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A major healthcare provider seeks a Transitions of Care RN to deliver patient education across programs for chronic disease management. This role involves conducting assessments, coordinating health-coaching plans, and monitoring the effectiveness...

*Quality Assurance Registered Nurse - 100% Remote* Contract duration: 520 hour contract to hire Training Schedule: M-F, 4-6 weeks *Contract Details* * *Contract Duration:* 520-hour contract-to-hire, long term opportunity *...

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...

Remote Clinical Review Nurse Prior Authorization Location: Must be located in Central or Eastern time zones Employment Type: Full?Time About the Role We are seeking an experienced Registered Nurse to join our team...

A leading healthcare management firm seeks an experienced RN for pharmacy utilization management services in Denver, Colorado. This role involves assessing patient medication usage, ensuring safety, and collaborating with medical professionals in...

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...

Explore opportunities with [agency name], 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 to helping people feel their best,...

Job Type Full-time Description Gateway Rehab Center (GRC) has an outstanding opportunity for a Nurse Liaison Gateway Rehab who will be responsible for the pre-admission case management, ASAM level of care assessment, and...

The position is work from home with field visits. JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include...

Job Description Under broad direction from the Centralized Utilization Management Manager, is responsible for the hospital-wide Utilization Management Programs in a general acute care hospital which serves infant, pediatric,...

Become a part of our caring community and help us put health first Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At...

Pre-Access Utilization Management Registered Nurse Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health insurance clients. This person will be responsible for...

The RN Case Manager is responsible for coordinating continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical regime. Essential Duties and...

Responsibilities Salt Lake Behavioral Health is currently seeking a compassionate and talented RN to serve in a Hybrid Floor Nurse and House Supervisor position.

Are you looking to work for mission driven and passionate warriors like yourself? Looking to grow within an organization? The Company: We are Ohana Pacific Health. We positively impact thousands of lives each year...

Medical Child Abuse Nurse Consultant (0.6FTE, Limited Term) Provides operational, quality improvement, and management consulting services. Plans implements, and evaluates projects related to system development, operational and strategic...

Fully Remote: Clinical Documentation Specialist Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical...

Join Our Caring Community: Help Us Prioritize Health The Pre-Authorization Nurse Specialist is responsible for reviewing prior authorization requests to ensure appropriate care and settings, adhering to established guidelines and...

Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This position is remote. Candidates must be local...

We believe everyone should have confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care...

A leading digital health company in Atlanta is seeking a Care Manager to provide high-quality telephonic case management for members. This role involves developing plans of care, collaborating with healthcare providers, and ensuring positive...

Description Join PeaceHealth in advancing compassionate, mission-driven care from wherever you are. PeaceHealth is looking for a skilled and motivated Registered Nurse Utilization...

divh2RN Care Review Clinician/h2pThe RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical...

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...

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position. ESSENTIAL...