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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...

ForzaCare is seeking a Field Medical Case Manager in Los Angeles, CA to coordinate care among medical providers, employers, insurers, and injured workers. The role emphasizes centralized case management, timely communication, and compliance with...

LVN 1.1 South LA Mon - Fri 9a-5pLos 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...

Details Client Name UCLA Health Bowyer Oncology Center Job Type Travel Offering Nursing Profession RN...

Job Details POSITION SUMMARY RN Case Manager POSITION DUTIES DCP in an acute care setting MINIMUM REQUIRED QUALIFICATIONS 2-3 years' experience in an acute care setting CA license LENGTH OF ASSIGNMENT 13...

RN Clinical Coordinator Home Health Attention all RN Home Health Clinical Coordinators! You Your new Journey awaits!!! Come share our passion, mission and vision tor extraordinary community-based services around the Hampton Roads. Lake...

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...

UM Review Nurse - Texas Department: HS - UM Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting...

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...

Medpace India Corporate Career Info-Session Looking for a better work-life balance without leaving the medical field? Medpace India is hosting an exclusive Corporate Career Info-Session tailored specifically for Nursing professionals. If...

Case Manager Monterey Park Hospital, a 101-bed acute care facility located in the San Gabriel Valley of Los Angeles County, is seeking a Case Manager for our Utilization Review Department. This is a full-time, 8-hour day shift position...

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,...

Description Job Title Nurse Case Manager 2 Location FL - Remote Position Description The Care Manager-Registered Nurse is a key member of our...

Join Silverado Hospice LA Silverado Hospice LA covering our Torrance and surrounding areas and be part of a nationally recognized team ranked in the top 10 nationwide by Fortune Magazine's Best Workplaces in Aging Services™. Since 1997,...

Job Overview: Pay Range: $46.76hr - $51.76hr Requirement/Must Have: 5+ years Clinical nursing experience. 2+ years Care Management. Bachelor's Degree in Nursing. In...

Utilization Management (UM) Nurse Supervisor The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team performance, accountability, and...

description: Provides excellent patient care by assisting in the collaboration, development, implementation, revision and reporting of the case management program. Acts as a liaison between the patient, family, nurse, physicians,...

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

Optum is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services, assess patient needs, and identify solutions to help members live healthier lives. This role supports a collaborative clinical and business team...

Company Overview: Join us in our mission to transform healthcare! nirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees at every stage...

POSITION TITLE The policy will provide the scope of the infection control program for the facility. Reports to: Director of Nursing POSITION SUMMARY The Infection Control Preventionist assumes the responsibility for the...

CVS Health is seeking a remote Community Care Case Manager to coordinate care for Medicare members. You'll assess, plan and facilitate services, communicating with doctors, insurers and families to optimize health outcomes. Required a valid...

Discover Vanderbilt Health: With eight hospitals and over 180 clinics, we are the region's largest comprehensive academic health system. Vanderbilt Health has a long tradition of providing world-class care to the people of the Mid-South,...

Nurse Case ManagerUnder the general supervision of the CM Director the nurse case manager manages clinical resource utilization and documentation affecting reimbursement, acting as a resource to staff and physicians in resource efficiencies and...

RN Coordinator Utilization Management The RN Coordinator Utilization Management will review submitted authorization requests for medical necessity, appropriateness of care, and benefit eligibility. This position reviews applicable...