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Remote Review Nurse SUMMARY DESCRIPTION: The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and Information Set...

RN/NP Clinical Quality Reviewer Primary Care, Acute Symptom Triage & Travel Health | Contract, up to 25 hrs/week About the Role We are seeking Nurses & Nurse Practitioners with clinical experience in one or more of the...

Nurse Consultant Come join our Symbria Team! We are seeking a highly professional and dedicated individual to join our EMPLOYEE-OWNED TEAM as a Nurse Consultant in the pharmaceutical industry at our Pharmacy in Pennsylvania!

Vivo Care, a patient-centered health platform, seeks a Care Navigator (RN/LPN/LVN) for remote work in the CST window. You'll build trusted relationships with patients, conduct wellness calls, and coordinate care using RPM data to drive health...

Job Description Responsibilities Review and evaluate electronic medical records of emergency department admissions and screen for medical necessity using InterQual or MCG criteria Apply evidence-based...

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving...

JOB DESCRIPTIONWe are searching for six TX licensed RNs to work telephonically with our Medicaid members across the state. Three of the positions are open to RNs with at least two years of experience in in Behavioral Health or Substance Abuse...

The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring that medical services are used efficiently and appropriately. They review medical records, treatment plans, and patient information to determine the...

Vail Health has become the world's most advanced mountain healthcare system. Vail Health consists of an updated 520,000-square-foot, 56-bed hospital. This state-of-the-art facility provides exceptional care to all of our patients, with the most...

Clinical Review Nurse - Prior Authorization Various, NV Clinical Review Nurse - Prior Authorization Various, NV All On-site Location: Fully Remote – Prefer Candidates reside in NV, but can reside elsewhere if they...

Job Summary Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical...

Clinical Nurse Consultant At Bristol Myers Squibb, our employees often ask, "Who are you working for?"—a question that fuels collaboration, accountability, and urgency in our work. Our purpose-driven culture inspires us to discover,...

Solventum is seeking an Infection Prevention Specialist, Peri-op, to drive field-based sales across the Philadelphia, PA area, delivering value to hospitals and surgical teams. You will leverage clinical insights and a consultative approach to...

Agency Dept of Health and Human Services Division Health Service Regulation Job Classification Title Nurse Consultant I (NS) Position Number 60054032 Grade MH16...

Fuze Health Inc. is seeking a Registered Nurse to support telehealth care for Medicare members, focusing on Stars measures and ED discharge follow-up. The role emphasizes compassionate, high-quality virtual care with remote outreach.

Care Management Nurse Consultant Competitive Compensation & Benefits Package! Position eligible for: Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan...

Medicare Par Provider Appeals Nurse Consultant 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...

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

Description We are hiring for a part- time School Nurse Consultant, come join our team! This is a non-benefited position that works on an as needed basis. See CESA 6 Values Here See details and apply on our website.

Summit provides independent insurance agents and their clients with market-leading workers' comp insurance and elite customer service. We're growing and currently serve more than 7,000 independent agents and 31,000 policyholders across the South,...

The American Heart Association is seeking a Program Consultant, Health Care Quality Improvement to implement quality programs for improving cardiovascular and stroke care. This role can be home-based in Chicago, IL, with up to 20% travel...

About Carisk Partners, Inc. Carisk Partners, a Best Places to Work award winning organization, is a specialty risk transfer, care-coordination company servicing insurers, government entities, self-insured plan sponsors...

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

Diabetes Specialist Nurse Are you a passionate and experienced Diabetic Specialist Nurse looking for flexible and rewarding opportunities? We are inviting skilled professionals to join our Healthcare Professionals Network for a series of...

MVP Health Care is seeking experienced Temporary HEDIS Abstractor Nurses to support seasonal Clinical Quality and HEDIS medical record review activities. This role involves medical record abstraction, provider outreach, quality review, and use of...