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Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities, ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

A workforce solutions company is seeking a Registered Nurse-Case Review Specialist to provide support for Federal Occupational Health. This remote position requires extensive nursing experience and strong communication skills to ensure timely...

Clinical Appeals Rn At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come...

Clinical Appeals Rn At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come...

Providence Health Plan Caregiver Opportunity Providence Health Plan caregivers are invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding,...

A leading healthcare provider is seeking a Clinic Registered Nurse (RN) for their urology team in Omaha, Nebraska. This hybrid role allows for remote work after training. The RN will collaborate with a multidisciplinary team to provide...

A leading health services company is seeking an Appeals Nurse 2 to join their team in Maryland. This role involves resolving clinical complaints and appeals, reviewing medical documentation, and coordinating clinical resolutions. Candidates should...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

A leading risk and claims administration company is seeking a part-time nurse to join their team in Annapolis. This role involves triaging medical calls to assess needs and offering appropriate care solutions. The ideal candidate should hold a...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

A healthcare service provider is seeking a compassionate registered nurse (RN) to provide after-hours triage support for hospice patients in a remote role. Candidates should hold an active multistate RN license and have preferred experience in...

A regional health insurance provider is seeking an Inpatient Utilization Management Clinician to evaluate inpatient treatments for medical necessity and facilitate discharge planning. This is a fully remote position requiring strong clinical...

A healthcare organization in Warrenville, Illinois is looking for a Registered Nurse Triage to provide patient care through inbound and outbound calls. The role requires current Illinois RN licensure and strong interpersonal skills. Ideal...

Overview Our client is a trusted leader in healthcare services, dedicated to improving outcomes for patients and providers through innovative solutions and high-quality care. Join a team committed to making a meaningful difference in the...

A prominent healthcare organization located in New York is looking for a Clinical Documentation Specialist to enhance patient documentation accuracy. Candidates should possess an RN license and significant nursing experience. This position allows...

A healthcare provider in New Orleans is looking for an experienced nurse to improve clinical documentation integrity and educate providers. The ideal candidate will have a graduate degree in nursing and at least 3 years of clinical experience.

Remote Registered Nurse (RN) Case Manager Join to apply for the Remote Registered Nurse (RN) Case Manager role at PharmaCord Remote Registered Nurse (RN) Case Manager 1 month ago Be among...

A leading healthcare provider in New Jersey seeks a tech-savvy Registered Nurse (RN) for a Virtual Nurse role in their Hospital at Home program. This remote position emphasizes virtual care delivery, requiring collaboration with in-home clinical...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

A healthcare services provider is looking for a part-time Field Case Manager (RN) in Riverside, CA. This role involves making in-person visits to assess patient needs and coordinate care among medical providers and injured workers. The role...

Utilization Management Nurse 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...

A leading healthcare provider is seeking a Clinical Documentation Integrity Specialist responsible for ensuring accurate healthcare documentation. The role requires a Registered Nurse with at least one year of clinical acute care experience.

Perform medical reviews on provider inquiries and member appeals. Works within Department of Labor and State guidelines. Adherence to all confidentiality regulations and agreements. Reviews and interprets Plan language appropriately. Utilizes...

A leader in medical examination services is seeking a Remote Clinical Quality Assurance Nurse Auditor. This role requires a Registered Nurse with critical care and ER experience. Responsibilities include evaluating clinical information, performing...