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aitrainer is seeking a Remote Registered Nurse (RN) to conduct health screenings for a health study. This role involves remote assessments, eligibility determination, and scheduling onsite sessions, all while ensuring HIPAA compliance.

Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does...

Oscar Health is seeking a Utilization Review Nurse to join our team. You will review cases, verify medical records, and consult with care providers to assess treatment appropriateness using Oscar Clinical Guidelines, MCG, and InterQual. The...

Clinical Nurse Professional Development Educator Advanced 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...

Fully Remote : Clinical Documentation Specialist Job Description Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers.

Guidehealth is seeking a dedicated Registered Nurse (RN) to join as a Telehealth Medicare Annual Wellness Visit Specialist - PRN. In this remote role, you will conduct AWVs via telehealth under physician supervision, focusing on preventive care,...

To support healthcare operations, the onsite contract Arizona Licensed Nurse Reviewer will ensure excellent customer service, generate program reports, and participate in departmental procedure development.Key responsibilitiesEnsures timely and...

Employment Type: Full time Shift: Night Shift Description: Position Summary: Reviews assigned cases applying specific criteria and payor guidelines and communicates this review to...

Call Center: Telecare Registered Nurse (RN) (REMOTE) Mesa AZ Trending Job Info Job Identification 22455 Job Category Registered Nurse Posting Date 08/20/2024, 07:37 PM Locations 20 E Thomas...

Market leading managed care organization looking for hybrid RN Case Managers! Great opportunity, please call us today! Please note, must have active NJ RN licensure for this role. Location: Hybrid-working remotely and traveling...

Santa Barbara Cottage Hospital is seeking an experienced RN/LPN to perform remote clinical reviews for appeal cases. You will review medical records, apply InterQual criteria, and prepare clinical determinations for physician review. The...

Remote Prior Authorization Registered Nurse We are seeking experienced Registered Nurses (RNs) to join a remote Prior Authorization team supporting Dual Eligible (Medicare and Medicaid) populations. In this role, you will review...

Get AI-powered advice on this job and more exclusive features. This range is provided by The Judge Group. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range...

Job Description The Clinical Care Partner position plays a critical role by offering support and case management when employees and family members call for services. If you want to make a positive difference in the lives of others and...

CVS Health is seeking a remote RN Case Manager to support fully and self-insured clients across the United States. This telephonic role includes training and collaborating with care teams to assess benefits, apply guidelines, and plan care.

A healthcare staffing company is seeking a Clinical Review Nurse for Prior Authorization Review. This remote role demands conducting reviews, collaborating with healthcare teams, and ensuring compliance. Candidates need an active RN license and...

Employment Type: Full time Shift: Night Shift Description: Position Summary: Reviews assigned cases applying specific criteria and payor guidelines and communicates this review to...

Job Description This posting is for multiple openings of a Call Center Advice RN at The Nurse Advice Call Center in Brea, CA! We offer Part Time and Full Time positions, based on availability. Please ask at the time...

CVS Health is seeking an experienced Utilization Management Nurse Consultant for a fully remote role across EST or CST zones. You will coordinate and document UM activities, ensuring safe, appropriate care and adherence to timelines while working...

At St. Tammany Health System, delivering world-class healthcare close to home is our goal. That means we are committed to attracting and retaining the very best professionals for every position in our health system. We believe the pristine...

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry‑leading solutions to build an integrated care model that holistically addresses an individual's...

Berkshire Health Systems in Massachusetts seeks a Psychiatric ED Clinician to perform independent behavioral health assessments, crisis stabilization, and disposition planning within the Emergency Department. You will serve as a behavioral health...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

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...

Clinical Nurse Consultant At Bristol Myers Squibb, our employees often ask, "Who are you working for?"—a question that fuels collaboration, accountability, and urgency in our work. Our purpose-driven culture inspires us to discover,...