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A health insurance company is seeking a Prior Authorization RN to review requests for health services and ensure compliance with Medicare and Medicaid guidelines. This remote role involves clinical decision-making and documentation for...

Per Diem Emergency Department Based Rn Case Manager This position is a per diem role, providing department coverage and cross trained to cover utilization review and discharge planning as needed. It is eligible for the per diem...

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A leading health system is looking for a Registered Nurse Quality Improvement Analyst to lead quality improvement initiatives in Baltimore. Responsibilities include conducting QI activities, leading performance improvement teams, and ensuring...

Building Location: Building B - St Marys Medical Center Department: 1005100 NURSING ADMINISTRATION - EH SS Job Description: The System Nurse...

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position. ESSENTIAL...

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 procedures, and medically...

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...

Site: Brigham and Women's Faulkner 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...

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.

A leading healthcare provider seeks an UM Nurse Reviewer responsible for conducting medical reviews, identifying at-risk patients, and ensuring continuity of care. The ideal candidate will have an active RN license, strong analytical and...

Job Description Are you a registered nurse ready to take your career in an exciting new direction-one where your expertise truly makes a difference? Join Pennsylvania's premier Quality Improvement Organization and step into a...

Description Who we are ...

Telephonic Case Manager At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions...

HJ Staffing is partnering with Impresiv Health, a specialized healthcare consulting partner, to find a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN). This critical...

A leading healthcare provider seeks a Clinical Appeals Nurse to research and evaluate member and provider disputes regarding adverse coverage decisions. The role requires 2 years of medical-surgical experience, with RN licensure necessary. Strong...

Salary : $89,904.00 - $147,312.00 Annually Location : Thurston County - Tumwater, WA Job Type: Full Time - Permanent Remote Employment: Flexible/Hybrid Job...

Discover. Achieve. Succeed. #BeHere Location: US:WI:MENOMONEE FALLS at our CP-NORTH HILLS HEALTH CENTER facility. This job is ON - SITE. FTE: 0.400000 Standard...

PURPOSE OF YOUR JOB POSITION: The primary purpose of your job position is to provide direct nursing care to the residents, and to supervise the day-to-day nursing activities performed by nursing assistants. Such supervision...

Job Opportunity At CVS Health At CVS Health, we are building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health...

Focus Staff is seeking a travel nurse RN Rehabilitation for a travel nursing job in Dublin, Ohio. Job Description & RequirementsSpecialty:...

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...

Description: Job Summary: Provides remote consultative and supportive nursing care to Intensive Care Units (ICU) to multiple medical centers utilizing in room camera and EPIC technology from a remote, centralized hub.

The position is work from home with field visits. JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include...

Overview Ensuring Compliance. Streamlining Authorizations. Supporting Patient Care. The Clinical Authorization Nurse plays a key role in supporting our authorizations department by reviewing clinical...