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Remote Clinical Review Nurse – Prior Authorization Location: Must be located in Central or Eastern time zones Employment Type: Full‑Time About the Role We are seeking an experienced Registered Nurse to join our team...

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

RN Clinical Appeals Nurse Job Summary: The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory...

What You'll Do: The Bureau of Infectious Diseases is seeking an Immunization Nurse Consultant to serve as the statewide expert on immunizations & vaccine-preventable diseases. This position will monitor & evaluate...

A healthcare provider is looking for an RN Coordinator Utilization Management to evaluate authorization requests and ensure proper care procedures. The position requires a current nursing license in Wisconsin and a minimum of four years of...

A healthcare organization is hiring a Remote Registered Nurse to provide care under the guidance of healthcare providers. Responsibilities include completing nursing workflows, ensuring safe patient care, and utilizing technology for...

Company Overview: Join an innovative startup health plan based in Wisconsin that is revolutionizing healthcare and empowering companies to combat the relentless rise in healthcare costs. Our mission is to provide accessible, high-quality...

Overview Contract role - 8/8/23-12/31/23, with possible extension Pay rate: $50-$65 Hourly Location: Remote IL Required License: RN, LCSW, LCPC Basic function: This position is responsible for discharge care...

A healthcare insurance provider is seeking a qualified individual for a clinical oversight role in Phoenix, AZ. The position requires significant clinical experience, including work with Medicaid/Medicare, and offers a hybrid work model.

Per Diem Emergency Department Based Rn Case Manager This position is a per diem role, providing department coverage and cross trained to cover utilization review and discharge planning as needed. It is eligible for the per diem...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: The Virtual Mental Health Intake RN is a Registered Nurse who provides competent and...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Leigh Hospital located in Norfolk, VA, is seeking a RN, Quality Improvement Coordinator! This is a full-time 40 hour per week day shift position. The Quality Improvement Coordinator...

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...

Description Leads the alignment, standardization and ongoing improvement of ministry length of stay for designated patient populations. Serves as designated ministry liaison with providers and ministry Care Coordination teams, to move patients...

Shift: Option of 5 8-hour shifts OR 4 10-hour shifts per week Location: Candidates in Texas, Tennessee, and Kansas preferred; PST, MST, CST time zones preferred Virtual: This role...

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 company, we reach millions of...

A healthcare management firm is seeking a Medical Review and Appeals RN. This remote role involves reviewing and authorizing medical service requests, ensuring compliance with regulations, and implementing discharge planning. Candidates must have...

A leading health care provider is seeking a Care Manager III based in Chicago, Illinois. This full-time position involves providing care coordination to members through telephonic and field-based management. Candidates must possess a valid nursing...

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

Part-Time Utilization Review Nurse Remote (Nevada License Required) Location: Remote (Reporting to Carson City, NV) Schedule: MondayFriday, 8:00 AM12:00 PM PST Compensation: $40,000$45,000 annually (part-time, 20 hours/week)...

A healthcare organization in California is seeking an RN, Clinical Care Manager I to enhance member care through assessment and coordination. Applicants should have a Bachelor's Degree in a health-related field and an active RN license. The role...

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

Remote Registered Nurse (RN) Case Manager Join to apply for the Remote Registered Nurse (RN) Case Manager role at PharmaCord We are looking for dedicated nurses to provide patient support services from the comfort of...

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

A healthcare services organization is seeking an Operations Leadership Support Specialist to provide onsite or remote support based on agency needs. The candidate must have current RN licensure and at least 1 year of experience in home health...