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Utilization Management Claims Review Nurse RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13077 Salary Range:...

OverviewThe Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing, and evaluating the care of patients. The staff RN utilizes the nursing process by use of technology,...

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...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh...

Clinical Review Clinician 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...

Evenings, Weekend Only, Full-time & Part-time opportunities available (20hrs +) Hiring for evenings and weekends (*weekends and holidays are required) Incentives for Bilingual Spanish Telephone Triage RNs! Are you looking for an...

Nurse Reviewer At Commence, we're the start of a new age of data-centric transformation, elevating health outcomes and powering better, more efficient processes to program and patient health. We combine quality data-driven solutions that...

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.

Registered Nurse (RN) - Clinical Documentation Specialist (Part Time) Remote The Clinical Documentation Specialist is responsible for the evaluation of physician documentation utilizing their clinical expertise to ensure the patients'...

Description Position at Northwell Health PART TIME- 20 hours per week- Mon-Fri 8pm- 12am shift- Rotating weekends and holiday coverage expected! Northwell is the largest not-for-profit...

Clinical Policy Nurse RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $88,854.00 (Min.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health...

Scion Nonprofit Staffing has been engaged to conduct a search for a Registered Nurse (RN) - Research for a mission-driven clinical research organization advancing equitable healthcare access and innovative treatment...

Location Address: 2925 Chicago AveLoading DockMinneapolis, MN 55407-1321 Date Posted: June 15, 2026 Department: 16007317 System Complex Care Management Shift: Day (United States of America)...

Clinical Review Nurse Duals Program Details- Brand new program of 2026 for Centene Duals = Medicare + Medicaid line of business. Members have one combined card and one authorization covering both benefit types. The duals...

Remote - Candidate is required to reside in California. The RN School Support Manager is responsible for the clinical oversight of the designated medical care needs per the district contract. This oversight includes support of care...

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...

Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical...

Job Description Registered Nurse - Full Time - Home Health (Florence County) *$15,000 with 2 years commitment Sign On Available! Responsibilities ...

Appeals Analyst We are currently hiring for an Appeals Analyst to join BlueCross BlueShield of South Carolina. In this role as Appeals Analyst, you will research the substance of complex appeal or retrospective review requests including...

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Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and quality improvement services for more than 50 years. We...

Position Status: Full time Shift: 12 Hour Day Shift (United States of America) Hours per week: 36 Job Information Exemption Status: Non-Exempt A Brief Overview Member of the care delivery team will function...

Clinical Auditor Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes.

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...

Nurse Navigator Join an innovative startup health plan based in Wisconsin that is revolutionizing healthcare and empowering companies to combat the relentless rise in healthcare costs. Our mission is to provide accessible, high-quality...