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JOIN TEAM TRILOGY: At Trilogy, you'll experience a caring, supportive community that values each team member. We prioritize meaningful relationships, genuine teamwork, and continuous growth. With the stability of...

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...

A growing healthcare provider in Texas is seeking a compassionate Registered Nurse (RN) to provide after-hours triage support for hospice patients. This remote role requires an active multistate RN license, with preference for candidates...

Capital City Hospice is proud to be Ohio-made. Every decision we make about hospice care is made with patients and families in mind. Our team is rooted in the communities we serve and are dedicated to delivering the highest quality of care...

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 further to help people...

*Employment Type:* Full time *Shift:* 12 Hour Night Shift *Description:* Qualified applicants may submit a resume to Senior Talent Acquisition Partner, Tonya Globlek at ...@mchs.com for expedited consideration. *Position Purpose: * The...

Immediate Hiring for Remote Clinical Review Nurses Immediate hiring for remote clinical review nurses. Review approximately 20 cases a day for medical necessity. Advocate for and protect members from unnecessary hospital admissions.

HEDIS Data Reviewer Philadelphia PA Duration 3 months Hybrid - 3 days OnsiteSchedule from 8 am -5:30 pm EST, Monday - Friday, some weekend work may be required Under the direction of the Manager...

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.

$40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical...

A healthcare organization is hiring a skilled Nurse Advice Line Clinical Triage Nurse for a part-time position. The role involves performing clinical triage and coordinating care based on inbound calls. The ideal candidate must hold an RN License...

A leading health solutions company is seeking a Remote Telephonic Case Manager in Denver, CO. This role requires a Registered Nurse with 5+ years of experience and expertise in areas such as Oncology and Specialty Pharmacy. Candidates must...

Position: Clinical Supervisor (RN) Clinical Case Manager Join a Company That Puts People First! Aveanna Healthcare is one of the largest private-duty nursing companies in the...

Clinical Administration Position at St Jude Medical Center Leads the alignment, standardization and ongoing improvement of ministry length of stay for designated patient populations. Serves as designated ministry liaison with providers...

Job Type Full-time Description WESTSIDE IS LOOKING FOR A NURSE / RN TO JOIN THE VIRTUAL NURSE TEAM! SIGN ON BONUS OFFERED! LOAN PAYOFF PROGRAMS...

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...

Requirements Qualifications / Experience Current multi-state RN license with no restrictions; nurses currently holding a single-state RN license must obtain a multi-state license prior to being made a job...

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an...

Duration: 3 months contract with possible extension Location: Philadelphia PA 19113(Hybrid- Schedule from 8 am - 5:30 pm EST, Monday - Friday, some weekend work may be required) Job...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh...

Description As an RN Care Manager, you will function as a clinician, advocate, and educator to achieve optimal clinical and quality outcomes by effectively managing care and resources to reduce unnecessary utilization. The RN Care Manager...

Requires home visits throughout the City of Los Angeles, including San Fernando valley, Santa Clarita valley, Palmdale and Lancaster. Education: Associates or Bachelors of Science degree in nursing required. Experience:...

Triage Nurse Opportunity Explore opportunities with Shared Services, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated...

Medical Claim Review Nurse The Medical Claim Review Nurse provides support for medical claim review activities. Responsible for ensuring timely claims payment processes, providing counsel to members regarding coverage and benefit...

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 build the health care...