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You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh...

Title: QIC Part A Nurse Consultant Location: Remote Duration: 6 months contract (possible extension) Shift hours: 8:30 am - 5:00 pm (Monday - Friday) Pay Rate: $30.00/hr on w2 Essential Duties and...

CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to...

CompanyHighmark Inc.Job SummaryThis job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization, identification of...

POSITION SUMMARY: The Triage RN is responsible for assessing patient needs over the phone, providing medical advice, and directing patients to appropriate care based on their symptoms. This role involves critical thinking,...

Randstad Healthcare is hiring a Utilization Management Clinical Consultant - Registered Nurse ***Must be licensed as a RN in ARIZONA with a compact license to be considered*** The Utilization Management Clinical...

$40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical...

These roles involve patient care, including assessment, diagnosis, treatment, and follow-up. May work across various healthcare settings, such as hospitals, clinics, long-term care facilities, and community health organizations. Responsibilities...

Job Description Job Description Job Summary Performs focused clinical reviews of inpatient and outpatient claims to verify that coded diagnoses, procedures, revenue codes, and...

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to...

Salary : $82,409.60 - $108,160.00 Annually Location : Throughout San Bernardino County, CA Job Type: Full-time Remote Employment: Flexible/Hybrid Job...

Job Summary: The Clinical Nurse Educator is responsible for assisting in identifying learning and development needs for clinical staff. Assesses competencies, need for additional training and education, and develops and delivers...

Introduction Are you a Registered Nurse, currently employed with DDS who is looking to grow within your career in state service? If so, we invite you to explore this internal opportunity! The State of Connecticut,...

Department BSD OBG - Gyn Onc About the Department The Section of Gynecologic Oncology is a part of the Department of Obstetrics and Gynecology. The Section is comprised of 12 faculty physicians, 7 advanced practice...

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...

DescriptionDirector of NursingLocation: Oakleaf Village and The Grove ColumbusJob Type: Full timePay Rate: up to $100k plus bonusMake a DifferenceAnd Own Your FutureAt Wallick Senior Living, our team understands that senior living is not just a...

ABOUT SIMMONS Located in Boston's historic Fenway area, Simmons University has a strong tradition of empowering women and challenging traditional gender roles. Simmons was founded for equality 125 years ago as one of the first higher...

Carries out communicable disease surveillance, prevention, and control measures for the City of Boston. Investigates reports of communicable diseases including pathogens of public health importance, reported outbreaks, or other...

UTILIZATION REVIEW NURSE HYBRID, must be able to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470 EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At Umpqua Health, we're more than...

This is a hybrid role based in West Hills, CA ACTIVE LVN or RN license required Key Responsibilities: Audit denied provider and member claims for accuracy and compliance...

Healthfirst is New York City's largest not-for-profit health insurer, dedicated to improving health through community-driven, value-based care. For over 30 years, we have led the shift from volume to value by focusing on better outcomes,...

Overview $5,000 sign-on bonus and $5,000 relocation (for greater than 100 miles) or $2,500 relocation (for greater than 50 miles) for nurses with 1 or more years experience - External...

Location: Avera McKennan Hospital Worker Type: Regular Work Shift: Rotating days/evenings ights/weekends/holidays (United States of America) Pay Range: The pay range for...

Founded in 1999 and headquartered in Central Ohio, we're a privately‑owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity of healthcare alone, and we're on a mission to...

Job Title: Utilization Management Nurse - Behavioral Health Focus (Remote) Time Zone Preference: Pacific or Mountain Time Zone is preferred Work Schedule: Tuesday through...