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Job Description: • Participates in the development and ongoing implementation of QM Work Plan activities. • Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet...

Current Employees: If you are currently employed at any of the Universities of Wisconsin, log in to Workday to apply through the internal application process. Job Category: Academic Staff...

Description & Requirements Be part of something great Maximus is a global organisation that specialises in providing health and employment services to millions of people every year. Here in the UK we employ...

Registered Nurse Case Review Specialist Position is Remote/Nationwide Job Summary STGi is currently seeking a Registered Nurse Case Review Specialist. The position is remote and open to candidates nationwide. Provides direct...

Registered Nurses are encouraged to consider a part-time remote Nurse Reviewer position with Liberty Healthcare Corporation. Liberty Healthcare operates a statewide program in Idaho which assesses children and adults who are living with...

Dept: Quality and Provider Ed ****Looking for a registered nurse in the Grand Rapids or northern Michigan (lower peninsula) area. Most work will be remote from home and/or traveling, however, there are occasions contractor will need to...

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...

Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The...

Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This position is remote. Candidates must be local...

Baptist Health is the regions largest not-for-profit healthcare organization, with 12 hospitals, over 28,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward...

In order to have an accurate count of participants, we need you to register for the Recruitment Fair on the District's website. Please select "apply for this position" under the heading to the right labeled "Apply Now". Interviews slots will fill up...

Overview The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in...

About the job Registered Nurse - Remote Company Overview: Confident Staff Solutions is a leading staffing agency in the healthcare industry, specializing in providing top talent to healthcare organizations across the country. Our...

Requirements Qualifications / Experience Current multi-state RN license with no restrictions; nurses currently holding a single-state RN license must obtain a multi-state license prior to being made a job...

Description As an RN Care Manager, you will function as a clinician, advocate, and educator to achieve optimal clinical and quality outcomes by effectively managing care and resources to reduce unnecessary utilization. The RN...

A leading healthcare organization is seeking a Prior Authorization RN to join its team. This role entails reviewing prior authorization requests to ensure medical necessity and compliance with Medicare and Medicaid guidelines. Applicants should...

A healthcare organization is seeking a Registered Nurse Care Manager to provide member-centric case management services. This role includes conducting assessments and care coordination while ensuring that health needs are met through effective...

A leading health insurance provider is seeking a Managed Care Coordinator I to join their team. This fully remote position requires you to review and evaluate medical eligibility regarding benefits and clinical criteria. Candidates must have an...

A prominent healthcare provider is seeking a Nurse Reviewer I for a virtual position responsible for conducting reviews of diagnostic imaging services. The ideal candidate should possess an AS in nursing and clinical nursing experience, alongside...

JOIN TEAM TRILOGY - Do you have excellent clinical skills and a commitment to customer service? We offer an exciting opportunity to use your skills in a purpose-focused and rewarding environment. The Area Assessment Support provides assessment...

A community-focused healthcare organization in Bloomfield, CT is seeking a Registered Nurse to provide individualized care to individuals with intellectual and developmental disabilities. This part-time hybrid role offers $37.00 per hour, flexible...

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture,...

A healthcare provider is seeking a Medicare UM Case Manager, RN, to perform utilization management activities for Medicare Advantage. This remote role focuses on reviewing authorizations for various services and requires an Associate's Degree in...

A leading healthcare provider is urgently seeking experienced Clinical Documentation Specialists for remote positions. Ideal candidates must be RN graduates from an approved nursing program and possess prior CDI experience, preferably in acute...

$40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical...