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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 to New England States for...

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...

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...

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

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...

Complex Medicare Claims Review Complex Medicare claims/prior authorization requests require the review of medical record documentation to determine the reasonableness and necessity of the billed service in accordance with Medicare rules...

The University of Southern California is seeking a Nurse Manager responsible for 24-hour accountability for patient care and operational efficiency. The ideal candidate will lead the nursing staff, promote effective communication, and ensure...

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...

Wellness Nurse Consultant Wellness Nurse Consultant Field: This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office...

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,...

Overview Performs inpatient chart review to determine appropriate DRG assignment and assures appropriate documentation in the chart to support clinical care provided, including severity of illness and risk of mortality which...

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,...

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...

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...

West Coast University is looking for a Nursing Academic Specialist in Los Angeles, California. In this role, you will guide nursing students, enhancing their educational experience through targeted support and collaboration with faculty.

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...

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,...

The purpose of your job position as Care Coordinator Nurse is to provide direct nursing care to residents, including the coordination of care that is safe, timely, effective, efficient, equitable, and resident-centered. You are responsible for...

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...

Your RoleThe Clinical Quality Team is responsible for reviewing and abstracting medical records to capture data and to ensure accuracy and completeness. The Clinical Quality Reviewer - Nurse, Senior will report to the Manager, Clinical Quality...

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...

Bristol Hospice seeks an Admissions RN in Lakewood, CA 90712, who is responsible for building community relationships and facilitating hospice care access. The ideal candidate will possess an RN license in California and demonstrate effective...

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...

Team Lead For Specialty Programs Acts as team lead for specialty programs, medical review, utilization management, and case management areas by providing assistance and support to unit supervisor/manager by giving...

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...