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Utilization Management Nurse Consultant (RN) We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate...

RegisteredNurse-ReviewAnalyst|Remote|Contract...

Job Responsibilities and Requirements KEY RESPONSIBILITIES *other duties as assigned* Job Summary: Reviews all medical (and other) documentation in claim files to answer the specific...

Nascentia Health is seeking an Licensed Practical Nurse to support Health Plan Health Support within Care Management. This fully remote role requires NY licensure and periodic travel to the nearest office. You will triage calls, educate...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans is hiring a Utilization Review Nurse/ RN for Imaging/Commercial- Remote! Status: Full-time, permanent position (40 hours) Standard working hours: 8am to 5pm EST, M-F.

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...

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...

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...

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...

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...

Discover Vanderbilt Health With eight hospitals and over 180 clinics, we are the region's largest comprehensive academic health system. Vanderbilt Health has a long tradition of providing world-class care to the people of the Mid-South,...

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...

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...

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the...

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...

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...

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...

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...

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...

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

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...

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...

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...

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...