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Clinical - Clinical Review Nurse - Concurrent Review Immediate need for a talented Clinical - Clinical Review Nurse - Concurrent Review. This is a 06+months contract opportunity with long-term potential and is located in U.S(Remote).

SCAN Health Plan is hiring a registered nurse for clinical review of medical claims and post-service appeals. You will analyze pre/post payments, perform audits, and apply CMS guidelines to determine medical necessity and appropriate care.

Jobgether, on behalf of a partner company, is seeking a Case Manager – Utilization Review Specialist for a remote US-based position. The role focuses on admission and concurrent reviews, denials prevention, and appeals support, leveraging...

Forensic Registered Nurse (RN) Scheduled Weekly Hours: 36 Work Shift: Days/Afternoons (United States of America) Summary of Primary Function The Forensic Registered Nurse (RN) is a highly specialized professional who...

Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to...

Job Title Conducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital...

Nurse - Clinical Review The Clinical Review Nurse makes prospective medical necessity determinations on prior authorization requests for HealthHelp's specialty programs, including Diagnostic Imaging, Cardiology, Musculoskeletal, Physical...

The Beverly Hills Cancer Center in Beverly Hills, CA is seeking a compassionate Licensed Vocational Nurse (LVN) to join the care team. You will liaise between patients, providers and the Program Director to ensure a seamless care experience from...

Insurance Or Managed Care Industry Registered Nurse (RN) $40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically...

Case Manager Utilization RNPrimary Location Los Angeles, California Facility Name Los Angeles Medical Center Employee Status: Regular Schedule Part-time Scheduled Weekly Hours: 24 Shift Day Salary $68.95 - $84.38 / hour Job Number 1452409 Worker...

*Job Summary and Responsibilities* As our surgical services nurse at Glendale Memorial Medical Center you will prepare patients for surgical procedures and assist in the operating room to ensure they receive excellent nursing when they are at...

Overview Join our team as a day shift, full-time, Virtual Care Registered Nurse (RN). Why Join Us? Thrive in a People-First Environment and Make Healthcare Better Thrive: We...

Job Requirements Education & Experience Bachelor's Degree in Nursing (BSN) – Preferred Acute care facility experience – Preferred Previous hospital/acute care nursing experience...

Utilization Review Nurse Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position, you will utilize your clinical judgement to approve or deny outpatient medical...

Registered Nurse Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Evenings Job Description Join a team that's shaping the...

Clinical Integrity Documentation Specialist Location: Remote Facility: Ascension Wisconsin Hospitals Department: Clinical Integrity Documentation Schedule: Days | Full-Time Salary Range: $79,511.52-$110,834.59...

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

Acute Care Cardiac (Main 7) Acute Care Cardiac (Main 7) is a 44 bed acute care cardiac unit dedicated to providing high-quality, compassionate care to a wide variety of patients. Our patient population consists of those with multiple...

Utilization Review Registered Nurse Excel. Empower. Advance. Shine. Belong. Explore. Flourish. Champion. Make It Happen At Hopkins! Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns...

Please make sure to complete all the questions in the application and continue through to the end in order to sign and submit it. The preferred work hours are 8:30 am / 9 am - 5 pm / 5:30 pm central time...

Telehealth Nurse – Providing Virtual Clinical Support & Care Coordination Telehealth Nurse All Seniors Foundation Los Angeles, CA (Remote Possible) About Us: All Seniors Foundation embraces innovative...

RN Utilization Review Review patient medical records to assess the appropriateness and medical necessity of hospital admissions, continued stays, and services, while coordinating with providers and payers to ensure compliance with...

Summary VA Greater Los Angeles Healthcare System (VAGLAHS) is seeking to hire experienced Registered Nurses to work in our Case Management/Care Coordination Program. The Case Manager provides patient centered care with expertise in the...

Job Title This is a remote, PRN position but will need onsite training in Mishawaka Indiana. Shift: Days - 8 hr shift LOCAL CANDIDATES ONLY! Why Choose Saint Joseph Health System? At Saint Joseph Health System, our values...

Details Client Name Dignity Health - California Hospital Medical Center Job Type Travel Offering Nursing Profession RN...