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A national health organization is seeking a clinical professional to perform concurrent reviews and evaluate member health. This remote position requires a Nevada LPN or RN license and offers a pay range of $26.50 - $47.59 per hour, along with...

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...

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...

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...

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...

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...

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...

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...

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...

A leading healthcare service provider is seeking an RN Clinical Compliance Partner. This role involves conducting compliance audits and ensuring adherence to regulations in the hospice environment. The ideal candidate will have an active RN...

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...

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...

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...

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...

A leading healthcare organization is seeking a qualified RN for a role that involves auditing medical records and communicating clinical findings. The position requires an undergraduate degree or equivalent nursing experience, along with a current...

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...

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...

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...

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...

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 national risk management provider is seeking a remote Utilization Review Case Manager. This role involves gathering clinical information, certifying medical necessity, and managing stakeholder communications. Ideal candidates will have a nursing...

A leading health services provider is seeking an Integrated Nurse Case Manager for a remote position in Virginia Beach, VA. The role includes performing clinical assessments and managing care for members with chronic illnesses. Candidates must...

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...

A leading non-profit healthcare organization in Minneapolis is seeking an RN Care Coordinator for the Masonic Cancer Clinic. This role involves coordinating patient care within a specialized healthcare setting, facilitating communications, and...

A large health service provider is seeking a Clinical Care Coordinator to ensure optimal continuity of care for patients in home health services. The role demands an Associate's degree, RN license, and at least 3 years of post-acute experience.