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Providing advanced clinical appeal services, the full-time Ohio RN Clinical Case Manager will manage complex patient account denials, perform clinical reviews, and assist in the development of denial prevention strategies while working...

Leading a team of Utilization Management Nurses, the full-time California Licensed Utilization Management Nurse Lead will review inpatient and prior authorization requests, ensuring timely processing and high-quality medical outcomes while working...

Bilingual Nurse Patient Access Specialist (RN), a full-time remote position responsible for facilitating patient access to therapy by conducting benefit investigations, verifying insurance eligibility, and providing ongoing patient support and...

A company is looking for a Clinical Review Nurse - Concurrent Review.Key ResponsibilitiesPerform concurrent reviews to assess member health and appropriate care levelsReview quality and continuity of care, including discharge planning and resource...