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Appeals Analyst We are currently hiring for an Appeals Analyst to join BlueCross BlueShield of South Carolina. In this role as Appeals Analyst, you will research the substance of complex appeal or retrospective review requests including...

Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff...

Inglewood Clinical is part of the Irvine Clinical Research site network, the largest of its kind on the West Coast. With 5 research centers in California, we are leaders in the search for new treatments in neurology, psychiatry, and obesity...

Post-Discharge Patient Outreach Coordinator Inspire health. Serve with compassion. Be the difference. Responsibility for initiating phone contact with discharged patients from specified units, conducting query on patient experience...

Your Role The Children's Services Program (CSP) team provides identification, referrals, and care management for all Medi-Cal members under 21 years old and collaborates within Promise Clinical Team. The...

EF ACADEMY is a private international boarding school in Pasadena, CA. We seek a part-time compassionate and empathetic Registered Nurse (RN) to join our Nursing Team in the Health Center which serves a high school population of...

About the Employer The Torrance Unified School District consists of 17 elementary, 8 middle, 4 high schools, 1 continuation, and 1 alternative high school. The District also has 3 adult school campuses. Torrance...

RN Utilization Mgmt Full-Time Day POSITION SUMMARY The RN Utilization Management (RN UM) functions as a support liaisons for a variety of UM functions which may include: the e-TAR process, denials management,...

TeamHealth is seeking an experienced CRNA to join our collaborative, all-CRNA model team at Northeastern Nevada Regional Hospital in Elko, Nevada, which offers a close-knit, rural setting. This full-time opportunity offers a diverse case mix with...

Job Title Clinical Services Specialist RN Job Type Full-Time Category Medical Services Location Work from Home FSM Based - Fort Smith, AR 72903 US (Primary) Education...

Job Description Job #218204 Chipton-Ross is seeking a Nurse 3 for a contract opportunity in Redondo Beach, CA. BASIC QUALIFICATIONS (REQUIRED SKILLS/EXPERIENCE) High School diploma or equivalent, and...

RN Triage Nurse (Full-Time) Anchor Health is looking for a compassionate RN Triage Nurse to join a strong supportive team of professionals that provide hospice/palliative care. Position Purpose: Under the general supervision...

Salary: See Position Description Location : North Central Community Health Center - St Louis County, MO, MO Job Type: Full-Time Remote Employment: Flexible/Hybrid...

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 role in collaborating with our Medical Director...

The Registered Nurse Care Manager provides case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare continuum. The Care Manager...

Care Manager The Care Manager collaborates with members of an inter-disciplinary care team (ICT), providers, community and faith-based organizations to improve quality and meet the needs of the individual, natural supports and the...

Downers Grove, Illinois Case Management Direct RN (Bilingual) Remote Case Manager - Metro Chicago Area (with Local Travel) This is a direct hire position. We are seeking a compassionate and...

Discharge Care Manager Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with...

Description The Clinical Operations Lead/Nurse Case Manager for the IMPACT Program provides clinical andadministrative leadership for a statewide prostate cancer treatment initiative. This role oversees clinical...

Company: Providence at Home with Compassus Position Summary The Clinical Liaison serves as the primary connection between Providence hospital facilities, Compassus Providence Joint Venture (JV) Agencies, and...

Join Vynca Join the dynamic journey at Vynca, where we're passionate about transforming care for individuals with complex needs. We're more than just a team; we're a close-knit community. Our shared commitment to caring for each other and...

Population Care Coordinator Prn The Population Care Coordinator Prn will support and participate in the Patient-centered Medical Home (PCMH) concepts of care coordination and team-based care. Assess, plan, implement, coordinate, monitor...

RN / Medical Reviewer / Remote Job Details Professional Discipline : Registered Nurse Specialty : Utilization Review Employment Type : Full Time City :...

Summary of Position Provide care management, as part of a multi-disciplinary care team, that includes care coordination, performing telephonic or face-to-face assessments of members' health care needs, identifying gaps in...

Case Management Nurse, Senior The Children's Services Program (CSP) team provides identification, referrals, and care management for all Medi-Cal members under 21 years old and collaborates within Promise Clinical Team. The Case...