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Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to...

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...

*Quality Assurance Registered Nurse - 100% Remote* Contract duration: 520 hour contract to hire Training Schedule: M-F, 4-6 weeks *Contract Details* * *Contract Duration:* 520-hour contract-to-hire, long term opportunity *...

$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...

Provide high-quality clinical services within scope of practice and infection control standards. Coordinate care with other members of the patient/client's care team from admission to discharge. Complete clinical nursing assessments per...

Sharecare is the leading digital health company that helps people no matter where they are in their health journey unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is designed to help...

Enjoy what you do while contributing to a company that makes a difference in people's lives. Shady Grove Fertility, one of the premier fertility centers in the United States, continually seeks experienced, compassionate, and dynamic team players...

Explore opportunities with [agency name], a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best,...

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...

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...

Overview Experience the advantages of real career change Join Piedmont to move your career in the right direction. Stay for the diverse teams you'll love, a shared purpose, and...

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...

Join Our Caring Community: Help Us Prioritize Health The Pre-Authorization Nurse Specialist is responsible for reviewing prior authorization requests to ensure appropriate care and settings, adhering to established guidelines and...

Job Type Full-time Description Gateway Rehab Center (GRC) has an outstanding opportunity for a Nurse Liaison Gateway Rehab who will be responsible for the pre-admission case management, ASAM level of care assessment, and...

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic...

The RN Case Manager is responsible for coordinating continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical regime. Essential Duties and...

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 Care Manager...

divh2RN Care Review Clinician/h2pThe RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical...

Become a part of our caring community and help us put health first Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At...

Job Description RN Utilization Review at Irvine, CA. This position is Part- time and will work Remote 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern...

Job Description Under broad direction from the Centralized Utilization Management Manager, is responsible for the hospital-wide Utilization Management Programs in a general acute care hospital which serves infant, pediatric,...

Description Location: UCHealth UCHlth Anschutz Outpt Pavilion, US:CO:Aurora Department: Preprocedure Services Work Schedule: Full Time, 80.00 hours per pay period (2 weeks) Shift: Days Pay: $32.01 - $49.62 / hour. Pay is dependent on applicant's...

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...

Job Description Job Summary Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and...

divh2Job Summary/h2pThe RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance...