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CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to...

HEDIS Data Reviewer Philadelphia PA Duration 3 months Hybrid - 3 days OnsiteSchedule from 8 am -5:30 pm EST, Monday - Friday, some weekend work may be required Under the direction of the Manager...

Requires home visits throughout the City of Los Angeles, including San Fernando valley, Santa Clarita valley, Palmdale and Lancaster. Education: Associates or Bachelors of Science degree in nursing required. Experience:...

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 Title: Nurse Liaison I - UM & QR Locations: Remote Role, IL 60563 Job Duration: 6 Months+ contract (possibility of extension) Schedule: Monday - Friday,...

Duration: 3 months contract with possible extension Location: Philadelphia PA 19113(Hybrid- Schedule from 8 am - 5:30 pm EST, Monday - Friday, some weekend work may be required) Job...

Medical Solutions is seeking a local contract nurse RN Post Partum for a local contract nursing job in Columbus, Ohio. Job Description & Requirements Specialty: Post Partum Discipline: RN Duration: 13 weeks 36 hours per week Shift: 12 hours, days...

A national health insurance company is seeking a Prior Authorization RN to review clinical appropriateness of prior authorization requests. This role is pivotal in ensuring compliance with Medicare and Medicaid criteria, while improving the...

*Employment Type:* Full time *Shift:* Day Shift *Description:* **Why Mount Carmel?** With five [hospitals]( over [60 free-standing outpatient clinics]( a [college of nursing]( a [Medicare Advantage plan]( and extensive outreach and...

Clinical Administration Position at St Jude Medical Center Leads the alignment, standardization and ongoing improvement of ministry length of stay for designated patient populations. Serves as designated ministry liaison with providers...

Care Coordinators (LPN) (LVN) CareHarmony's Care Coordinators (LPN) (LVN) work comprehensively with providers to deliver value-based care management initiatives for their patients. CareHarmony is seeking an experienced Licensed...

Description Who we are Founded in 1999 and headquartered in Central Ohio, we're a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity...

JOIN TEAM TRILOGY Do you have excellent clinical skills and a commitment to customer service? We offer an exciting opportunity to use your skills in a purpose-focused and rewarding environment. ...

Job Opportunity at Highmark Inc. This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization,...

Join BoldAge PACE and Make a...

Job Type Full-time Description WESTSIDE IS LOOKING FOR A NURSE / RN TO JOIN THE VIRTUAL NURSE TEAM! SIGN ON BONUS OFFERED! LOAN PAYOFF PROGRAMS...

RN Health Care Facility Surveyor - Remote Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting...

A growing healthcare provider in Texas is seeking a compassionate Registered Nurse (RN) to provide after-hours triage support for hospice patients. This remote role requires an active multistate RN license, with preference for candidates...

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an...

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.

Summary Responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. Assesses, plans, implements, and evaluates care based on age specific components. Assumes responsibility for the...

Requirements Qualifications / Experience Current multi-state RN license with no restrictions; nurses currently holding a single-state RN license must obtain a multi-state license prior to being made a job...

The range for this role is $25.00 to $34.13/hr Actual base pay will be determined based on a successful candidate's work location, skills/abilities, experience, and education. Interested...

HJ Staffing is seeking a highly detail-oriented HEDIS Data Reviewer to join our team in support of Impresiv Health. Working under the direction of the Manager of Medical Record Review Operations, you...

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...