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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,...

Behavioral Health Clinical Reviewer Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services are medically necessary and align with established clinical...

Agency Dept of Health and Human Services Division Health Service Regulation Job Classification Title Nurse Consultant II (NS) Position Number 65026151 Grade MH17...

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,...

Utilization Management Nurse Consultant Clinical Precertification RN (Medicare Home Care) Remote | Full-Time | Weekday Schedule Are you a Registered Nurse ready to make an impact beyond the bedside? Join our team and use your...

Job Title Real Job *Works with any department, if a patient complaint arises* *Experience in Critical Care or ED is a plus* *Weekends will not typically be required unless survey is on site* *2 years experience required, hard stop* *First...

Job Title Conducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital...

*NURSING AT CHILDREN'S HOSPITAL LOS ANGELES* As a nurse, you approach care with energy and resolve. When you join us, you'll find the perfect environment to develop your nursing career. We stop at nothing to make sure that every patient we see...

Clinical Integrity Documentation Specialist Location: Remote Facility: Ascension Wisconsin Hospitals Department: Clinical Integrity Documentation Schedule: Days | Full-Time Salary Range: $79,511.52-$110,834.59...

Infection Preventionist Nurse - Acute Care is an exciting opportunity to lead infection prevention initiatives at a respected Southern California medical center. The Infection Preventionist Nurse - Acute Care will advance patient...

SHIFT: Any (United States of America) Seeking Breakthrough Makers Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will...

Job Summary: Provides consultation and leadership in designated areas of expertise independently. Collaborates with interdisciplinary teams and stakeholders to address issues and achieve project objectives. Coordinates...

Details Client Name PIH HEALTH Job Type Travel Offering Nursing Profession Registered Nurse Specialty...

Job Responsibilities and Requirements KEY RESPONSIBILITIES *other duties as assigned* Job Summary: Reviews all medical (and other) documentation in claim files to answer the specific...

At Virtua Health, we exist for one reason - to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists,...

Nurse Consultant II (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,...

*Job Summary and Responsibilities* As our surgical services nurse at Glendale Memorial Medical Center you will prepare patients for surgical procedures and assist in the operating room to ensure they receive excellent nursing when they are at...

Registered Nurse - Review Analyst | Remote | Contract Walker Healthforce is seeking a Registered Nurse - Review Analyst with 2-4 years of clinical experience to provide clinical utilization reviews, evaluate medical...

Job Description Provides support for clinical facility site reviews. Under the supervision of leadership, uses clinical judgement within appropriate scope to independently conduct reviews and other monitoring activities for primary care...

Summary VA Greater Los Angeles Healthcare System (VAGLAHS) is seeking to hire experienced Registered Nurses to work in our Case Management/Care Coordination Program. The Case Manager provides patient centered care with expertise in the...

Job Title This is a remote position but will need onsite training in Mishawaka Indiana. Shift: Days - 8 hr shift LOCAL CANDIDATES ONLY! Why Choose Saint Joseph Health System? At Saint Joseph Health System, our values guide...

RN Utilization Review Review patient medical records to assess the appropriateness and medical necessity of hospital admissions, continued stays, and services, while coordinating with providers and payers to ensure compliance with...

Centene Corporation is seeking a nursing professional to analyze prior authorization requests and determine medical necessity in alignment with regulatory guidelines and member benefits. You will collaborate with healthcare providers and...

Piper Companies is seeking a Clinical Appeals Nurse to join a leading health insurance organization for a contract remote opportunity located in North Carolina. The Clinical Appeals Nurse will serve as a clinical...

Utilization Management 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 colleagues...