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JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

POSITION SUMMARYThe RN Certified Diabetes Care and Education Specialist has experience in diabetes care and education. The RN will contribute to developing, reviewing, and revising all diabetes education material. The RN promotes self-management...

Description Location: UCHealth Anschutz Outpatient Pavilion - Aurora, CO Department: Hospital Based Sub-Specialty Work Schedule: Full Time, 80.00 hours per pay period (2 weeks) Shift: Days Pay: $38.91 - $60.31 / hour. Pay is dependent on...

Telephone Triage Nurse Line Advisor Apply today to join our 34,000+ employees and 5,000+ system providers working to build lasting relationships with the people we serve: our patients, our communities, and each other! Are you ready...

Reporting to the Clinical Nurse Director, this position is responsible for planning, directing, coordinating and providing high quality, individualized patient care using the components of the nursing process. Performs duties in a manner that...

Responsible for the provision and coordination of patient centered care. The Registered Nurse, RN, coordinates care to achieve desired outcomes, participates in patient and family teaching and provides leadership by delegating and working...

Clinical Claim Review Nurse 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...

Ocean State Job Lot is seeking an RN for Utilization Management in Los Angeles, CA. This role involves coordinating care submissions and documentation for patient admissions, focusing on high-quality care and efficiency. Candidates must hold an...

The Elevance Health Companies, Inc. is seeking a Nurse Appeals-RN to manage medical necessity appeal requests. The position allows for virtual work full-time with in-person training required. Successful candidates will investigate appeals, review...

Job Description: The Intake Coordinator is a Registered Professional Nurse who takes referrals and processes appropriate home care services. To maintain open lines of communication with referral sources and within Americare...

ResponsibilitiesSupervises nursing staff assigned to a particular shift. Assigns patients to available nursing staff taking into consideration the patients condition and the employees skill level.Assesses monitors and educates the nursing staff on...

Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This position is remote. Candidates must be...

Prior Authorization RN - Contract Role Location Requirement: Candidate must reside in NJ, PA, NY, CT, or MD Work Model: WFH, but must be able...

Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical Nurse - Work from Home! Get AI-powered advice on this job and more exclusive features.Direct message the job poster from BroadPathGlobal Talent Attraction...

Bristol Hospice seeks an Admissions RN in Lakewood, CA 90712, who is responsible for building community relationships and facilitating hospice care access. The ideal candidate will possess an RN license in California and demonstrate effective...

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus — a rejuvenating place for associates...

Overview Carenet Health is not authorized to hire in certain states due to internal business considerations: CA, CO, NY, NJ, NV, OR, WA, MD, RI, WV, AK, HI, CT, DE, VT, or Puerto RicoAre you a compassionate, self-motivated registered nurse with...

Utilization Management Registered Nurse The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the coordination, documentation and communication of medical services and benefit administration...

OverviewSt. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who count on the hospital...

Providence Health & Services is seeking a Revenue Cycle Auditor RN to provide compliant revenue cycle support. The role is critical for financial objectives and offers the chance to work within a supportive environment focused on patient care.The...

Post-Discharge Patient Outreach Coordinator Inspire health. Serve with compassion. Be the difference. Responsibility for initiating phone contact with discharged patients from specified units, conducting query on patient experience...

A healthcare facility in California is seeking a Utilization Review Case Manager to validate patient admissions and levels of care. The role involves performing patient chart reviews, securing authorizations for clinical services, and...

RN – Utilization Review Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30) Shift Notes: Days (5×8) | 08:00 – 16:30 PAY DETAILS (72 HOURS / 2 WEEKS) Pay Rate: $65/hr...

Overview Performs inpatient chart review to determine appropriate DRG assignment and assures appropriate documentation in the chart to support clinical care provided, including severity of illness and risk of mortality which...

Job Description Health Advocates Network is currently seeking a Registered Nurse to work at a facility in Los Angeles, California. These are registry positions with our company.