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Job Requirements Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the patient's need...

Full-Time Hospice Intake & Admissions RN Are you an RN who values meaningful connections and wants to make a difference at one of life's most important moments? Join The Community Hospice as part of our Central Intake & Admissions Team,...

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...

Grievance & Appeals Nurse, RN Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience! Reporting to the...

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...

Utilization Management Nurse Specialist RN II Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary...

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...

Job 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...

Clinical Eligibility & Intake Nurse Part Time/1099 Contractor Fully Remote Monday-Friday; 3-5 hours per day / 15-20 hours per week*; schedule must overlap intake hours** Clinical Operations Reporting to:...

Clinical File Assessments Position Position Purpose: Responsible for clinical file assessments. Identifies monthly insights for improvement and participates in Interrater Reliability meetings. Aids in efforts to continuously develop...

Nurse Care Manager Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Days Job Description Join a team that's shaping the...

Overview Jobs for Humanity is partnering with CEDARS‑SINAI to build an inclusive and just employment ecosystem. We prioritize individuals from diverse communities including Refugee, Neurodivergent, Single Parent, Blind or Low Vision,...

Job Description Responsibilities Review and evaluate electronic medical records of emergency department admissions and screen for medical necessity using InterQual or MCG criteria Apply evidence-based...

Rising Medical Solutions has an opening for a Utilization Review Nurse, and we want to hear from you! We're a bill review and cost containment company - so what does that mean? Basically we are trying to fix a very broken healthcare...

Job Title This is a remote, PRN 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...

Clinical Appeals Intake & Review Coordinator The Phia Group, LLC is a thriving, service-oriented company headquartered in Canton, Massachusetts. As consultants, we represent health plans nationwide, providing our clients with innovative...

Peraton Overview Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world's leading mission capability...

Where You'll Work Founded in 1887, Dignity Health - California Hospital Medical Center is a 318-bed, acute care, nonprofit hospital located in downtown Los Angeles. The hospital offers a full complement of services including...

Public Health Nurse The County of Los Angeles Department of Public Health is seeking qualified candidates to fill emergency Public Health Nurse vacancies related to the homelessness crisis. Under the emergency order, applicants who...

LPN/LVN - LVN – LICENSE VOCATIONAL NURSE ~ CONTRACTLocation: Los Angeles, CANumber of positions: 5+Start Date: ASAPEnd Date: Jan. 16, 2017Shift: 3pm to 11pm (PM Shift)Schedule: 40 hours/weekExperience: 2+ years in Skilled Care|Long-term CarePay...

Pediatric Hospice RN Case Manager The Hospice Pediatric RN Case Manager will work with our Pediatric team. Primarily responsible for providing professional nursing care to assigned patients. With input from the interdisciplinary team,...

Aya Healthcare has an immediate opening for the following position: Case Manager Registered Nurse in Beverly Hills, CA. We'll work with you to build the healthcare career of your dreams. Whether you want a job close to home or across the country,...

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...

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

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...