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Job Description Are you a registered nurse ready to take your career in an exciting new direction-one where your expertise truly makes a difference? Join Pennsylvania's premier Quality Improvement Organization and step into a...

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...

We are more than a health system. We are a belief system.We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach...

Payrate: $45.00 - $47.00/hr. Summary: The Utilization Management team reviews the inpatient stays for our members and correctly applies the guidelines for nationally recognized levels of care. The...

Capital City Hospice is proud to be Ohio-made. Every decision we make about hospice care is made with patients and families in mind. Our team is rooted in the communities we serve and are dedicated to delivering the highest quality of care...

Job Title: Traveling Nurse Location: Multiple Locations / Nationwide Employment Type: Contract / Full-Time / Temporary Department: Healthcare /...

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...

A leading healthcare organization is seeking a Senior LTSS Assessor (RN) to conduct assessments and coordinate care for complex populations. This remote role requires strong care management and communication skills, along with a Bachelors degree...

Job Description Job Summary Join our team as a Clinical Review Nurse, where you will play a crucial role in supporting the review of medical claims and appeals. You will ensure compliance with state and federal...

Medical Claims Review Support 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...

A leading healthcare provider is urgently seeking experienced Clinical Documentation Specialists for remote positions. Ideal candidates must be RN graduates from an approved nursing program and possess prior CDI experience, preferably in acute...

Employment Type: Full timeShift: Day Shift Description: Job Description Summary At MercyOne, health care is more than just a doctor's visit or a place to...

A healthcare provider is seeking a full-time Clinical Informatics System Analyst, RN, to improve clinical information systems. This role involves optimizing EMR applications, providing user support, and collaborating with clinical staff.

Job Description: • Participates in the development and ongoing implementation of QM Work Plan activities. • Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet...

A Quality Improvement Consulting Company is seeking a Remote RN Health Care Facility Surveyor to conduct surveys evaluating compliance with healthcare regulations. Responsibilities include on-site assessments, communication of deficiencies, and...

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 Title: Utilization Management NurseJob Description As a Utilization Management Nurse - Post Acute, you will be responsible for reviewing and documenting prior authorization and concurrent stay requests, as...

Position Title Virtual Nurse/Nursing Care Partner (Per-Diem) Job Description Purpose & Scope: Across inpatient Medical-Surgical, Telemetry, and Intermediate Care Unit (IMCU),...

Job Title: Nurse Liaison I - UM & QR Locations: Remote Role, IL 60563 Job Duration: 6 Months+ contract (possibility of extension) Schedule: Monday - Friday,...

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and...

Bridge Nurse Requirements Normal 0 false false false EN-US X-NONE X-NONE Graduate of an accredited school of nursing required. Licensed as a Registered Nurse (RN) or Licensed Practical Nurse (LPN) in the State of Ohio required. A minimum of one-year...

Care Coordinators (LPN) (LVN) CareHarmony's Care Coordinators (LPN) (LVN) work comprehensively with providers to deliver value-based care management initiatives for their patients. CareHarmony is seeking an experienced Licensed...

*Pay: $28.50/hr (Fixed rates, no opportunity for negotiation)* *Shift: *Monday- Friday- 8-4:30PM EST, MUST have flexibility twice a month to start as early as 7 and end as late as 7PM * * *Overview* We're hiring Clinical Quality...

Job Opportunity At Highmark Inc. Job Summary: This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource...

Care Manager Sharecare is the leading digital health company that helps people no matter where they are in their health journey unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is...