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CVS Aetna Appeals Nurse Consultant 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...

Registered Nurse (RN) - Utilization Management 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...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse. The Utilization Review Nurse is...

Title: Clinical Review Nurse Concurrent Review Location: Remote Duration: 12 months (Potential Extension) Schedule: Mon-Friday, 11AM to 8pm CST; Weekends and Holidays on a rotation basis based on...

*Job Summary and Responsibilities* As our Director Nursing Perioperative Services at California Hospital, you will be responsible for Surgical Services including Main OR, Pre-Op, PACU, GI, and SPD. We have 7 operating rooms and a robust surgical...

Nurse - Clinical Review The Clinical Review Nurse makes prospective medical necessity determinations on prior authorization requests for HealthHelp's specialty programs, including Diagnostic Imaging, Cardiology, Musculoskeletal, Physical...

*Job Summary and Responsibilities* As our Charge Nurse, you'll oversee a department of frontline nurses caring for patients. Your previous experience in acute care, LTC, or nursing homes adds tremendous value to our nursing team. Every day...

Nurse Consultant I (NS) The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health,...

Agency Dept of Health and Human Services Division Health Service Regulation Job Classification Title Nurse Consultant II (NS) Position Number 65026151 Grade MH17...

Clinical Integrity Documentation Specialist Location: Remote Facility: Ascension Wisconsin Hospitals Department: Clinical Integrity Documentation Schedule: Days | Full-Time Salary Range: $79,511.52-$110,834.59...

Job Title Conducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital...

CVS Health Nursing Position 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...

Job Title This position is fully remote, however, you must reside in the State of Texas. The position is a contract for about 6 months. RN working in the insurance or managed care industry using medically accepted criteria to validate the...

Why This Role Matters Every determination you make decides whether a member gets the care they need, when they need it. This role sits at the exact point where clinical judgment meets real-world impact, translating evidence-based criteria...

Please make sure to complete all the questions in the application and continue through to the end in order to sign and submit it. The preferred work hours are 8:30 am / 9 am - 5 pm / 5:30 pm central time...

Claims Medical Review Nursing Consultant Job No: 544045 Work Type: Full-time Location: REMOTE OPTIONS, VARIOUS-STATEWIDE, PHOENIX Categories: Healthcare/Medical Support Level,...

SHIFT: Any (United States of America) Seeking Breakthrough Makers Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will...

Summary VA Greater Los Angeles Healthcare System (VAGLAHS) is seeking to hire experienced Registered Nurses to work in our Case Management/Care Coordination Program. The Case Manager provides patient centered care with expertise in the...

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 know you've honed your career in a fast-moving...

Job Title Real Job *Works with any department, if a patient complaint arises* *Experience in Critical Care or ED is a plus* *Weekends will not typically be required unless survey is on site* *2 years experience required, hard stop* *First...

RN, Regional Advice, Part Time, Nights (Must Reside in Oregon/Washington) Primary Location Portland, Oregon Employee Status: Regular Schedule Part-time Scheduled Weekly Hours: 28 Shift Night Salary $56.74 - $84.16 / hour Job Number...

Health Screener The primary responsibility of the Health Screener is to provide coverage in the field ensuring that health screenings are completed accurately and on time. Maintain a safe and professional environment for clients and...

At Virtua Health, we exist for one reason - to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists,...

Job Title This is a remote position but will need onsite training in Mishawaka Indiana. Shift: Days - 8 hr shift LOCAL CANDIDATES ONLY! Why Choose Saint Joseph Health System? At Saint Joseph Health System, our values guide...

*Job Summary and Responsibilities* As our Registered Nurse (RN), you will be a pivotal healthcare professional, delivering compassionate, high-quality care that truly impacts our patients' well-being and recovery. Every day, you will...