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Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The...

Remote Patient Monitoring - LVN/LPN Clinical | Remote Employment Type: Full-Time Start Date: March 23, 2026 About Nsight Health Nsight Health is transforming how care is delivered through Remote Patient Monitoring...

Immediate Hiring for "Remote Clinical Review Nurses" Job Description: Review approximately 20 cases a day for medical necessity. Advocate for and protect members from unnecessary hospital...

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...

Find your calling at Mercy! Under the direction of the primary care operations team, the Primary Care Nurse works directly with Mercy Primary Care Providers to provide safe, timely, effective, efficient, equitable,...

By clicking the "Apply" button, I understand that my employment application process with Takeda will commence and that the information I provide in my application will be processed in line with Takeda's Privacy Notice and Terms of Use. I further...

" 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...

If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Day - 08 Hour (United States of America) This is...

The Admissions Nurse is responsible for the overall direction and coordination of activities related to admission of residents to the facility while providing superior customer service. Position: Admissions Nurse - Remote...

Prior Authorization Clinical Reviewer 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...

By clicking the “Apply” button, I understand that my employment application process with Takeda will commence and that the information I provide in my application will be processed in line with Takeda's Privacy Notice ( and Terms of Use ( . I...

What You'll Be Doing - Core Responsibilities Clinical Leadership & As-Needed Clinical Support The IR Nurse Supervisor is clinically competent and expected to step in when required, including to: ...

Job Description: Position Summary: The Community Clinical Liaison performs a key role in the generation of referrals to HSL Home and Community Based Services with primary focus on Home Health and Hospice referral generation. This role serves as...

Join a meaningful mission Maximus is a global organization dedicated to providing vital health and employment services that significantly impact the lives of millions. With a workforce of approximately 5,000 professionals, we deliver...

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...

Wound Care Nurse - LPN or RN Riverview Full-Time Flexible hours Competitive Wages. plus Attendance Bonus We offer paid holidays, generous PTO, excellent benefit package as well as...

Staff Nurse-B - Transplant The Ohio State University Wexner Medical Centers mission is to improve health in Ohio and across the world through innovation in research, education, and patient care. The team provides patient care and...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: Aids patients in obtaining the correct level of care with...

Pluto Healthcare is seeking a travel nurse RN Outpatient Infusion for a travel nursing job in Columbus, Ohio. Job Description & Requirements Specialty: Infusion Discipline: RN Duration: 12 weeks 40 hours per week Shift: 10 hours, days Employment...

Company Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable,...

BJC HealthCare is seeking a Registered Nurse (RN) Oncology for a nursing job in Valley Park, Missouri. Job Description & Requirements Specialty: Oncology Discipline: RN Duration: Ongoing Employment Type: Staff At Vivian Health, candidates with...

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the...

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...

We believe everyone should have confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care...

Review and abstract medical record data into appropriate application(s)Support chart chase processes by requesting/obtaining records as needed. Primary source verify abstracted medical record data. Analyze chart data, evaluate for possible data...