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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...

Care Management Team Member The Care Management team independently manages complex and high-risk care management cases by applying advanced clinical judgment to assess medical necessity, develop cost-effective care plans, and support...

Job Description Are you ready to bring your clinical competencies to a world-class Medical Group known for the very highest clinical standards? Do you have a passion for the highest quality and patient satisfaction? Then...

8 weeks. DAYS - 5x8 SCHEDULE: M-F - 8am to 4:30pm Care Coordinator inpatient. Must Be/Have: Experienced CM • a RN • Discharge planning assessment exp • Excellent UR • Psych social assessment skills • Acute hospital...

This is a remote role. CircleLink Health is looking for passionate, tech savvy registered nurses to work remotely and serve patients enrolled in Medicare's Chronic Care Management Program. In this part time role...

Clinical Review Nurse - Prior Authorization Various, NV Clinical Review Nurse - Prior Authorization Various, NV All On-site Location: Fully Remote – Prefer Candidates reside in NV, but can reside elsewhere if they...

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...

Chronic Care Coordinator Location: MICHIGAN - 100% REMOTE (NOT A COMPACT STATE) Join our mission to help transform healthcare delivery from reactive, episodic care to proactively managed patient care that prevents live-changing...

Medlivo is seeking a travel nurse RN Utilization Review for a travel nursing job in Downey, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration:...

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...

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...

Primary City/State: Virtual Arizona Category: Case Management Shift: Day Department: Case Management Seeking Applicants That Can Work at Least 8 Shifts per Month Great care starts...

Job Title Employment Type: Full time Shift: Rotating Shift Description: This is a remote position but will need onsite training in Mishawaka Indiana. Shift: Days - 8 hr shift LOCAL CANDIDATES ONLY! Why Choose Saint...

Hospice Admissions Nurse Peoples Health Services is the only family-owned, locally governed Hospice and Home Health provider in the Florida Panhandle. We believe that when we take care of the people who care for our patients, everyone...

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure...

Experience 2-5 years needed. Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific...

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...

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...

Job Summary and Responsibilities As our RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these services. The RN Care Coordinator performs this...

Sensorum Health Patient Monitoring and Triage Nurse Job Description ABOUT SENSORUM HEALTH Sensorum Health (sensorum.ai) enables better proactive and preventative healthcare for older adults living at-home.

Mercor connects elite creative and technical talent with leading AI research labs. A remote Utilisation Management leader role is available, requiring RN licensure and physician-advisor experience. Contract position with high-level...

Job description California Post Acute is a premier healthcare facility dedicated to providing exceptional care to our residents and patients. Our commitment to excellence, compassionate care, and innovative practices sets us apart as a...

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...

Job Title This is a remote position but will need onsite training in Mishawaka Indiana. Shift: Days - 8 hr shift LOCAL CANDIDATES ONLY! Why Choose Saint Joseph Health System? At Saint Joseph Health System, our values guide...

Utilization Management Team Member Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk...