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Molina Healthcare is hiring a remote RN Care Manager. Preference for candidates in Washington State. This role will be working Pacific Standard Time hours. This role supports Medicare members through telephonic case management and...

Baptist Health is seeking a remote Clinical Documentation Specialist to evaluate physician documentation and ensure accurate illness severity portrayal for coding precision. The role requires an active Kentucky license and involves guiding...

Essentia Health in Duluth, MN is hiring for a Health Services professional to conduct Managed Care Programs in coordination with third party administrators. You will help implement referral, prior authorization, and precertification processes...

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...

TriHealth is seeking a Clinical Documentation Specialist RN to review inpatient records, ensuring accuracy of diagnoses, severity of illness and quality measures. You will educate physicians and nurses, collaborate with coding staff, and drive...

Position Title: Remote Telephonic RN Case Manager Mandatory Requirement: Must hold an Active Compact RN License and/or an Active California (CA) RN License to be considered. Pay Rate: $48.00 – $50.00 per hour...

About This Role The Preservice Review RN position at UnitedHealth Group involves assessing customer needs, identifying solutions to complex issues, and conducting clinical research to support medical determinations. This role is ideal for...

Memorial Hermann Health System is seeking a Clinical Documentation & Integrity Specialist for a remote role in Texas. The RN must hold a BSN or MSN and have at least five years of inpatient acute care experience, with ICU exposure preferred.

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Centene Corporation in Wisconsin is seeking an Appeals Liaison to coordinate statewide appeals, fair hearings, and external reviews. You will ensure letters meet State and NCQA requirements and work with Medical Directors to clarify medical...

Ssbv Clinical Claims Review RnOptum 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...

Ascension is seeking a Clinical Documentation Specialist to join the Clinical Integrity Documentation team in a remote, full-time capacity. The role focuses on admission reviews, DRG assignment, and ensuring documentation supports severity of...

Allegheny Health Network is seeking an RN Clinical Document Specialist to support remote work from Pennsylvania within 50 miles of Pittsburgh or Erie. The role focuses on improving documentation accuracy to optimize reimbursement, with extensive...

Clinical Documentation Integrity Specialist IIThe Clinical Documentation Integrity Specialist II (CDI) is responsible for utilizing independent clinical judgement in facilitating the integrity, overall quality, accuracy, and completeness of...

WORK REMOTELY after training! CANDIDATE MUST RESIDE IN THE METROPOLITAN NEW YORK AREA! !! Process all requests for services in accordance with Medicare and NYS Medicaid guidelines as well as departmental criteria and...

Prime Staffing is seeking a travel nurse RN Research / Clinical Research for a travel nursing job in Fullerton, California. Job Description & RequirementsSpecialty:...

Under general supervision and according to established policies and procedures, provide remote Blood Pressure (BP) monitoring for all patients enrolled in the Blip Care program. Communicates significant blood pressure changes and patient concerns...

Job OverviewPay Range: $46.76hr - $51.76hrRequirement/Must Have5+ years Clinical nursing experience.2+ years Care Management.Bachelor's Degree in Nursing.In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required...

Health Care Service Corporation seeks a Quality of Care (QOC) Nurse to review and investigate potential quality of care issues in a timely manner. This role supports QA activities in line with CMS and NCQA requirements, under the supervision of...

Cambia Health Solutions is seeking an Appeals Clinician I to work from home within Oregon, Washington, Idaho or Utah. You will complete the clinical component of all appeal types to resolve member and/or provider appeals, leveraging nursing...

GQR Healthcare is seeking a travel nurse Correctional for a travel nursing job in Downey, California. Job Description & RequirementsSpecialty:...

IQVIA is seeking a Flex Nurse Educator to educate patients remotely and to provide in-field support as needed. This non-clinical role empowers patients to manage their disease and improve treatment compliance, with travel up to 50% and occasional...

Clinical Research Nurse I Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Days Job Description Join a team that's...

Prior Authorizations Nurse (RN) (Temporary) Remote in California OUR COMMITMENT TO A HUMAN HIRING PROCESS We believe every candidate deserves thoughtful consideration.That'swhy we do not use AI or automated...

Medical Review Nurse (RN)Remote position, however candidates must reside in the State of TX or State of ILThis position is a contract for about 9 months.Pay: $41/hourRN working in the insurance or managed care industry using medically accepted...