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Pre-Payment Review Nurse Consultant- Wisconsin 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.

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...

Utilization Management Claims Review Nurse RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13077 Salary Range:...

Job Title: RN Utilization Review City: Santa Rosa State: CA Job Type: Travel Discipline: RN Speciality: Utilization Review...

Registered Nurse Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout...

Blind Childrens Center Inc in Los Angeles seeks a Registered Nurse Consultant to provide pediatric nursing and health training. Responsibilities include conducting health screenings and developing health plans for children.The ideal candidate...

Job Address: 10123 Alliance Road, Suite 320Blue Ash, OH 45242 Telehealth Administrator on Call (Registered Nurse), Remote Position The PHP Telehealth Administrator on Call has a passion for providing remote...

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...

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...

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...

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...

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus — a rejuvenating place for associates...

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...

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,...

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...

Registered Nurse Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout...

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,...

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...

Utilization Management Position Provide health care services regarding admissions, case management, discharge planning and utilization review. Review admissions and service requests within assigned unit for prospective, concurrent...

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...

RN - Clinic Nurse Out-patient clinic nurse City: Los Angeles State: CA Start Date: 01/06/2025 End Date: 04/07/2025 Duration: 13 Week(s) Shift: 5X8 Days Shifts Per Week: 5 Scheduled...

Overview Clinical Liaison VIPC, Inpatient Hospice Admissions RN Location: Cedars Sinai Hospital Position Type: Full Time...

JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include gathering, analyzing and providing date for regulatory...

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...

Admissions RN Bristol Hospice Greater LA, CA - Lakewood, CA 90712 Overview Salary Range $55.00 - $58.00 Hourly Position Type PRN Hourly Description Do you enjoy being at the beginning of the journey? The...