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Job Description: • Participates in the development and ongoing implementation of QM Work Plan activities. • Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet...

A leading pharmacy company is seeking a Clinical Outcomes Quality Assurance Nurse to ensure the quality of documentation and implement clinical best practices. Responsibilities include managing outcomes forms and communicating with patients and...

Job Description Home Health Care, Hospice Care, Palliative Care, Long Term Care, Rehab No weekends, No afterhours support, No holidays Job Description Job Summary...

Type: Full-time, salaried, FLSA exempt Pay: $80,000 - $85,000 annually, plus bonus potential Location: US, remote; some evening hours, weekend hours, and travel are required...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health is currently hiring for a Utilization Review Nurse- Remote in VA! Status: Full-time, permanent...

Discover. Achieve. Succeed. #BeHere Location: US:WI:MENOMONEE FALLS at our CP-NORTH HILLS HEALTH CENTER facility. This job is ON - SITE. FTE: 0.400000 Standard...

Overview The Patient Clinical Services team is a centralized nursing service where the Patient Clinical Services RN implements best practices in patient care and coordination for participating Primary Care locations by...

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...

This position is fully remote, however, you must reside in the State of Texas The position is a contract for about 6 months. RN working in the insurance or managed care industry using medically accepted criteria to validate the...

Overview Join Piedmont to move your career in the right direction. Stay for the diverse teams you'll love, a shared purpose, and schedule flexibility that frees you to live for what matters both in and outside of work. You'll...

Job Summary: The Registered Nurse (RN) is accountable for providing competent nursing care. Responsible for coordination of the patient's plan of care through assessment, planning, implementation, and evaluation of nursing...

divh2RN Care Review Clinician/h2pThe RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical...

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.

The VITAS Telecare RN is a member of the interdisciplinary team who is the pivotal person responsible for identifying the physical, psychological, social, and spiritual needs of those patients and families needing assistance after normal business...

Location: Avera Medical Group Pulmonary & Sleep Medicine-Sioux Falls Worker Type: Regular Work Shift: Pay Range: The pay range for this position is listed below. Actual pay rate...

CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to...

Overview: Employee Health RN at the Livingston Orthopedic Surgery Center (LOSC) location 32-36 hours per week Monday - Friday, Day Shift, No Weekends or Major Holidays Benefits...

Join Encompass Health: Where Nursing Meets Heart, Home, and Healing. Are you looking for a fulfilling nursing career that resonates with your passion for care? At Encompass Health, we provide a transformative experience where your skills as a...

Overview Registered Nurse (RN), Clinical Decision Unit Rockville Centre, NY Explore a career with Mercy Hospital, a 375-bed not-for-profit hospital and member...

A healthcare solutions company is seeking a Clinical Review RN (Independent Dispute Resolution) to provide remote case determinations for Independent Dispute Resolution. This role requires a licensed RN in New York State with a minimum of two...

Supplemental Health Care is seeking a travel nurse RN PICU - Pediatric Intensive Care for a travel nursing job in Columbus, Ohio. Job Description & RequirementsSpecialty:...

Details Client Name OSU - Speilman Breast Center Job Type Travel Offering Nursing Profession RN Specialty...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...

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 supportive...

divh2Job Summary/h2pThe RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance...