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JOB DESCRIPTION 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...

A leading healthcare staffing company is seeking a Transition of Care Registered Nurse to oversee patient transitions post-hospital discharge. This role involves working closely with healthcare teams to ensure safe and effective care transitions,...

Description & Requirements Be part of something great Maximus is a global organisation that specialises in providing health and employment services to millions of people every year. Here in the UK we employ...

A leading health system is looking for a Registered Nurse Quality Improvement Analyst to lead quality improvement initiatives in Baltimore. Responsibilities include conducting QI activities, leading performance improvement teams, and ensuring...

Site: Brigham and Women's Faulkner Hospital, Inc. 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...

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...

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 Southern...

Are you an RN looking to step into a role where your skills, curiosity, and initiative truly shine? At Central Ohio Urology Surgery Center, we're not just any ASC; we're nationally recognized for excellence and proud to lead the way in...

Pediatric Cancer Cellular Therapy (CCT) Research Nurse 2 (Hybrid) The Stanford Cancer Institute (SCI) is one of an elite number of National Cancer Institute-Designated Comprehensive Cancer Centers in the country, and is a...

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DocCafe has an immediate opening for the following position: Nurse Practitioner - Urology in Circleville, Ohio.DocCafe is the premier physician and advanced practice job board to help you advance your healthcare career.----------------Register now...

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 local...

A leading global healthcare service provider is seeking a Remote RN to provide pharmacy utilization management services, focusing on patient safety and quality standards. Candidates should have a Bachelor's degree in Nursing and an active RN...

Access Healthcare is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Columbus, Ohio. Job Description & RequirementsSpecialty: Med Surg /...

Discover. Achieve. Succeed. #BeHere Location: US:WI:MENOMONEE FALLS at our CP-NORTH HILLS HEALTH CENTER facility. This job is ON - SITE. FTE: 0.400000 Standard...

Pre-Access Utilization Management Registered Nurse Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health insurance clients. This person will be responsible for...

Job Type Full-time Description Gateway Rehab Center (GRC) has an outstanding opportunity for a Nurse Liaison Gateway Rehab who will be responsible for the pre-admission case management, ASAM level of care assessment, and...

Requirements Qualifications / Experience Current multi-state RN license with no restrictions; nurses currently holding a single-state RN license must obtain a multi-state license prior to being made a job...

Dept: Quality and Provider Ed ****Looking for a registered nurse in the Grand Rapids or northern Michigan (lower peninsula) area. Most work will be remote from home and/or traveling, however, there are occasions contractor will need to...

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach...

Overview The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in...

UM Review Nurse Department: HS - UM Employment Type: Full Time Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Reporting To:...

Coast Medical Service is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Columbus, Ohio. Job Description & RequirementsSpecialty: Med Surg /...

A leading health insurance provider is seeking a Managed Care Coordinator I to join their team. This fully remote position requires you to review and evaluate medical eligibility regarding benefits and clinical criteria. Candidates must have an...