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Job Description Summary We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach...

Job Summary Provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical...

Job Description: The RN Transition and Triage Care Manager offers comprehensive, time-limited services to patients and their families, ensuring continuity of care as they move across healthcare settings and clinicians. This...

Job Description RN Utilization Review at Irvine, CA. This position is Part- time and will work Remote 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our...

Registered Nurse, Quality Assurance Reviewer The Registered Nurse, Quality Assurance Reviewer will work in conjunction with the Quality Manager and will be responsible for completing quality reviews for the Clinical Services and Provider...

Registered Nurse (RN) Boston Medical Center - Boston Allied Partners (BAP) This is a hybrid role, requiring on-site presence in our office but flexible. As an LTSS Registered Nurse (RN), you'll...

Position Purpose **This position is in-person and is not remote** The Transfer Center & Virtual Care RN provides leadership, accountability, and comprehensive nursing services to ensure optimal patient care, resource...

Utilization Management Nurse Job Description Responsible for reviewing and documenting prior authorization and concurrent stay requests, as well as member case histories, in compliance with...

Job Description Job Summary Join our team as a Clinical Review Nurse, where you will play a crucial role in supporting the review of medical claims and appeals. You will ensure compliance with state and federal...

The candidate for this role must live in these states: TX, LA, WA, FL or GA. At Houston Methodist, the Clinical Documentation Specialist is responsible for improving the overall quality and completeness of clinical documentation. This...

Nurses Needed At Pleasant View Healthcare Center Nurses are at the heart of our world-class, patient-centered standard of care. Day in and day out, they go the extra mile to make a lasting difference in the lives of our residents and...

Employment Type: Full time Shift: Description: Posting POSITION PURPOSE This RN position includes incorporating approved processes, systems, protocols and tools when...

To apply you must live in the following States: MA, NH, RI, IA, CO, FL, SC, NC, RI, CT, VA, MD, UT Our Chart Audit Nurses (CA Nurse) conduct and coordinate quality assurance and improvement activities through a collaborative...

Entity: Owensboro Health Regional Hospital | Department: Virtual Care | Work Hours: 7P - 7:30A | Weekend Requirements: One | 0.9 FTE Job Summary: Provides direct nursing care in accordance with established policies,...

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...

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.

Vetted is seeking a RN - Correctional for a travel job in Delaware, Ohio. Must have 2+ years of experience. This contract pays approximately $10,049/month...

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Provide high-quality clinical services within scope of practice and infection control standards. Coordinate care with other members of the patient/client's care team from admission to discharge. Complete clinical nursing assessments per...

A leading healthcare provider is urgently seeking experienced Clinical Documentation Specialists for remote positions. Ideal candidates must be RN graduates from an approved nursing program and possess prior CDI experience, preferably in acute...

Registered Nurse Utilization Management (UM) Reviewer Join PeaceHealth in advancing compassionate, mission-driven care from wherever you are. PeaceHealth is looking for a skilled and motivated Registered Nurse Utilization Management (UM)...

Salary: $95,000-$100,000 plus performance based-incentives and full benefits package Job Summary: Our client is seeking an experienced Registered Nurse (RN) to oversee care delivery for Principal Care...

Scope of Position University Hospital East is committed to enhancing the quality of care provided to patients. The Patient Care Coordinator - Registered Nurse (PCC-RN) functions as an integral member of a team of care providers on a...

Our hospital provides high-quality care that transforms the lives of those living with disabling injuries and illnesses. We distinguish ourselves through our commitment to excellence, to our patients, to our employees, and to the communities we...

LanceSoft is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Torrance, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 03/02/2026 Duration: 8 weeks 40...