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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...

Cambia Health Solutions seeks an experienced Utilization Management Nurse to support member care across multiple states. The role performs prospective, concurrent and retrospective reviews to ensure medical necessity and optimal outcomes,...

Job Summary: This Utilization Review (UR) Registered Nurse (RN) position supports the Mission of Pipeline Health through the provision of distinctive and compassionate care to our patients. This position is responsible for...

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:...

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

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing, and evaluating the care of patients. The staff RN utilizes the nursing process by use of...

1st TIME OK/ 2 YR EXP required for Utilization Review RN every other weekend required or more depending on unit needs no call or floating required MUST HAVE experience with Milliman Care Guidelines and Acute Hospital Experience!! The Emergency...

Nurses - are you looking for a change? Want to work no nights, and no holidays? Check out Hines & Associates! ABOUT US: Hines is a nationwide, independent leader in personalized managed health care,...

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...

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...

Ambulatory Care Coordinator RN Could you be our next Ambulatory Care Coordinator RN at Main Line HealthCare? Why work as a Ambulatory Care Coordinator RN with Main Line Health? Make an Impact! Coordinating the care of a patient's...

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...

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...

Registered Nurse (RN) Are you a dedicated Registered Nurse (RN) seeking a meaningful role where your skills directly contribute to patient recovery? At Recovery Centers of America (RCA), we prioritize personalized, evidence-based...

Home Health Nurse California, California, United States Or refer someone Job Openings Home Health Nurse About the Job Home Health Nurse These are just some of the reasons a Home Health RN role at our company is unlike any...

MAJOR RESPONSIBILITIES/ESSENTIAL FUNCTIONSThe primary job duties this position is responsible for achieving are listed in order of importance.Job Summary:To facilitate a safe discharge and/or transition of care for patients from hospital, lower...

Join The BILH Team When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. LPN's encouraged to apply! Pay Range: $30.00 – $44.58 The pay range listed for this position is...

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...

RN Care Coordinator Care Coordination 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...

Case Management Support To provide support and facilitate care for members who require case management. To work collaboratively with the Health Plan and Hospital Case Management Departments to facilitate services. To collaborate with the...

Managed Medical Review Organization, Inc. is seeking an experienced RN to join our team in a remote, home-office capacity. The role emphasizes telephonic/customer service, accurate documentation, and clinical review of cases. Candidates...

Join Gainwell It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career...

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...

CenExel Clinical Research Position Each of CenExel's research sites specialize in Phase I to Phase IV clinical trials. Our Centers of Excellence comprise some of the most well respected and long-standing research facilities in the...

firsthand supports individuals living with SMI (serious mental illness). Our holistic approach includes a team of peer recovery specialists, benefits specialists and clinicians. Our teams focus on meeting each individual where they are and walking...