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Utilization Management Claims Review Nurse RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13077 Salary Range:...

Company: Providence at Home with Compassus Position Summary The Clinical Liaison RN - PAH is responsible for modeling the Compassus values of Compassion, Integrity, Excellence, Teamwork, and Innovation and for...

Medical Review RN IV – Commercial Appeals & Grievance Nurse Location: Remote – Candidate Must Reside in California Duration: 6+ Months Contract-to-Hire Schedule: Monday-Friday | 9:00 AM – 5:00 PM Pay Range:...

Complex Medicare Claims Review Complex Medicare claims/prior authorization requests require the review of medical record documentation to determine the reasonableness and necessity of the billed service in accordance with Medicare rules...

Job Address: 10123 Alliance Road, Suite 320Blue Ash, OH 45242 Telehealth Administrator on Call (Registered Nurse), Remote Position The PHP Telehealth Administrator on Call has a passion for providing remote...

A leading health services organization is seeking a Clinical Education RN to support staff development in Los Angeles, CA. This role involves facilitating educational processes for various health staff and requires a Bachelor's of Science in...

Clinical Liaison RN - PAH The Clinical Liaison RN - PAH is responsible for modeling the Compassus values of Compassion, Integrity, Excellence, Teamwork, and Innovation and for promoting the Compassus philosophy, using the 6 Pillars of...

Overview Performs inpatient chart review to determine appropriate DRG assignment and assures appropriate documentation in the chart to support clinical care provided, including severity of illness and risk of mortality which...

Elevance Health is seeking a Nurse Appeals RN to work virtually full-time, with in-person training required. The role involves investigating medical necessity appeals requests and requires a high school diploma and 2+ years of managed care...

The purpose of your job position as Care Coordinator Nurse is to provide direct nursing care to residents, including the coordination of care that is safe, timely, effective, efficient, equitable, and resident-centered. You are responsible for...

Job Summary: In addition to the responsibilities listed below, this position is also responsible for applying advanced clinical and regulatory knowledge of evidence-based guidelines, insurance policies, and clinical criteria to consult on...

A healthcare staffing agency is looking for a Travel Nurse RN Clinical Document Improvement Specialist based in Tarzana, California. The role involves managing patient complaints, providing clinical oversight, and performing medical record...

CVS Health Job Opportunity 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...

RN Utilization Mgmt Full-Time Day POSITION SUMMARY The RN Utilization Management (RN UM) functions as a support liaisons for a variety of UM functions which may include: the e-TAR process, denials management,...

Remote Rn – Medical Claims Reviewer At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled...

Registered Nurse Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout...

Your RoleThe Clinical Quality Team is responsible for reviewing and abstracting medical records to capture data and to ensure accuracy and completeness. The Clinical Quality Reviewer - Nurse, Senior will report to the Manager, Clinical Quality...

Payrate: $60.00 - $62.00/hr. Summary: The main function of the nurse is to provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and...

Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical...

Admissions Nurse The Admissions RN is a registered nurse and an Interdisciplinary Team member whose primary responsibility is to present VITAS services and philosophy to patients and families in a manner that results in the admission of...

Nurse Consultant I (NS) The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health,...

Please contact: To discuss this amazing opportunity, reach out to our Talent Acquisition Specialist Nikhil Jhajharia at email address [email protected] can be reached on # 630-576-1935. We have...

# Legal Nurse Consultant## Company DescriptionAt Expert Institute, we are pioneers and disruptors in the legal space. Simply put, we pair attorneys with the perfect expert witnesses to win high-stakes cases and be the hero for the people,...

Care Management Nursing Consultant Job No: 540542 Work Type: Full-time Location: REMOTE OPTIONS, PHOENIX Categories: Healthcare/Medical Professional Level, Healthcare/Medical Support...

Thekey-2 is seeking Licensed Registered Nurses (RNs) for high-end private duty care in Los Angeles, California. Enjoy a flexible schedule as a 1099 independent contractor, providing personalized 1:1 care in patients' homes. Pay starts at $65/hr,...