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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...

Clinical Review Nurse Duals Program Details- Brand new program of 2026 for Centene Duals = Medicare + Medicaid line of business. Members have one combined card and one authorization covering both benefit types. The duals...

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:...

Providing clinical review support on an as-needed basis, the part-time PRN Clinical Review Specialist will review medical records for medical necessity, level of care, and authorization compliance while ensuring timely appeal submissions and...

Nurse Reviewer Appeals and Hearings- Remote It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We...

Nursing Assistant - Medical Surgical at Providence Little Company of Mary Torrance in Torrance, CA. This position is Full Time and will work 12-hour, Day shifts. Providence Little Company of Mary in Torrance is celebrated in 2025 as one of Americas...

Job Opportunity At CVS Health 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...

WE ARE TITANIUM HEALTHCARE Titanium is a healthcare company that puts heart and compassion above all else. Millions of Americans just aren't getting the medical care they need. We're on a mission to change that. For patients that means...

The Bed Control Coordinator RN oversees patient throughput in the hospital(s). The key roles and functions of this position are to optimize hospital bed capacity by matching patients' clinical needs with available patient care units, coordinating...

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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...

In collaboration with the interdisciplinary team, the Case Manager provides care coordination services evaluating options and services required to meet an individual's health care needs to promote cost-effective, quality outcomes. Serves as a...

Pacificare Health Management is seeking a Nurse Consultant in Los Angeles, CA to provide support for long-term care facilities, ensuring compliance with regulatory standards. The role requires a Bachelor's degree in Nursing, with at least 5 years...

Registered Nurse Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland. The Center for...

RN Clinical Documentation Improvement Specialist This is a REMOTE opportunity Your experience matters: Frye Regional Medical Center, located in the beautiful foothills of North Carolina is a 355-bed acute care hospital,...

RN Clinical Consultant The RN Clinical Consultant serves as a clinical resource for the investigation and assessment of medical information regarding disability by providing comprehensive medical reviews and analysis of long-term and or...

Care Management Orthopedic Navigation Program Allina Health is a not-for-profit health system that cares for individuals, families and communities throughout Minnesota and western Wisconsin. If you value putting patients first, consider a...

Job Description: Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical...

In this role, you will provide direct nursing care, infusion therapy and documentation to patients in the Community Oncology Practice. Major functions include: patient assessment, patient evaluation and preparation and administration of...

Description Location: UCHealth Anschutz Outpatient Pavilion - Aurora, CO Department: Hospital Based Sub-Specialty Work Schedule: Full Time, 80.00 hours per pay period (2 weeks) Shift: Days Pay: $38.91 - $60.31 / hour. Pay is dependent on...

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 join a...

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RN Health Care Facility Surveyor - Louisiana Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting...

The Clinical Nurse Partner is responsible for assigned patient care tasks under the direct supervision of licensed care providers. Transports medications and requests to and from Pharmacy/ Nurse on a non-routine basis when necessary. Job...

Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho or Utah *Please be advised that this role is part of our candidate pool, which allows us to identify and attract...