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Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The...

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, innovate with purpose, hold...

Job title Care Manager - Temporary Classification Non-Exempt Reports to Senior Operations Manager We care about our customers. We care about our employees. We are transparent.

Explore opportunities with Apex Home Healthcare, 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...

JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the...

Job Description We're on a journey to advance how health happens with technologies that empower patients, support clinicians, inspire innovation, and save lives. Our mission? To create a human-centric...

Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately...

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...

City/State Lynchburg, VA Work Shift First (Days) Overview: Sentara Healthcare is currently hiring an Integrated Nurse Case Manager for Charlottesville & Roanoke Virginia...

Overview About us: Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon...

JOB SUMMARY The Utilization Review (UR) Nurse is a registered nurse who provides clinical review against nationally recognized medical necessity criteria for the purpose of evaluating medical necessity or hospitalization...

Fully Remote : Clinical Documentation Specialist Job Description Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers.

Randstad Healthcare is hiring for a Utilization Management Clinical Consultant - Registered Nurse to work remotely. ***Must be licensed as a RN in Arizona or hold a compact license to be considered*** The Utilization...

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach...

Join BoldAge PACE and...

About Us : Signature HealthCARE of Terre Haute, a 176-bed facility. It is our mission as a family-based organization to revolutionize the long-term care industry through a culture...

Overview Otterbein is a not-for-profit, faith-based ministry that is a national leader and innovator in retirement living communities and long-term care. Otterbein is seeking a *Universal Hospice RN,* to assist in the growth of our Universal...

Responsive recruiter Benefits: Flexible schedule Position Summary Boost Home Healthcare is seeking a motivated Clinical Manager (RN) to help build and lead our clinical...

Registered Nurse Job Type: Full Time/Parttime Shift: Nights 36 hour weeks (12 hour...

Department BSD OBG - Gyn Onc About the Department The Section of Gynecologic Oncology is a part of the Department of Obstetrics and Gynecology. The Section is comprised of 12 faculty physicians, 7 advanced practice...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job...

Assured Nursing is seeking a travel nurse RN OR - Operating Room for a travel nursing job in Columbus, Ohio. Job Description & RequirementsSpecialty: OR - Operating...

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...

A bit about us: We are a multi-disciplinary practice that provides integrated primary care, dental, and mental health. We are looking for an experienced RN Care Manager to join a dynamic team. Want learn more?

Site: Martha's Vineyard Hospital, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit,...