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Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The...

We believe everyone should have confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care...

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...

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position. ESSENTIAL...

What You'll Do: The Ohio Department of Health / Complex Medical Help program is looking for an experienced nursing leader to oversee statewide public health nursing programs, guide policy development and ensure consistent,...

RN - Utilization Review Nurse | 3+ Years of Experience | Remote in IL | Contract Walker Healthforce is seeking a RN - Utilization Review Nurse with 3+ Years of Experience to support a Healthcare Payor Client based out of IL.

Description RN Utilization Review at Irvine, CA. This position is Part- time and will work Remote 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our...

Pre-Access Utilization Management Registered Nurse Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health insurance clients. This person will be responsible for...

Serious Medicine is what we do. Being extraordinary is who we are. Every colleague plays a key role in upholding this promise to our patients and their families. Shift: First Shift (United States of America)...

Requirements Qualifications / Experience Current multi-state RN license with no restrictions; nurses currently holding a single-state RN license must obtain a multi-state license prior to being made a job...

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an...

In order to have an accurate count of participants, we need you to register for the Recruitment Fair on the District's website. Please select "apply for this position" under the heading to the right labeled "Apply Now". Interviews slots will fill up...

A community-focused healthcare organization in Bloomfield, CT is seeking a Registered Nurse to provide individualized care to individuals with intellectual and developmental disabilities. This part-time hybrid role offers $37.00 per hour, flexible...

Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This position is remote. Candidates must be local...

Registered Nurses are encouraged to consider a part-time remote Nurse Reviewer position with Liberty Healthcare Corporation. Liberty Healthcare operates a statewide program in Idaho which assesses children and adults who are living with...

A leading healthcare management firm seeks an experienced RN for pharmacy utilization management services in Denver, Colorado. This role involves assessing patient medication usage, ensuring safety, and collaborating with medical professionals in...

Salary: $70,779.53 Annually Location : Homebased, GA Job Type: Full-Time Salaried Job Number: 2020-02252 Division: Healthcare Facility Regulation...

Summary We are currently hiring for an Appeals Analyst to join BlueCross BlueShield of South Carolina. In this role as Appeals Analyst, you will research the substance of complex appeal or retrospective review requests...

Provide high-quality clinical services within scope of practice and infection control standards. Coordinate care with other members of the patient/client's care team from admission to discharge. Complete clinical nursing assessments per...

Facility: CoxHealth South: 3801 S National Ave, Springfield, Missouri, United States of America, 65807 Department: 1651 Virtual Care Command Center Scheduled Weekly Hours: 24 Hours:...

A healthcare organization in Washington, DC, is seeking a qualified nurse for clinical review and care coordination. This role requires evaluating medical services and ensuring effective patient care while maintaining communication with various...

Job Description Scope of Position: The Ohio State University Wexner Medical Center?s mission is to improve health in Ohio and across the world through innovation in research, education, and patient care. The team provides patient care and...

Become a part of our caring community and help us put health first Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At...

Requisition Details GENERAL REQUISITION INFORMATION EEO Statement: UNMC is an Equal Employment Opportunity Employer, including an equal opportunity employer of protected veterans and...

Job Title: Registered Nurse - Clinical Documentation Specialist Location: Fully Remote Duration: 3+ Months (Possible Extension) Schedule Notes: Day shift, 8x5...