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A company is looking for a RN Call Center Obstetrics - Remote from a Compact State.Key ResponsibilitiesConduct telephonic assessments with obstetric patients and provide care coordinationEducate patients and families about treatment and services,...

A company is looking for a Nurse Auditor.Key ResponsibilitiesPerform charge audits and assessments to resolve incorrect or missing chargesMonitor revenue loss reports and identify documentation needs to support charge captureEducate stakeholders...

A company is looking for a Utilization Management RN to ensure efficient healthcare resource use while promoting quality patient care.Key ResponsibilitiesCoordinate with healthcare teams to assess and monitor the delivery of healthcare...

A company is looking for a Clinical Review Nurse - Correspondence.Key ResponsibilitiesDrafts correspondence letters based on clinical review outcomes in accordance with NCQA standardsInvestigates denials and provides supplemental information to...

A company is looking for a Nurse Case Manager (WC and PIP).Key ResponsibilitiesNegotiate fees and coordinate referrals with rehabilitation and medical case management vendorsGather, analyze, and report service data significant to clients and...

A company is looking for a Utilization Review RN.Key ResponsibilitiesReview and evaluate clinical information to support Utilization Management decisionsCommunicate medical necessity to payors and facilitate the authorization processCollaborate...

A company is looking for a Utilization Management Director - RN Required - Remote.Key ResponsibilitiesOversee day-to-day operations of the Utilization Management Department to ensure compliance with payer requirements and regulatory...

A company is looking for a Utilization Management Nurse.Key ResponsibilitiesCoordinate and facilitate correct identification of patient statusConduct concurrent and retrospective reviews and support the medical necessity denial and appeal...