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Nurse Care Manager Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Days Job Description Join a team that's shaping the...

Job Description Responsible for the retrospective review of medical records and compiling data to validate quality of care, appropriateness of care , and accuracy of documentation. RN Peer Review Analyst will audit charts for...

Telephonic Nurse Case Manager II Telephonic Nurse Case Manager II Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and...

Description Under general supervision, performs review of patient charts as required by the Hospitals Utilization Management Review Plan. The Utilization Review Case Manager (UR CM) validates the patient's placement to be at the most appropriate...

Description The UM Denial Nurse Reviewer supports high-quality, cost-effective care by applying clinical knowledge, policies, and regulatory guidelines to the review and processing of adverse organization determinations. This role reviews...

OverviewAs our Educator, RN in Periop, you will serve as a consultant/resource professional by providing staff development expertise as an educator, facilitator, change agent, leader, and researcher, ensuring educational initiatives are...

Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude...

Clinical Documentation Integrity Specialist IIThe Clinical Documentation Integrity Specialist II (CDI) is responsible for utilizing independent clinical judgement in facilitating the integrity, overall quality, accuracy, and completeness of...

About This Role The Case Manager Utilization RN works collaboratively with physicians to coordinate patient admissions and continued stays, ensuring appropriate care levels and safe discharge plans. This role is ideal for nurses who excel in a...

About Sunnyside Nursing Post-Acute Care Centrally located in Torrance, California, Sunnyside Nursing and Post-Acute Care provides sub-acute nursing care, rehabilitation services, skilled nursing, and long-term care.

Health Care Position 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 deeply,...

Overview In New Mexico, you'll deliver lifesaving care for the community you love and live in, soaring above Amazing landscapes. With 3+ years of recent critical care you'll fly in state-of-the-art helicopters-an ICU in the...

Pain Management Nurse (Home Health) – Enhancing Comfort & Quality of Life for Seniors All Seniors Foundation is dedicated to improving comfort and quality of life for elderly patients. Effective pain management is a cornerstone of our...

NirvanaHealth Utilization Management Nurse Join us in our mission to transform healthcare! NirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees...

Company Overview: Join us in our mission to transform healthcare! nirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees at every stage...

JOB DESCRIPTION We are searching for six TX licensed RNs to work telephonically with our Medicaid members across the state. Three of the positions are open to RNs with at least two years of experience in in Behavioral Health or Substance Abuse...

The Clinical Research Nurse (CRN) will provide direct patient care to patients enrolled in or considering a clinical trial. The CRN, in collaboration with the satellite physician(s), is responsible for the implementation and evaluation of clinical...

Telephonic Nurse Case Manager (Remote) Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location: Home United States...

Medication Nurse - Substance Use Disorder Treatment CRI-Help is a substance use disorder treatment center with several locations across Los Angeles County. We've been around since 1971 and are noted as an organization practicing integrity...

Job Title: Utilization Management Registered Nurse (UM RN) – SNF / MLTC Location: Remote (Must reside in NY, NJ, or CT) Schedule: Monday – Friday, 9:00 AM – 5:00 PM Position Type: ...

School Nurse St. Paul the Apostle School is deeply committed to serving children and plays a critical role in supporting the health, wellness, and academic success of our students. Our mission goes beyond academics—we provide holistic...

Professional Staff Nurse, OP Are you passionate about helping kids be their best selves? UPMC Children's Community Pediatrics is hiring a Full-Time Professional Staff Nurse, OP to support the offices in Bethel Park. Weekend availability...

Medical Review Nurse (RN)Remote position, however candidates must reside in the State of TX or State of ILThis position is a contract for about 9 months.Pay: $41/hourRN working in the insurance or managed care industry using medically accepted...

Job Description Remote Prior Authorization LVN/LPN Location: Remote (United States) Type: W2 Contract (Temporary) | Hours: 40/week Pay Rate:...

Utilization Management Nurse The primary role of the Utilization Management Nurse is to review and monitor members' utilization of health care services with the goal of maintaining high quality cost-effective care. The role includes...