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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...

A healthcare organization in California is seeking an RN, Clinical Care Manager I to enhance member care through assessment and coordination. Applicants should have a Bachelor's Degree in a health-related field and an active RN license. The role...

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...

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...

A healthcare organization in Atlanta, Georgia is seeking a Registered Nurse (RN) to create care plans and perform evaluations for clients. Responsibilities include reviewing charts, ensuring quality care, and communicating with various...

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...

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...

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...

The position is work from home with field visits. JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include...

Current Employees: If you are currently employed at any of the Universities of Wisconsin, log in to Workday to apply through the internal application process. Job Category: Academic Staff...

American Medical Staffing is seeking a local contract nurse Correctional for a local contract nursing job in Lancaster, Ohio. Job Description & RequirementsSpecialty:...

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...

PURPOSE OF YOUR JOB POSITION: The primary purpose of your job position is to provide direct nursing care to the residents, and to supervise the day-to-day nursing activities performed by nursing assistants. Such supervision...

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...

Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff...

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to...

Salary: $95,000-$100,000 plus performance based-incentives and full benefits package Job Summary: Our client is seeking an experienced Registered Nurse (RN) to oversee care delivery for Principal Care...

Christie Clinic's department of Value-Based Care is seeking a full-time RN at the University clinic in Champaign from Monday-Friday 8:00am-5:00pm. with no night or weekend requirements. This position will allow for remote work following the...

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,...

HJ Staffing is partnering with Impresiv Health, a specialized healthcare consulting partner, to find a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN). This critical...

Become a part of our caring community and help us put health first The Pre-Authorization Nurse 2 reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services...

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families,...

RN - Utilization Review Nurse | 3+ Years of Experience | Remote in IL | Contract Walker Healthforce is seeking a RN - Utilization Review Nurse with 3+ Years of Experience to support a Healthcare Payor Client based out of IL.

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...

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