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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...

Role Overview Acts as a patient advocate by providing education, support, and interventions that lead to prevention and early detection of cancer, and navigating patients through diagnosis, treatment, and rehabilitation process. Performs...

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...

Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit,...

Location: Avera McKennan Hospital Worker Type: Regular Work Shift: Rotating days/evenings ights/weekends/holidays (United States of America) Pay Range: The pay range for...

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)...

49942353 Overview Remote Registered Nurse (RN) DH Direct Triage Part-Time, 20 hours per week Position Summary The RN - DH Direct Triage provides high-quality,...

Precertification And Authorization Call Center Representative I Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first,...

Remote Rn – Medical Claims Reviewer At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled...

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...

In this role, you will provide direct nursing care, infusion therapy and documentation to patients in the Community Oncology Practice. Major functions include: patient assessment, patient evaluation and preparation and administration of...

The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nations top hospital systems for best...

Overview As an Enrolled Nurse , you will work under the supervision of a Registered Nurse to deliver high-quality nursing care and achieve positive outcomes for residents, in line with Arcare's values and standards.Key Responsibilities Personal...

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...

Registered Nurse Remote Triage Professional Guideway Care is The Patient Activation Company™. We don't just "engage" patients; we activate them. By utilizing our proprietary Motivational Patient Guidance (MPG) model and AI-powered...

Employment Type: Full time Shift: Description: ESSENTIAL FUNCTIONS Our Trinity Health Culture : Knows, understands, incorporates &...

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...

Part Time Care Transitions Nurse - This is a part-time remote role that requires high-speed internet and requires some evening and weekend coverage. Care Transitions role for both 30 and 90-day programs Medicare/ACO patient population/Medicare FFS...

Medical Review Nurse (RN) Remote position, however, candidates must reside in the State of TX or State of IL This position is a contract for about 9 months. Pay: $41/hour RN working in the insurance or managed care...

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

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'...

Nurse, Concurrent Review WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries. We bring together deep domain excellence with AI-powered...

Nurse Reviewer - Itemized Bill Review It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know...

About the Employer Welcome to Paramount Unified School District. Paramount strives to create a collaborative and supportive environment for our employees so that they may focus on our main goal to serve the needs and...

Works collaboratively with an assigned panel of physicians to manage the patients specialized needs. The managing team does differ according to the chronic disease. Duties include assessment to identify member needs and development of specific care...