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Santa Barbara Cottage Hospital is seeking a QIC Part A Nurse Consultant for a remote six-month assignment. The role focuses on reviewing determinations and rendering medical necessity decisions for Medicare State East cases, while resolving...

Exceptional care starts with exceptional people. For us, this is more than a job– it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you...

Case Manager Utilization RNWorks 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 not meet the...

Elevance Health in Florida is seeking a Medical Management Nurse to review complex cases, apply nursing judgment, and determine medical necessity for services. This role combines remote work with required in-person training sessions and periodic...

Teleperformance is seeking a Healthcare Customer Service Representative to handle inquiries via phone, email, chat, and social media. The role focuses on de-escalation, issue resolution, and proactive payment processing while maintaining quality...

MaziCTools is seeking a Freelance Utilization Management Nurse Consultant to work remotely in the United States. This full-time role requires an active RN licensure and 3+ years of clinical experience. Responsibilities include assessing healthcare...

WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of...

Public Health Nurse Employer: County of Los Angeles Salary: $105,247.44 - $157,542.24 Annually Location: Los Angeles County, CA Job Type: Full time Job Number: PH5230H Department: PUBLIC HEALTH...

Healthcare Management Solutions, LLC is seeking experienced CHSD Audit reviewers to conduct independent medical record reviews for the STS CHSD program. This remote, part-time role focuses on data accuracy, source verification, and adherence to...

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...

Turing is looking for candidates who have solid experience in nursing care, patient assessment, and clinical documentation, particularly at the level expected for licensed registered nurses working in hospital or outpatient care...

Nurse Consultant/ Regional Director Of Clinical Operations Relocation to Southern New Mexico is required. The Nurse Consultant/ Regional Director of Clinical Operations position is comprised of two essential objectives; to partner...

Job Description This position will be supporting Oregon Home Infusion Pharmacy. The Home Infusion Clinical Liaison position is responsible for creating and maintaining positive referral relationships in order to...

Nurse Consultant Polaris Group, the SNF Clinical branch of Assembly Health, is seeking a dynamic, client-focused Nurse Consultant. We are looking for a clinically trained professional who stays current on federal and state regulations,...

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...

CVS Health is seeking a licensed RN Case Manager to work remotely across the United States, conducting telephonic case management for fully insured and self-insured clients with clinical judgment and collaboration with care teams. The role...

Leveraging clinical expertise, the fully remote Multi Benefit Services RN Consultant in Wisconsin will review Medicaid prior authorization requests, determine medical necessity, and support providers while ensuring compliance with state policy...

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...

Alliance Liaison If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One! We strive to be an employer of choice and establish a reputation for being a talent rich organization where...

Relocation to Southern New Mexico is required. The Nurse Consultant/ Regional Director of Clinical Operations position is comprised of two essential objectives; to partner with facilities as the primary clinical resource in...

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...

PIH Health Downey Hospital is seeking an RN Case Manager to guide patients from pre-admission through post-discharge, ensuring smooth transitions and appropriate utilization of hospital services.You will focus on maximizing reimbursement from...

BCBST BlueCross BlueShield of Tennessee, Inc. is hiring an Appeals & Grievance Nurse Analyst to review and process member and provider appeals, ensuring timely and compliant resolutions under CMS, Medicare, and TennCare guidelines. The role...

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...

Connect America is seeking a Remote Care Nurse II to deliver high-quality nursing care to patients in a remote setting via telehealth. You will perform remote assessments, develop care plans, and coordinate with a multidisciplinary team to improve...