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RN/NP Clinical Quality Reviewer Primary Care, Acute Symptom Triage & Travel Health | Contract, up to 25 hrs/week About the Role We are seeking Nurses & Nurse Practitioners with clinical experience in one or more of the...

Job Title: Utilization Management Registered Nurse (UM RN) – SNF / MLTC Location: Remote (Must reside in NY, NJ, or CT) Schedule: Monday – Friday, 9:00 AM – 5:00...

Your Role The Utilization Management team manages accurate and timely prior authorization and inpatient stays reviews for our members and correctly applies the guidelines for nationally recognized levels of care for our...

Details Client Name Providence SoCal Shared Services Case Management Job Type Travel Offering Nursing Profession Registered Nurse...

RadHealth+ is seeking a travel nurse RN Utilization Review for a travel nursing job in Torrance, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start...

Details Client Name UCLA Health Santa Monica Medical Center Job Type Travel Offering Nursing Profession RN...

Virtual Care Registered Nurse We are seeking a licensed Registered Nurse to deliver virtual care to patients on behalf of one of our partner organizations. This role involves delivering remote patient care, symptom triage, health...

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...

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...

Collaborative Practice Nurse (CPN) Blue Ridge Cancer Care is seeking an experienced and highly motivated Collaborative Practice Nurse (CPN) to support oncology patients across the continuum of care. The CPN serves as a clinical resource...

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

Clinical Documentation Improvement Specialist-RN- Remote The Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) assists with the identification of diagnoses, conditions, and procedures that are representative of the...

Benefits: 401(k) 401(k) matching Dental insurance Health insurance Vision insurance Wellness resources Company parties Opportunity for advancement Paid time off Parental...

Trillium Health Resources is seeking a Compliance Nurse to perform clinical compliance reviews and evaluate claims to ensure adherence to regulatory and coverage requirements. The role applies clinical judgment to assess documentation, determine...

Ochsner Health, a leading not-for-profit healthcare provider in the Gulf South, seeks an experienced RN for a remote case management role. You will coordinate care by liaising with patients, caregivers, multidisciplinary teams, and payers to...

Optum is seeking a Fertility Utilization Management RN to work remotely within the United States. You will assess and determine the appropriateness of inpatient and outpatient services, translating clinical concepts into practical care-management...

Job Description Cedars-Sinai has been named to the Honor Roll for the ninth consecutive year and tied for #1 in California and Los Angeles in U.S. News & World Report's "Best Hospitals 2024-25" rankings, as well as placed...

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the "12...

Details Client Name Providence Saint Joseph Medical Center - Burbank Job Type Travel Offering Nursing Profession RN...

Salary : $107,352.48 - $160,692.96 Annually Location : Los Angeles County, CA Job Type: Full time Job Number: PH5230F-EA Department: PUBLIC HEALTH...

Overview Who We Are Because health is personal. That's why Personify Health created the first and only personalized health platform-bringing health plan administration, holistic...

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...

LPN/LVN Utilization Management Nurse 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...

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...

Full-Time, Salaried, Monday-Friday No Weekends & No Holidays This position is Hybrid and will require on-site training. JOB...