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Appeals Analyst 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 including...

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 TitleNurse 3Job LocationRedondo Beach,...

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...

RN Triage Nurse (Full-Time) Anchor Health is looking for a compassionate RN Triage Nurse to join a strong supportive team of professionals that provide hospice/palliative care. Position Purpose: Under the general supervision...

Where You'll Work Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of...

Interested in working for the Golden Isles' healthcare provider and employer of choice? Throughout the many locations that make up the Southeast Georgia Health System network, there is a common thread that pulls everything...

UM Review Nurse Department: HS - UM Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To:...

Summary We are currently hiring for an RN Case Management Coordinator to join BlueCross BlueShield of South Carolina. In this role as an RN Case Management Coordinator, care management interventions focus on improving care...

Itlearn360 seeks a Registered Nurse (RN) in Los Angeles to provide skilled nursing care and case management for patients with serious illnesses. The ideal candidate will hold an active RN license, possess a Bachelor's degree in Nursing, and have...

Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and quality improvement services for more than 50 years. We...

RN Provider Performance Specialist Senior Step into a high-impact role where your clinical expertise directly influences provider quality and patient outcomes. As an RN Provider Performance Specialist Senior, you will serve as a trusted...

Job Description Job #218204 Chipton-Ross is seeking a Nurse 3 for a contract opportunity in Redondo Beach, CA. BASIC QUALIFICATIONS (REQUIRED SKILLS/EXPERIENCE) High School diploma or equivalent, and...

Job Title Provides, coordinates, teaches, and supervises nursing care for a group of patients in the setting of the patients' home. Employs the nursing process to develop and implement plans of care for patients requiring in-home...

Care Management Nurse (NY License Required) - Remote Title: Care Management Nurse (NY License Required) - Remote Location: Remote About Us: Mobile Primary Care is a home-based primary care practice that specializes in...

Find your calling at Mercy! Position Details: Primary Care Nurse RN or LPN Mercy Clinic Quailbrook (Oklahoma City) Monday-Friday, 40 hours per week *This is a hybrid...

The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring that medical services are used efficiently and appropriately. They review medical records, treatment plans, and patient information to determine the...

Summary Greater Los Angeles Healthcare System (GLVAHCS) is seeking 1 highly skilled experienced Registered Nurse (RN) for our West Los Angeles Primary Care Unit. Located in Los Angeles, CA. Responsibilities Primary care service. The Nurse I, Level...

Integra is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will play a key role in collaborating with our Medical Director...

Utilization Review LVN Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic...

Dormont Manufacturing Co in Glendale, California is looking for a Unit Supervisor to lead day-to-day operations focusing on high-quality patient care. The ideal candidate will have significant experience in clinical settings and supervisory roles,...

Job Title Job Summary: Review clinical documentation within the medical record to ensure that all principal diagnosis, secondary diagnoses, and PCS procedures have been coded accurately and completely as well as certain abstract items in...

We are seeking an experienced Nurse Practitioner to provide locum services in an outpatient oncology setting in Los Angeles, CA. This is an excellent opportunity for an NP looking for full-time coverage starting January 26, 2026. Job...

RN / Medical Reviewer / Remote Job Details Professional Discipline : Registered Nurse Specialty : Utilization Review Employment Type : Full Time City :...

Company : Highmark Inc. Job Description : JOB SUMMARY This job has primary ownership and oversight over a specified panel of members that range in health status/severity...

About Company: Lunera Health Center is a private, 501(c)(3) non-profit community health center serving Prince William County and the Cities of Manassas and Manassas Park, as well as other surrounding areas of Northern...