative healthcare for older adults living at-home.