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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...

*Quality Assurance Registered Nurse - 100% Remote* Contract duration: 520 hour contract to hire Training Schedule: M-F, 4-6 weeks *Contract Details* * *Contract Duration:* 520-hour contract-to-hire, long term opportunity *...

A leading commercial insurance company is seeking a Clinical Review Nurse who will evaluate the medical necessity and quality of services for Workers Compensation claims. This hybrid position requires an active RN license and 5+ years of...

A major healthcare provider seeks a Transitions of Care RN to deliver patient education across programs for chronic disease management. This role involves conducting assessments, coordinating health-coaching plans, and monitoring the effectiveness...

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic...

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...

A healthcare solutions company is seeking a Clinical Review RN (Independent Dispute Resolution) to provide remote case determinations for Independent Dispute Resolution. This role requires a licensed RN in New York State with a minimum of two...

Fully Remote: Clinical Documentation Specialist Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical...

Job Description Under broad direction from the Centralized Utilization Management Manager, is responsible for the hospital-wide Utilization Management Programs in a general acute care hospital which serves infant, pediatric,...

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...

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 designed to help...

Are you looking to work for mission driven and passionate warriors like yourself? Looking to grow within an organization? The Company: We are Ohana Pacific Health. We positively impact thousands of lives each year...

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...

Responsibilities Salt Lake Behavioral Health is currently seeking a compassionate and talented RN to serve in a Hybrid Floor Nurse and House Supervisor position.

The RN Case Manager is responsible for coordinating continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical regime. Essential Duties and...

Become a part of our caring community and help us put health first Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At...

A leading healthcare management firm seeks an experienced RN for pharmacy utilization management services in Denver, Colorado. This role involves assessing patient medication usage, ensuring safety, and collaborating with medical professionals in...

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...

Explore opportunities with [agency name], a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best,...

Join BoldAge PACE and Make a...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health is currently hiring for a Utilization Review Nurse- Remote in VA! Status: Full-time, permanent...

Supplemental Health Care is seeking a travel nurse RN Rehabilitation for a travel nursing job in Columbus, Ohio. Job Description & RequirementsSpecialty:...

Description As an RN Care Manager, you will function as a clinician, advocate, and educator to achieve optimal clinical and quality outcomes by effectively managing care and resources to reduce unnecessary utilization. The RN Care Manager...

A major health care company is looking for a Utilization Management Nurse 2 to utilize clinical nursing skills in coordinating and communicating medical services. The ideal candidate holds a valid RN license and has over a year of experience in an...

We believe everyone should have confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care...