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BlueCross and BlueShield of South Carolina seeks an RN Medical Reviewer II to join the Palmetto GBA Medical Review team. You will perform medical reviews using clinical information, apply guidelines, and help ensure accurate coverage and payment...

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Manage patients assigned to your Care Team, ensuring visit frequencies align with acuity levels. Communicate via phone and video conferencing, assess and enroll patients, and develop care plans. Manage medications,...

The University of Texas MD Anderson Cancer Center is seeking a Denials Management Coordinator to support revenue cycle operations by coordinating review, analysis, and resolution of insurance denials and to help secure accurate reimbursement. This...

TriWest Healthcare Alliance is seeking a Utilization Management Clinical Review nurse to assess medical necessity and manage prior authorizations for Behavioral Health and Medical/Surgical requests. You will apply InterQual criteria, document in...

GQR Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: Case...

Prime Staffing is seeking a travel nurse RN Short Stay for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: Short...

HCSC is seeking a remote QOC Nurse under the supervision of the QOC Manager to conduct review and investigation of quality of care issues. The role supports quality improvement activities in compliance with CMS, NCQA and other regulatory...

UnitedHealthcare is seeking an HSS Clinical Coordinator RN to serve as the primary care manager for a panel of members with complex health needs, including behavioral health, with a focus on coordinating medical, behavioral, and social...

Nursing AttendantPrimary Location Baldwin Park, California Facility Name Baldwin Park Hospital Employee Status: Regular Worker Location: Onsite Schedule Part-time Scheduled Weekly Hours: 24 Shift Night Salary $25.57 - $27.74 / hour Job Number...

Conduct telephonic nursing assessments and triage using protocols.Provide health education and referrals to diverse patient populations.Work Schedule:Full-time evenings with weekend shifts every two weeks.Virtual training for 2-4 weeks, 100%...

Intermountain Health is seeking an RN Utilization Review Care Management I for remote work. The role focuses on screenings, assessments, and evaluations to ensure cost-effective, high-quality care while coordinating with patients, families,...

The VITAS Telecare RN is a member of the interdisciplinary team who is the pivotal person responsible for identifying the physical, psychological, social, and spiritual needs of those patients and families needing assistance after normal business...

Buena Vista Home Health, Palliative Care & Hospice (BV) is seeking an experienced OASIS Review Nurse (RN) for a remote, part-time QA role. The RN will ensure OASIS assessments are accurate, complete, and compliant with CMS regulations and state...

Trinity Health At Home is seeking a Virtual Care Coordinator RN to deliver telehealth hospice care and coordinate individualized care plans for patients and families from a remote setting. The role involves monitoring patient conditions,...

Job Summary and ResponsibilitiesAs our Educator in Critical Care Emergency, In accordance with our mission and core values of integrity, compassion, collaboration, and excellence, this position is established to serve as a consultant/resource...

LanceSoft is seeking a travel nurse RN Wound Care for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: Wound...

Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to...

Responsibilities Plans, implements, coordinates, and evaluates comprehensive care for designated patients to ensure quality of care and continuity of care delivery through telehealth platforms. QualificationsMinimum...

8 Hours POSITION SUMMARY The Clinical Staff Nurse is a skilled and experienced professional Registered Nurse (RN) responsible for excellence in the clinical practice of nursing and the management of patient care.

5K Sign On Bonus!Southwest Care Center employees can answer yes to these 3 questions: 1. Do you want to make a difference? 2. Do you believe everyone is entitled to quality healthcare? 3. Do you desire to serve the...

Trinity Health Corp. in Michigan is hiring an RN Intake Coordinator to act as the clinical gatekeeper for admissions to the Inpatient Psychiatric Medical Unit. The role coordinates the patient intake and admission process, conducts clinical...

JOB DESCRIPTIONWe are searching for six TX licensed RNs to work telephonically with our Medicaid members across the state. Three of the positions are open to RNs with at least two years of experience in in Behavioral Health or Substance Abuse...

AuthoraCare Collective is seeking an RN for our After-hours Triage department serving our Burlington and Greensboro service areas. This is a remote part-time position; Every other Saturday and Sunday 10:00am - 4:00pm. Must reside in the...

Navitus is hiring a Telehealth Registered Nurse to conduct telephonic comprehensive medication reviews (CMRs) and provide medication counseling to members. This role ensures CMS and HIPAA compliance while coordinating with healthcare providers,...