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RN - Utilization Review Nurse | 3+ Years of Experience | Remote in IL | Contract Walker Healthforce is seeking a RN - Utilization Review Nurse with 3+ Years of Experience to support a Healthcare Payor Client based out of IL.

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 leading health solutions company is seeking a Care Manager-Registered Nurse in Connecticut. This role requires developing and coordinating care plans for members with multiple chronic conditions while ensuring effective telephonic engagement.

We believe everyone should have confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care...

Job Title: Prior Authorization NurseJob Description The Prior Authorization Nurse plays a critical role in analyzing prior authorization requests to determine the medical necessity of services and the appropriate level of care. This position...

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...

A leading healthcare organization is seeking a Utilization Management Nurse RN to review clinical data and support patient care from a remote setting. This role requires critical thinking and clinical expertise to ensure proper hospital admissions...

Job Description JOB SUMMARY Responsible for reviewing medical records to facilitate and obtain appropriate physician documentation for any clinical conditions or procedures to support the appropriate...

Description & Requirements Maximus is seeking a Registered Nurse, Clinical Assessor to join our growing team. As a Nurse Assessor, you will conduct person-centered assessments in accordance with contract directives,...

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure...

Immediate RN Clinical Consultant - ADA Medical Accommodation Review remote contract opportunity. This is a 100% remote/work from home position. Pay Rate: $85.00/hr Work Details: ...

A leading healthcare provider in Virginia is seeking a Registered Nurse Case Manager (RN) to join the team. The role is full-time, focusing on patient discharge planning, data analysis for care continuity, and collaboration with healthcare...

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...

Deep Roots. Solid Growth. Caring People. Rooted in Wyoming! We are Blue Cross Blue Shield Wyoming: a not-for-profit health insurer with offices throughout the state. Ever since a small group of caring,...

Job Description The Customer Success Nurse Consultant (CSNC) is responsible for ensuring post-go-live success for ICU Medical's full line of infusion devices and consumables. This role focuses on exceeding customer...

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...

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...

Clinical Nurse Liaison, RN 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...

JOIN TEAM TRILOGY: At Trilogy, you'll experience a caring, supportive community that values each team member. We prioritize meaningful relationships, genuine teamwork, and continuous growth. With the stability of...

A healthcare technology firm is seeking a Nurse Consultant with experience in adult health. This hybrid position involves creating detailed patient medical records and building relationships with providers. Ideal candidates possess at least three...

City/State Charlottesville, VA Work Shift First (Days) Overview: Sentara Martha Jefferson Hospital is hiring a Clinical Nurse Specialist for a Full-Time role in Charlottesville, VA. About the position: Reporting directly to the CNO, the Clinical...

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...

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...

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...

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...