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Seeking a California Licensed UM Nurse for a full-time remote position, who will review prior authorization requests for medical necessity, apply CMS and Milliman Care Guidelines, and collaborate with providers to ensure high-quality care, working...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing and evaluating care of patients. The Clinic RN utilizes the nursing process by use of...

Work From Home Nurse Practitioner – Telehealth Women's Health | $125K+2 days ago Be among the first 25 applicantsThis range is provided by NPHire. Your actual pay will be based on your skills and experience — talk with your recruiter to learn...

Pager Health℠ redefines how members navigate to care and wellness, validated by clinicians and powered by AI. We connect people to the right care at the right time, closing care gaps, reducing total cost of care, and...

The Utilization Review Clinician is responsible for reviewing medical records to determine medical necessity. This includes conducting patient evaluations, managing admissions and informational visits, and ensuring timely...

Townsen Memorial is looking for a full time Registered Nurse, PAT to join our team remotely ! Must reside in Texas. SUMMARY The Registered Nurse, Pre‑Admission Testing (PAT) is responsible for...

Harris Health System, Inc. is seeking a Nurse Manager to oversee the operational management of clinics and delivery of care. This role involves managing quality, human resources, and financial aspects of the clinics while collaborating with...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.Patient...

Qualifications VA Health Professional Trainees (HPT) pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. A HPT is an individual...

Clinical Quality Assurance Specialist (Remote) Contract‑to‑Hire | RN: $28.50/hr | LPN: $26.50/hr (Non‑Negotiable) Location: 100% Remote About the Role Network Medical Review Company is seeking an entry‑level...

CVS Health Quality Management Project Manager 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...

RN Education Development Specialist, Comprehensive Care Advocacy HealthPartners is hiring an RN Education Development Specialist, Comprehensive Care Advocacy. This position is responsible for onboarding new employees during department...

We are so glad you are interested in joining Sutter Health! Position Overview: Aids patients in obtaining the correct level of care with the appropriate provider at the right time. Provides advance clinical telephone support to...

Description Location: UCHealth Anschutz Inpatient Pavilion, US:CO:Aurora Department: OR Operating Room AIP Work Schedule: Full Time, 80.00 hours per pay period (2 weeks) Shift: Nights Pay: $38.91 - $60.31 / hour. Pay is dependent on applicant's...

Job Description Effect change daily! At Cedars-Sinai, the work you do every day directly affects others' lives. Our passionate and dedicated culture has earned us six Magnet designations for nursing excellence. Join us and...

Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff...

Nurse Case Management Senior Analyst | Remote | Contract Walker Healthforce is seeking a Nurse Case Management Senior Analyst with 2 years of experience. This is a Contract opportunity.

Clinical Review Nurse (Remote) We are seeking a detail-oriented and clinically skilled Clinical Review Nurse to join our team in a fully remote role. The Clinical Review Nurse is responsible for conducting medical necessity reviews,...

Job Opportunity Responsible for triaging incoming patient referrals, assessing needs, giving appropriate clinical dispositions and facilitating referrals to WVU Medicine primary care and specialty care providers. This position will...

To support coding accuracy and clinical documentation integrity, the fully remote HCC Clinical Documentation Specialist will validate chronic conditions, perform prospective reviews of medical records, and utilize Epic to ensure accurate HCC...

Telephonic RN Case Manager 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...

PUBLIC HEALTH NURSE / EMERGENCY APPOINTMENT Print ( Apply  PUBLIC HEALTH NURSE / EMERGENCY APPOINTMENT Salary $105,247.44 - $157,542.24 Annually Location Los Angeles County, CA Job...

Registered Nurse - Case Management Duration: 13 Weeks Start: 03/10/2025 Job Type: Travel Minimum Guaranteed Hours: 40 Jobs Notes: Day Shift, inpatient RN CM Acute hospital experience, Day shift – 0800-1630, Monday through Friday, every...

*Lahey Clinic | Beth Israel Lahey Health* Londonderry, NH | Full-Time, Hybrid (3 days in-person / 2 days remote) *About the Role* Join our collaborative team of physicians, APPs, behavioral health specialists, and registered dietitians dedicated...

Clinical Care Nurse Educator Become a part of our caring community The Clinical Care Nurse Educator plans, directs, coordinates, evaluates, develops, and/or delivers training and education programs for professional nursing...