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Job Description: Join a compassionate hospice team where your nursing expertise helps patients experience comfort, dignity, and quality of life in the place they call home. As a Hospice RN, you'll provide individualized, patient-centered care...

Utilization Management Admissions Liaison 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 provide health...

Description The Peer Review RN is responsible for facilitating the design, implementation and the ongoing evaluation of the physician peer review program and nursing peer review process in collaboration with physician...

Admissions Nurse Do you enjoy being at the beginning of the journey? The Admissions Nurse is responsible for establishing and maintaining positive relationships with customers and referral sources within the community. The Admissions RN...

Paradigm seeks a Telephonic Case Manager with a compact RN license and CCM to provide remote case management for injured workers, primarily in the Eastern time zone. You will coordinate medical services, assess progress, and explore vocational...

Case Manager Monterey Park Hospital, a 101-bed acute care facility located in the San Gabriel Valley of Los Angeles County, is seeking a Case Manager for our Utilization Review Department. This is a full-time, 8-hour day shift position...

Shearwater Health Registered Nurse, Utilization Review At Shearwater Health, we know that better patient outcomes are never achieved alone – especially when there aren't enough hands to deliver care. That's why we've built something...

Details Client Name AYA-Cedars-Sinai Medical Center Crisis Response Job Type Travel Offering Nursing Profession RN...

Reviewing and resolving insurance denials, the full-time remote RN Appeal Specialist II will analyze claims for reimbursement accuracy, collaborate with internal teams for appeal resolutions, and provide trend reporting on denials.Key...

Job Title Job Requirements: Experience: 2 years acute care case manager experience Certs: BLS Education: BSN or MSN FLU VACCINE (no exemptions) during flu season Special Requirements: EPIC...

RN Coordinator Utilization Management The RN Coordinator Utilization Management will review submitted authorization requests for medical necessity, appropriateness of care, and benefit eligibility. This position reviews applicable...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Registered Nurse, Phone Triage Remote + Sign on Bonus! Clinical Full Time...

Clinical Navigator - Remote Patient Support, License Required, Oncology/Infusion a Plus US - remote This is a fully remote position. Preferred candidates possess telehealth/remote patient support experience. The...

UM Review Nurse - Texas Astrana Health is looking for a Utilization Review Nurse with a Texas LVN license to assist our Health Services Department in reviewing a high volume of outpatient and inpatient cases. This position will require...

Maximus is seeking a Lead Coordinator - Clinical Review (LPN/RN) for our CA IMR team. This fully remote role supports workers' compensation medical case reviews by interpreting records and producing concise summaries for expert review.

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...

Role Title: Registered Nurse Role Type: Contractor Location: United States, Remote We are engaging Registered Nurses to contribute their expertise to a dynamic project for a valued customer. In this role,...

RN Case Manager This position functions autonomously and in collaboration with all members of the healthcare team to coordinate and facilitate quality, cost-effective care while minimizing fragmentation of the healthcare delivery system...

Logan Health is hiring a Utilization Management Specialist to join the UM team. The role focuses on reviewing admissions, validating documentation and determining appropriate admission status across the hospital system. You will collaborate...

CVS Health is seeking a nurse case manager to coordinate comprehensive care for members in Michigan. You will assess needs, develop care plans, and coordinate services with providers, insurers, and families. The role emphasizes advocacy,...

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...

Tennova Healthcare- Turkey Creek Medical Center is seeking a PRN Remote Clinical Utilization Review Specialist to evaluate the necessity and efficiency of hospital services and to support payer requirements. You will review admissions and...

Utilization Management Nurse I, RN Huntington Beach Office - Huntington Beach, CA 92647; Arcadia Office - Arcadia, CA 91007 Overview Salary Range $72,758.00 - $89,128.00 Salary/year Position Type Full Time...

The Department of Family Medicine of the Keck School of Medicine of USC provides care for every member of the family, across generations and over lifetimes. We aim to enhance the quality of life for underserved and vulnerable patients while...

Responsible for collaborating with healthcare providers and physicians for problem solving, prioritizing and facilitating patient care objectives, the coordination and...