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Supports the values of service excellence, teamwork, and integrity while managing patient care. Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers. Qualifications: Requires a...

Business Office Coordinator Work Location: Los Angeles, CA, USA Work Schedule Monday - Friday, 8:00am - 5:00pm Salary Range: $34.30 - 52.20 Hourly Employment Type 2 - Staff: Career Duration Indefinite Primary...

CVS Health is seeking an RN Nurse Consultant for a remote role focused on utilization management and benefit coordination. The position emphasizes evidence-based decision making and collaboration with providers to ensure appropriate patient care.

The Ohio State University is seeking a Staff Nurse (RN) for Oncology Continuing Care Triage. This remote phone triage role handles oncology patient calls, performs initial assessments, and uses triage algorithms to guide care. The nurse documents...

TALENT Software Services is seeking a Clinical Quality Reviewer to join our CA-based remote team. You will review PQI allegations and coordinate multi-level reviews, applying clinical judgment to determine escalation paths and final...

Are you passionate about serving seniors? Do you want to be part of team that strives to create experiences that celebrate our seniors?

SCP Health seeks a Senior Vice President, Anesthesia APP to lead multi-site CRNA teams and drive clinical leadership across the network. You will partner with hospital leadership, oversee performance and compliance, and help shape growth...

JOB DESCRIPTION Opportunity in Southern California for an experienced Managed Care Leader to join our health plan in California. Candidates must have a minimum of 7 years of healthcare experience, 3 of those should be with a Managed Care...

LiveWell Homecare Agency seeks a Certified Registered Nurse Anesthetist (CRNA) to deliver high-quality anesthesia in a hospital setting. You will collaborate with physicians across ORs, outpatient centers, endoscopy labs and more to ensure safe,...

Job Title: Clinical Chart Reviewer Job Description This role involves reviewing clinical charts for medical necessity in inpatient admissions, ensuring compliance with healthcare standards, and making appropriate referrals based...

UnitedHealth Group is seeking an HSS Clinical Coordinator RN to conduct clinical reviews and evaluations related to Medicaid appeals, ensuring compliance and accuracy in assessments. This remote role is ideal for experienced RNs seeking meaningful...

UnitedHealth Group's OptumCare is seeking a Telephonic Nurse Practitioner for a remote, part-time role licensed in Colorado. The position includes after-hours call responsibilities, with a strong emphasis on care coordination and telehealth...

Talentify is seeking a Revenue Cycle Analyst (Remote) to support anesthesia billing for our client practices. You will analyze A/R performance, monitor claim statuses, denials, and payment trends while ensuring compliance with payer rules and...

Location: San Diego, California, United StatesCompany: AAPCPosted: UC San Diego Health's Revenue Cycle department seeks an experienced coder specializing in anesthesia, pain management and critical care. Under supervision, perform in-depth...

TEEMA partners with a top healthcare organization to recruit a Clinical Quality Reviewer. You will review medical records for quality and utilization concerns, and prepare clear recommendations for quality improvement. Remote or onsite...

Physicians East seeks a QEC Pre Procedure Screening Nurse for a part-time remote role based in Greenville, NC. The nurse will review patient charts, screen for procedural eligibility, and coordinate with physicians to ensure proper evaluation and...

HST Pathways is looking for a PayCare Specialist to join their remote team. This role involves proactive communication with patients regarding anesthesia service charges to ensure financial transparency prior to procedures. You will handle inbound...

Qlarant, a nonprofit organization, seeks a Nurse Specialist II to perform medical record and claims review for Medicare, Medicaid, and other data. This remote role in the United States involves ensuring adherence to guidelines while assessing for...

Spectraforce Technologies, Inc. is seeking a Clinical Review Nurse - Prior Authorization for a 12-month assignment. The role is remote (PST/CST) with scheduling across multiple shifts, supporting national guidelines and contractual requirements.

Clinical Documentation Improvement Specialist-RN- Remote The Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) assists with the identification of diagnoses, conditions, and procedures that are representative of the...

A healthcare staffing agency in the United States seeks a medical coding specialist to analyze and code surgical records from Anesthesia departments. This position requires various coding certifications and at least 2 years of relevant experience.

Sagility is hiring an RN Utilization Management Reviewer for a fully remote, home-based role in the United States. You will perform day-to-day clinical and service authorization reviews for medical necessity and ensure compliance with CMS...

Yoh is seeking a Utilization Management Nurse Coordinator (RN or LVN) for a 6+ month remote contract with a managed care client based in Northern California. Training occurs onsite in Fairfield or Redding for three weeks, then transitions to fully...

56512 Job Description Join a team that's shaping the future of pediatric care. Childrens Hospital Los Angeles is consistently ranked among the top 10 children's hospitals in the nation, delivering world-class care through more...

As a Clinical Documentation Review Specialist (RN), you will help medical staff clarify patient records to ensure appropriate reimbursement and reflect care complexity. You will perform concurrent reviews and engage with physicians...