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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...

Piper Companies is seeking a Clinical Appeals Nurse to join a leading health insurance organization for a contract remote opportunity located in North Carolina. The Clinical Appeals Nurse will serve as a clinical...

Agency Adult Correction Division COO - Health Services Job Classification Title Registered Nurse (S) Position Number 60070732 Grade MH15 About Us...

About Vitra Health Vitra Health is a mission-driven healthcare organization committed to improving the quality of life for individuals and families across Massachusetts. Through innovative home- and community-based services, Vitra supports...

Maternity Nurse Care Manager We are seeking a Maternity Nurse Care Manager to join our Care and Case Management team. This role is ideal for a compassionate, patient-centered nurse who is passionate about supporting individuals through...

TruHealth Advanced Practice Provider Opportunity Ready to make a difference in healthcare? At TruHealth, we're transforming care for seniors in long-term care with an innovative, proactive model that promotes dignity, independence, and...

Overview: Dane Street is seeking highly motivated candidates to join our team as a Clinical (RN) QA Specialist, specializing in Disability. We offer an exciting work environment, competitive compensation, and strong growth...

Clinical Appeals and Grievances Specialist Will this role be fully remote? Yes. Are there any specific locations the candidates should be in (i.e., do they need to live in IL)? No but must have CA license. Work Schedule/Shift & Time Zone:...

About Carisk Partners, Inc. Carisk Partners, a Best Places to Work award winning organization, is a specialty risk transfer, care-coordination company servicing insurers, government entities, self-insured plan sponsors...

Virtual Care Registered Nurse We are seeking a licensed Registered Nurse to deliver virtual care to patients on behalf of one of our partner organizations. This role involves delivering remote patient care, symptom triage, health...

Clinical Guide Part A The weekly schedule choice is either Monday - Friday 10am-7pm EST OR Tuesday - Saturday 9am-6pm EST A bit about this role: The Clinical Guide Part A will be part of the Utilization Management team,...

Field & Infusion Nurse (RPN/LPN) Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that...

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 those we...

Nurse Practitioner Role At Fresh Health As a Nurse Practitioner within Fresh Health, you'll lead virtual (telehealth) clinical care across our Women's Health program. You will conduct comprehensive assessments, prescribe within scope, and...

Mass General Brigham Health Plan Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we...

Utilization Review Nurse Rising Medical Solutions has an opening for a Utilization Review Nurse, and we want to hear from you! We're a bill review and cost containment company - so what does that mean? Basically we are trying to fix a...

Concurrent Review Registered Nurse (RN) Location: Fully remote. Our client is seeking an experienced Concurrent Review Registered Nurse (RN) to join its Utilization Management team. In this role, you will perform concurrent...

RN Care Manager This is not an active opening. We're building a talent community of experienced RN Care Managers for future opportunities supporting patients in Oregon, Washington, and Alaska. If you're interested in being considered as...

RN/NP Clinical Quality Reviewer Primary Care, Acute Symptom Triage & Travel Health | Contract, up to 25 hrs/week About the Role We are seeking Nurses & Nurse Practitioners with clinical experience in one or more of the...

Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho or Utah Preference will be given to current employees and candidates who reside in Idaho and Utah...

Job Summary: The LVN Case Manager works under the direction of an RN following assessment, planning, facilitation and advocacy, which are achieved through collaboration with the client and other health care...

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...

This is not an active opening. We're building a talent community of experienced RN Care Managers for future opportunities supporting patients in Oregon, Washington, and Alaska. If you're interested in being considered as...

Case Management Supervisor (RN) Lead. Influence. Transform Patient Care in Your Community. Jamaica Hospital Medical Center, a 384-bed community teaching hospital serving one of New York City's most diverse populations, is seeking a...

Utilization Management Nurse 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...