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Providing advanced clinical appeal services, the full-time Ohio RN Clinical Case Manager will manage complex patient account denials, perform clinical reviews, and assist in the development of denial prevention strategies while working...

Job Title : Hybrid Review & Evaluation RN Location: Harrisburg Pennsylvania 17101 (2 days onsite, 3 days WFH) Training may be onsite! Some travel may be required , and additional details can be discussed further during interviews Work Schedule:...

BlueCross BlueShield of South Carolina is looking for a qualified applicant to perform medical reviews and support medical claims processing. The role involves reviewing complex claims and documenting decisions based on established clinical...

CVS Health is seeking a Remote Case Manager RN to join the Costco Team and impact members' health from home. This full-time position requires a multi-state RN license and 3+ years of clinical RN experience. You will assess member needs, create...

OverviewPosition Type: Full timeJob Title: Care Review Clinician ILocation: 100% Remote (Must reside in one of the following states: NV, AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater-NYC), OH, TX, UT, WA (outside greater-Seattle),...

A healthcare service provider is seeking a Case Manager to manage individual patient caseloads remotely in Florida. Responsibilities include assessing patient needs, managing care plans, and ensuring quality service delivery. Candidates must...

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 with the care, pharmacy benefits, data...

CVS Health is seeking a Care Manager-Registered Nurse in Pennsylvania to join their Special Needs Plan care team. This full-time role requires an active RN NY license and involves coordinating care for members with chronic medical and behavioral...

A healthcare provider is seeking a compassionate Patient Support Program Nurse to deliver exceptional one-on-one support to patients. This remote role involves using motivational interviewing techniques and working within a collaborative team to...

A healthcare services provider is seeking a dedicated Case Manager to offer exceptional case management services focusing on quality care and positive outcomes. Responsibilities include developing individualized care plans, screening...

Job Description: HSL provides enhanced housing with services to seniors living in its four affordable housing locations, and at partner housing sites, with the goal of improving quality of life and supporting independent living. At its core,...

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 offer 2 years of RN experience Proficiency...

A quality improvement consulting company is seeking a RN Health Care Facility Surveyor to conduct surveys assessing compliance with regulations in a remote role that requires up to 75% travel. Candidates must have a nursing degree, relevant...

To support clinical auditing efforts, the full-time RN Clinical Auditor will perform retrospective chart reviews on Readmission and Place of Service Claims, utilizing clinical guidelines and proprietary systems while maintaining productivity and...

Find your calling at Mercy! Nurse Auditor will be a representative for Mercy in defense audit processes, while driving the evaluation and implementation of improved charge capture procedures to ensure compliance, accuracy, and revenue...

*Employment Type:* Full time *Shift:* 12 Hour Night Shift *Description:* *Position Purpose:* The Medical/Surgical – General Surgery (Bariatric/Ortho/Neuro/Surgical) Unit at Mount Carmel Grove City is 42 beds. The RN, Registered Nurse would...

Job Title: Clinical Trial Nurse (Remote) Company: Angel City VA Location: Work From Home Pay Rate: $7 USD/hour About Us Angel City VA is a people-first organization specializing in talent acquisition, onboarding, and...

Location: Any city, AK, US, 99999 Work Mode: Virtual (Exception only) It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways...

A health care organization in the United States is seeking an ECM Clinical Manager to oversee clinical management and support Lead Care Managers in delivering quality care. This role includes supervising a team, collaborating with care providers,...

A prominent health services provider in Albany, NY is seeking a Care Manager—Registered Nurse to coordinate care for members with multiple chronic conditions. The role involves telephonic engagement, developing individualized care plans, and...

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 with the care, pharmacy benefits,...

A prominent healthcare organization is seeking an A&G Clinical Specialist to manage health member complaints and appeals. This fully remote position requires expertise in clinical case management, understanding of regulatory compliance, and the...

A healthcare staffing agency is seeking a Remote Nurse Care Manager to guide high-risk members through their healthcare journeys. In this role, you will engage through telephonic outreach, develop care plans, and collaborate with a...

At Amped HQ, we're on a mission to connect top talent with opportunities that drive real impact. We're constantly expanding our global network, seeking the best and brightest to join our team and contribute to our partners' success. With...

Job Title: Medical Claim Review Nurse Location: 100% Remote Duration: 3 to 6 months ( Opportunity for ext. / based off performance/evaluation and team needs/budget) Schedule: 40hr- Must work PST hours. Once trained and working independently,...