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Clinical Appeals Nurse The Remote Clinical Denials/Appeals Nurse will be directly responsible for securing pre-service approvals, and reviewing pre/post service denials, medical necessity review and completing appeals and/or coordinating...

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...

Description The on-call HEDIS Clinical Audit Coordinator is responsible for conducting clinical quality audits for the Quality Department. The auditor identifies and coordinates clinical audits to determine potential areas...

Vetted is seeking a RN - Clinical for a travel job in Columbus, Ohio. The job was posted 2 days ago. The assignment starts on Jan 12 and is 13 weeks long with 8 hour shifts 5 days a week.You must live 60 miles away from the facility in order to get...

ResPro Health is dedicated to providing our partners in the respiratory space with the tools and resources needed to implement meaningful programs like remote patient monitoring and chronic care management in their pulmonary practices. With a...

Vetted is seeking a RN - Clinical for a travel job in Columbus, Ohio. The job was posted 2 days ago. The assignment starts on Jan 12 and is 13 weeks long with 8 hour shifts 5 days a week.You must live 60 miles away from the facility in order to get...

Description RN Utilization Review at Providence Holy Cross Medical Center in Mission Hills, CA. This position is Part- time and will work 8-hour, Day shifts. Providence Holy Cross Medical Center is...

UnitedHealthcare Health Care Reviewer At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people...

Job Details Job Location Orange, CA - Orange, CA Remote Type Fully Remote Position Type Full Time Salary Range $45.00 - $45.00 Hourly Travel Percentage None...

Registered Nurse (Specialty Phone Triage) - Remote Opportunity Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years! We are one of central Texas' largest professional medical groups with...

Function as a member of a self-directed team to meet specific individual and team performance metrics. Ability to communicate in writing and verbally, all types of benefit determinations including decisions regarding coverage guidelines,...

Telephonic Case Manager At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions...

Unit Description: The Primary Nurse in Ambulatory Oncology serves as a pivotal member of the patients' multidisciplinary team, coordinating care across the continuum. Key aspects of this role include telephone triage of acute illness, ongoing...

A national risk management provider is seeking a remote Utilization Review Case Manager. This role involves gathering clinical information, certifying medical necessity, and managing stakeholder communications. Ideal candidates will have a nursing...

Soleo Health is seeking a Per Diem Infusion Nurse to support our infusion patients in the Sunbury, OH and surrounding areas . Join us in Simplifying Complex Care! **This position...

Ardor Health Solutions is seeking a travel nurse RN Home Health for a travel nursing job in Columbus, Ohio. Job Description & RequirementsSpecialty: Home...

LeaderStat is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Columbus, Ohio. Job Description & RequirementsSpecialty: ED - Emergency...

Registered Nurse, Clinical Assessor Maximus is seeking a Registered Nurse, Clinical Assessor to join our growing team. As a Nurse Assessor, you will conduct person-centered assessments in accordance with contract directives, company...

Company Overview : Dozee Health AI is the pioneer in Contactless Remote Patient Monitoring (RPM), proven to drive transformation at scale. Headquartered in Bengaluru, India, Dozee has emerged as India's no. 1 RPM Company. We are seeking...

A home health care provider in San Diego is seeking a passionate Registered Nurse (RN) to lead Quality Assurance and Performance Improvement (QAPI) efforts. The role offers flexible schedules and is focused on enhancing patient care quality at...

Join a Leading Healthcare Client team in Akron, OH for a rewarding Travel RN Psych contract! Competitive pay, full support, and multiple bonus opportunities. Location: Akron,...

This is a remote role. CircleLink Health is looking for passionate, tech savvy registered nurses to work remotely and serve patients enrolled in Medicare's Chronic Care Management Program. In this part time role...

Telephonic Case Manager At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions...

A leading care provider is seeking a Registered Nurse - Quality Assurance to oversee audits and ensure high-quality standards in care. The ideal candidate will hold a valid RN licensure, have at least two years of nursing experience, and possess...

Nurse Appeals -Licensed Nurse Location : Ohio, candidates must be residents of Ohio to be considered. Hybrid 1 : This role requires associates to be in-office 1-2 days per week,...