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Appeals Nurse The Appeals Nurse examines medical records and claims information for first-level appeal cases to determine whether services provided were medically necessary and meet Medicare coverage guidelines in accordance with Medicare...

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...

Home Care Coordinator LVNAlhambra, CAAbout Seen HealthAt Seen Health, we are revolutionizing the way senior care is delivered through the PACE (Programs of All-Inclusive Care for the Elderly) model. Backed by top VCs, Seen Health is a...

Utilization Management Nurse The primary role of the Utilization Management Nurse is to review and monitor members' utilization of health care services with the goal of maintaining high quality cost-effective care. The role includes...

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...

La Casa Health Care | Take Your Nursing Career Beyond the Bedside! Location: Tarzana, CA Job Type: Full-Time | Office-Based Pay: $30.00 per hour...

Nurse Care Manager We're looking for Nurse Care Managers for our Care and Case Management team, who are passionate about caring for members holistically through their healthcare journey and ensuring needs are met with industry-leading...

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...

Summit provides independent insurance agents and their clients with market-leading workers' comp insurance and elite customer service. We're growing and currently serve more than 7,000 independent agents and 31,000 policyholders across the South,...

Registered Nurses| School Cases | 1 on 1 | Full Time | | Pediatrics | ASAP | 27402 Job Description: Are you a licensed RN with a passion for working with children? Do you want a role with a...

Job Title Provides support for clinical member services review assessment processes. Job Description Verifies that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Utilization Management Nurse We are seeking a Utilization Management Nurse to join our team! As a Utilization Management Nurse on the team, you will be responsible for reviewing patient files and treatment methods with an eye for...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

LVN 1.1 Woodland Hills 7p-7aLos Angeles, CaliforniaPay: $30 - $35 an hourWeekly Pay | Flexible SchedulingProvide Care One Patient at a TimeJoin Maxim Healthcare and deliver personalized 1:1 nursing care in patients' homes. Enjoy consistent...

Resp & Qualifications We are looking for an experienced professional to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for...

Job Title This position is fully remote, however, you must reside in the State of Texas. The position is a contract for about 6 months. RN working in the insurance or managed care industry using medically accepted criteria to validate the...

Job Summary: This Utilization Review (UR) Registered Nurse (RN) position supports the Mission of Pipeline Health through the provision of distinctive and compassionate care to our patients. This position is responsible for...

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...

Assisted Home Health & Hospice is seeking LVNs for shift work in the San Fernando Valley. New grads welcome; training provided. You will deliver in-home nursing care to one patient at a time, in a stress-free environment. Pay is $28/hr with...

Utilization Management Nurse I, RN Huntington Beach Office - Huntington Beach, CA 92647; Arcadia Office - Arcadia, CA 91007 Overview Salary Range $72,758.00 - $89,128.00 Salary/year Position Type Full Time...

Details Client Name PIH Health Hospital - Downey Job Type Travel Offering Nursing Profession Nursing...

Department: Claims Administration & Adjusting Location: Home United States Description Our Story Imagine being part of a team that's not just shaping the future but actively driving it. At Davies North...

Forensic Registered Nurse (RN) Scheduled Weekly Hours: 36 Work Shift: Days/Afternoons (United States of America) Summary of Primary Function The Forensic Registered Nurse (RN) is a highly specialized professional who...

HealthRIGHT360 gives hope, builds health, and changes lives for people in need by providing comprehensive, integrated, compassionate care that includes primary medical care, mental health services, and substance use disorder treatment. ...

Aya Healthcare has an immediate opening for the following position: Case Manager Registered Nurse in Burbank, 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, we've...