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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 statements of duties does not exclude...

Clinical Appeals Specialist The Clinical Appeals Specialist completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The Clinical Appeals Specialist utilizes...

This position is offered fully Home based (Remote) As a pharmaceutical support industry leader, UBC is devoted to empowering health solutions for a better tomorrow. We take pride in improving patient outcomes and advancing healthcare. At UBC we...

The Neuron Clinic in California is seeking an experienced infusion nurse with leadership abilities to join our busy outpatient neurology practice. This full-time role focuses on care management within CCM and PCM programs, managing a patient panel...

Medical Necessity Review Nurse Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service and level of...

Claims Medical Review Nursing Consultant Job No: 544045 Work Type: Full-time Location: REMOTE OPTIONS, VARIOUS-STATEWIDE, PHOENIX Categories: Healthcare/Medical Support Level,...

Clinical Grievances Nurse At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the...

DRG Specialist UPMC Corporate Revenue Cycle is hiring a DRG Specialist to work on inpatient auditing within our Coding Department. This position will be a work-from-home position working during standard business hours Monday through...

Florida Cancer Specialists & Research Institute is seeking a knowledgeable RN to triage oncology calls, provide symptom management, and guide patients and families. This role supports an integrated cancer care team and requires strong...

Location This is a hybrid role. Applicants must be able to commute to or travel to Mitchell and Dougherty counties, GA, when required. About Us The Columbus Organization is a nationally...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.Patient...

Hi. We're Hummingbird. We're elevating patient access so patients can get healthcare how, when, and where they need it. We partner with healthcare systems to transform how patients access care, enabling their providers to focus on...

POSITION SUMMARY Reporting to the Director, Ambulatory Services of Martin Luther King, Jr. Los Angeles (MLK-LA) Healthcare Corporation, the Ambulatory Clinical RN as the leader of the health care team, provides professional...

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...

AltaMed Health Services Corp. in Commerce, CA seeks an LVN Case Manager to coordinate care for hospital and SNF patients, with emphasis on inpatient and ambulatory management.The role requires valid LVN licensure, 3+ years in related fields, and...

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.

Job Description Cedars-Sinai has been named to the Honor Roll for the ninth consecutive year and tied for #1 in California and Los Angeles in U.S. News &...

Prior Authorization Nurse Case Manager (PACM) The role of the Prior Authorization Nurse Case Manager (PACM) is to promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of...

Our promise to you: Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is...

Clinical Specialist As a Clinical Specialist, you will use your practical or vocational nursing experience and knowledge of medical and behavioral health conditions to support timely disability claim decisions. You will identify and...

Remote Registered Nurse Position Join a stable work-from-home team! This is a great opportunity for a local remote position. There is no communication with patients. This position supports all units/staff (commercial, behavioral health,...

Job Title Day to Day Responsibilities Research and design treatment/care plans to promote quality of care, cost-effective health care services based on medical necessity complying with contract for each appropriate plan type.

Registered Nurse (RN) Schedule Available: 9:00 AM to 5:00 PM, Monday - Friday. With additional hours during evenings, weekends, and on-call; as needed. Benefits Include: Low patient-to-nurse ratio...

About Company: Connect America and our family of brands, including Lifeline, have helped aging individuals and at-risk populations live safely and independently in their homes for more than 40 years. As North America's...

CVS Health Corporation is seeking a remote RN Case Manager to support members nationwide, coordinating care with patients and care teams. This full-time role includes telephonic case management and adherence to clinical guidelines. The...