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Evaluating and managing catastrophic episodes of illness, the full-time remote South Carolina Licensed Stop Loss RN will facilitate cost estimates for underwriting, consult on claims, and provide case management oversight.Key...

JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member...

Associate Director Of Nursing Informatics The Associate Director of Nursing Informatics provides strategic and operational leadership for nursing informatics across Geisinger. Reporting directly to the Chief Nursing Informatics Officer...

Clinical Documentation Integrity Specialist/Consultant The Clinical Documentation Integrity (CDI) Specialist/Consultant serves as a trusted advisor to client organizations, providing expert guidance in clinical documentation practices...

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...

Field Based Registered Nurse At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the...

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...

Job Description $15,000 Sign-On Incentive for eligible rehires and external hires that meet required qualifications and conditions for payment. Our home health and hospice agencies are located...

A company is looking for a Utilization Review Nurse.Key ResponsibilitiesPerform inpatient utilization reviews for acute and post-acute casesComplete a minimum of 9 authorization determinations per dayEvaluate clinical information to determine...

Director of Wellness Transitions & Compliance (RN) Vitality Living is seeking a dynamic, compassionate leader of people to oversee Health and Wellness efforts for one of the area's best senior living communities. This critical leadership...

Job Title: RN Case Manager - Medicare Advantage (Telephonic, Hybrid) Job Description This role offers an experienced RN the opportunity to provide telephonic case management for Medicare Advantage members in Florida. You will...

Join BoldAge PACE and Make a...

Triage Nurse Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an...

RN Appeals Analyst We are currently hiring for a RN Appeals Analyst to join BlueCross BlueShield of South Carolina. In this role, you will research the substance of complex appeal or retrospective review requests including pre-pay and...

Infection Control Preventionist Job Category: QA - Quality Control Requisition Number: 01INF004409 Full-Time Remote Brunswick, GA 31520, USA Description Essential Responsibilities: This description of job...

California Licensed Registered Nurse (RN) - Remote Welcome to Pine Park Health! Pine Park Health is a value-based primary care practice revolutionizing healthcare for senior living community residents. We empower seniors to get...

Cabell Huntington Hospital is seeking a casual, as needed Virtual Integrated Care Coordinator (RN) for our CHH Virtual Integrated Care Department. This job is responsible for supporting and...

Contract | Remote | We're hiring 10 elite nurses CircleLink Health is building a team of top-tier Compact Registered Nurses who want more than a typical remote role. This is a performance...

Clinical Risk Adjustment Specialist (RN) At St. Luke's Health System, we're committed to improving patient outcomes through accurate documentation, ethical coding practices, and strong provider partnerships. We are seeking an experienced...

At Curana Health, we're on a mission to radically improve the health, happiness, and dignity of older adults-and we're looking for passionate people to help us do it. As a national leader in value-based care, we offer senior living...

Description Position at Healthmap Solutions Company Background Healthmap Solutions is the future of specialty health management that focuses on progressive diseases, with a particular expertise...

Case Manager, Registered Nurse (Field-Based) – Middlesex County, NJ 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...

Bilingual Nurse Patient Access Specialist (RN), a full-time remote position responsible for facilitating patient access to therapy by conducting benefit investigations, verifying insurance eligibility, and providing ongoing patient support and...

Case Manager The Case Manager manages an individual caseload using the Case Management process to meet the needs of MedWatch, LLC customers and consumers. This includes authorization of services, review of treatment plans for medical...

Candidate must be located within 1 hour of one of the following Corewell Hospitals: Big Rapids, Greenville, or Fremont Candidates must maintain an active bedside nursing role in addition to this virtual position Job...