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CVS Health Job Opportunity 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...

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus — a rejuvenating place for associates...

Utilization Management Position Provide health care services regarding admissions, case management, discharge planning and utilization review. Review admissions and service requests within assigned unit for prospective, concurrent...

Remote Rn – Medical Claims Reviewer At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled...

Urgent Hiring for "Remote Clinical Review Nurses" Job Description: Review approximately 20 cases a day for medical necessity. Advocate for and protect members from unnecessary hospital...

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,...

RN Utilization Mgmt Full-Time Day POSITION SUMMARY The RN Utilization Management (RN UM) functions as a support liaisons for a variety of UM functions which may include: the e-TAR process, denials management,...

Blind Childrens Center Inc in Los Angeles seeks a Registered Nurse Consultant to provide pediatric nursing and health training. Responsibilities include conducting health screenings and developing health plans for children.The ideal candidate...

Join Us At CVS Health 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 deeply,...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Care Management Nursing Consultant Job No: 540542 Work Type: Full-time Location: REMOTE OPTIONS, PHOENIX Categories: Healthcare/Medical Professional Level, Healthcare/Medical Support...

Admissions Nurse The Admissions RN is a registered nurse and an Interdisciplinary Team member whose primary responsibility is to present VITAS services and philosophy to patients and families in a manner that results in the admission of...

JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include gathering, analyzing and providing date for regulatory...

Payrate: $60.00 - $62.00/hr. Summary: The main function of the nurse is to provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and...

Minimum QualificationsCitizen of the United StatesProficient in written and spoken EnglishParticipation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP)Preferred...

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health...

Please contact: To discuss this amazing opportunity, reach out to our Talent Acquisition Specialist Nikhil Jhajharia at email address [email protected] can be reached on # 630-576-1935. We have...

Elevance Health is seeking a Nurse Appeals RN to work virtually full-time, with in-person training required. The role involves investigating medical necessity appeals requests and requires a high school diploma and 2+ years of managed care...

Remote Rn Mds Consultant-Full Time Engage Consulting is seeking an experienced Registered Nurse (RN) with strong MDS, Case Mix, and Quality Measure experience to join our team. This is a fully remote opportunity for a detail-oriented...

Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical...

Prior Authorization RN - Contract Role Location Requirement: Candidate must reside in NJ, PA, NY, CT, or MD Work Model: WFH, but must be able...

A healthcare staffing agency is looking for a Travel Nurse RN Clinical Document Improvement Specialist based in Tarzana, California. The role involves managing patient complaints, providing clinical oversight, and performing medical record...

Job Description Health Advocates Network is currently seeking a Registered Nurse to work at a facility in Los Angeles, California. These are registry positions with our company.

Telephonic Triage And Document Review Services Provides telephonic triage and document review services that require clinical judgement and interpretation and acts as a liaison between the patient, care team(s), and their primary care...

Job Summary: In addition to the responsibilities listed below, this position is also responsible for applying advanced clinical and regulatory knowledge of evidence-based guidelines, insurance policies, and clinical criteria to consult on...