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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...

Job Description The Division of Metabolism, Endocrinology and Nutrition has an excellent opportunity for a Registered Nurse 2 - Research to join their team. This is an hourly position with a variable shift. Located in...

As an integral member of the patient care team, the Registered Nurse supports the Chief Nursing Officer in leading the patient care team in providing for the safety, recovery and comfort of patients by implementing the nursing process (assessment,...

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.

Start the day excited to make a difference...end the day knowing you did. Come join our team. Job Summary: The Virtual Registered Nurse (VRN) is responsible for providing professional nursing care with collaboration from the...

Registered Nurse Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland. The Center for...

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...

Job Description Your Role The Clinical Quality Team is responsible for reviewing and abstracting medical records to capture data and to ensure accuracy and completeness. The Clinical Quality Reviewer...

As a Patient Family Liaison Clinical, you will:Collaborate with Admissions Department and Marketing staff to manage patient family information and sign-on visits. Communicate appropriately with providers, attending physicians, other appropriate...

Utilization Management Position Provide health care services regarding admissions, case management, discharge planning and utilization review. Review admissions and service requests within assigned unit for prospective, concurrent...

Overview This is a short-term assignment. What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and...

Working remotely in a full-time capacity, the RN Clinical Documentation Specialist will review medical records to enhance the accuracy of clinical documentation, ensuring it reflects the patient's severity of illness and risk of mortality while...

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...

Registered Nurse Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout...

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...

49942352 Overview Remote Registered Nurse (RN) DH Direct Triage Part-Time, 20 hours per week Position Summary The RN - DH Direct Triage provides high-quality,...

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'...

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...

RN Clinical Reviewer / IDR - Remote (#25310C) Location: Remote Employment Type: Full-time Hourly Rate: $50/hr...

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:...

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...

" The Utilization Review Specialist is responsible for the assessment and review of the healthcare delivery system with a concentration on tasks that promote cost-effective quality care and cost containment in accordance with various federal...

Job Description: Job Summary: Responsible for patient focused programs which may include but is not limited to: collaborating with health care team in providing direction for maintaining high quality...

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...