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Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Job Summary The RN Transition of Care Coach provides support for care transition activities. Facilitates transitional care processes and coordination for member discharge from hospital admission to all other settings. Strives to ensure...

A healthcare staffing company is seeking a Registered Nurse for a contract position based in Madison, WI. The role involves working in diverse settings such as community immunization clinics and providing quality care to a broad population. Ideal...

A healthcare services provider is seeking a remote provider relations specialist in Columbia, SC. This role requires effective communication with providers about Medicare coverage and documentation. The ideal candidate must have relevant nursing...

A staffing and recruitment firm is seeking an experienced RN Case Manager for a fully remote position. The role involves conducting utilization reviews, completing patient assessments, and collaborating with healthcare teams. Candidates should...

Clinical Appeals Nurse The Remote Clinical Denials/Appeals Nurse will be directly responsible for securing pre-service approvals, and reviewing pre/post service denials, medical necessity review and completing appeals and/or coordinating...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities, ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Remote position, however, candidates must reside in the State of TX or State of IL. This position is a contract for about 9 months. Pay: $41/hour Job Responsibilities: RN working in the insurance or managed...

Join to apply for the RN Call Assist Remote in PST role at Optum 1 day ago Be among the first 25 applicants Join to apply for the RN Call Assist Remote in PST role at...

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because...

RN Transition Of Care Coach The RN Transition Of Care Coach provides support for care transition activities. Facilitates transitional care processes and coordination for member discharge from hospital admission to all other settings.

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Clinical Appeals Rn At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come...

WellMed, part of the Optum family of businesses, is seeking a RN, Clinical Quality Consultant to join our team in San Antonio, TX. Optum is a clinician‑led care organization that is changing the way clinicians work and...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities, ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Job Description Job Description Job Title : Registered Nurse (RN) Disease Manager Job Overview : The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of...

A leading medical service provider in Washington, DC is seeking a DME Medical Reviewer to ensure compliance with nursing standards and provide comprehensive management reports. The ideal candidate must hold an active RN license and have at least...

A leading health insurance provider is seeking a Utilization Management Nurse 2 to support coordinated care for members healing at home. The ideal candidate will have an Associate Degree in nursing, a valid RN license, and at least three years of...

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 company, we reach millions of...

A leading healthcare provider is seeking a Clinic Registered Nurse (RN) for their urology team in Omaha, Nebraska. This hybrid role allows for remote work after training. The RN will collaborate with a multidisciplinary team to provide...

Quality Assurance (2 Openings) Responsibilities: Perform quality assurance review of peer review reports, correspondences, addendums, or supplemental reviews. Ensure clear, concise, evidence-based rationales are...

Employer Industry: Healthcare Services Why consider this job opportunity Opportunity for career advancement and growth within the organization Work remotely, with flexibility in scheduling Engage in...

Utilization Management Nurse Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people...

Care Manager Rn Job Responsibilities: The care manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health plan population with a variety of health and...

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...