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Job Summary The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

Business (Non-Clinical) General Summary: Under minimal supervision, reviews and screens the appropriateness of services, the utilization of hospital resources and the quality of patient care rendered. Combines clinical, business,...

A healthcare provider in West Valley City, UT, is seeking a Registered Nurse to provide clinical support through a work-from-home model. The ideal candidate should have 2 years of nursing experience, a valid RN license, and strong communication...

KPG Healthcare is seeking a travel nurse RN Home Health for a travel nursing job in Columbus, Ohio. Job Description & RequirementsSpecialty: Home...

Job DescriptionScope 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...

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...

Description RN Utilization Review at Providence Holy Cross Medical Center in Mission Hills, CA. This position is Full- time and will work 8-hour, Day shifts. Providence Holy Cross Medical Center is...

Join Team Trilogy At Trilogy, youll experience a caring, supportive community that values each team member. We prioritize meaningful relationships, genuine teamwork, and continuous growth. With the stability of long-term care, competitive...

Details Client Name Martha Morehouse Medical Plaza Job Type Travel Offering Nursing Profession RN...

Join Our Team As A Registered Nurse 1 We're unique. You should be, too. We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the...

Employment Type: Full time Shift: 12 Hour Night Shift Description: Qualified applicants may submit a resume to Senior Talent Acquisition Partner, Tonya Globlek at ...@mchs.com for expedited...

JOB DESCRIPTION **Job Summary** The Care Review Clinician (RN) provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical...

Live the Mission FULL TIME DAY SHIFT 7:00 am - 7:00 pm New grads welcomed! Come and grow with us! We are affiliated with Life Care Centers of America, which is a privately owned 47-year industry leader in healthcare with more than 200 locations...

Care Navigator Position at Healthmap Solutions Healthmap Solutions is the future of specialty health management that focuses on progressive diseases, with a particular expertise in kidney health populations. Healthmap Solutions...

Utilization Review - Fully Remote This role involves performing precertification and medical necessity reviews for designated referrals and targeted outpatient procedures, services, and inpatient admissions. The position requires...

The CommunityOversight RN ensures RN delegation and community compliance is achieved forassigned communities. The Community Oversight RN has the responsibility to understand the rules for delegating tasks of nursing care and achieve the competence to...

Telephonic Case Manager At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions...

Vetted is seeking a RN - Clinical for a travel job in Columbus, Ohio. The job was posted 23 days ago. The assignment starts on Dec 1 and is 13 weeks long with 9 hour shifts 5 days a week.You must live 60 miles away from the facility in order to get...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: Aids patients in obtaining the correct level of care with...

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions...

Company: Compassus Position Summary The Goals of Care Registered Nurse is responsible for modeling the Compassus values of Compassion, Integrity, Excellence, Teamwork, and Innovation and for promoting the Compassus philosophy, using...

Registered Nurse, Clinical Assessor Maximus is seeking a Registered Nurse, Clinical Assessor to join our growing team. As a Nurse Assessor, you will conduct person-centered assessments in accordance with contract directives, company...

Employment Type: Full time Shift: Description: As a Home Care Registered Nurse (RN) at Mount Carmel Home Care, you'll deliver one-on-one, high-quality care to patients in the comfort of their homes. Using advanced technology and...

Job Description: Sharecare is the leading digital health company that helps people - no matter where they are in their health journey - unify and manage all their health in one place. Our comprehensive and data-driven...

Become a part of our caring community and help us put health first The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and...