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Clinical Appeals Nurse We are seeking an experienced Clinical Appeals Nurse to support the appeal and grievance processes by analyzing and responding to adverse coverage decisions. This role involves clinical judgment, regulatory...

Workers' Compensation Care Coordinator 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 and...

Overview California Rehabilitation Institute *A Joint Venture with Cedars, UCLA, and Select Medical* Century City - Los Angeles, CA Registered Nurse (RN) / Full Time – Days 7:00am...

Registered Nurse - Case Manager Burbank, CA, 91505, United States Job Description Winter Bill Rate Increase The winter bill rate increase will be effective from October 4, 2026, through February 27, 2027. After February...

Job Title Summary: Work Mode: 100% Remote - MS (candidates can be outside Mississippi but MUST have compact license & willing to work CST hours) Duration: 3 months, possible extension Shift: 8am-5pm (Central) OT is...

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...

Registered Nurse (RN) - National After-Hours Team - Part Time At Curana Health, we're on a mission to radically improve the health, happiness, and dignity of older adults—and we're looking for passionate people to help us do it.

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...

ATC Candidate Medical Clearance Coordinator Serves as a member of a multidisciplinary team to provide assessment, planning, implementation, coordination, evaluation and monitoring of ATC Candidates throughout the medical clearance...

We are looking for an MDS Coordinator to join our team! The MDS Coordinator completes MDS for all residents according to OBRA and PPS guidelines. Assists in providing a clean, safe, happy and healthy environment for residents by performing the...

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...

Employment Type: Full timeShift: Day Shift Description: This is not a remote position The licensed Registered Nurse (RN) plans & provides...

Nurse Care Manager - Telephonic (Local Remote) Tandigm Health, a transformational leader in population health management, is looking for a Nurse Care Manager - Telephonic in the greater Philadelphia area. We offer a competitive...

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...

Description Job Title Nurse Case Manager 2 Location Remote - OK Position Description The Case Manager utilizes a collaborative process of...

Summary The Case Manager has the responsibility to identify, assess, plan, coordinate, implement, monitor, and evaluate options and services for individuals requiring case management services. The goal of the case manager is to...

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...

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...

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.

Nurse - Clinical Review Performs utilization review of cases to determine if the request meets medical necessity criteria in accordance with medical policies agreed upon with the Client and any applicable governing body. Facilitates...

Research Nurse - Danbury, Connecticut (Per Diem) Illingworth Research Group provides a range of patient focused clinical services to the pharmaceutical, healthcare, biotechnology and medical device industries. These include mobile...

Per-Diem Registered Nurse (RN) Assessor - Home Care Aarris Homecare Make a Difference-On Your Schedule Aarris Homecare is a California-based, family-owned home care agency dedicated to helping seniors and adults remain safe and...

Job Description The Staff Registered Nurse provides professional nursing care for assigned patients in the operating room, before during and after surgery. Assesses, plans, evaluates, and documents the...

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:...

Ansible Health Ansible Health is a virtual multi-speciality medical group that unites physicians, nurses, respiratory therapists, and tech experts from Columbia, Johns Hopkins, Google, Amazon, and other top institutions to revolutionize...