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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...

Open Non-Competitive Job Opportunity Exam Number: Y5134L First Day of Filing: 3/3/2026, 8:00 A.M., PT, until the needs of the service are met and is subject to close without prior notice. COVID-19 Vaccination Mandate: All...

Nurse - Clinical Review The Clinical Review Nurse makes prospective medical necessity determinations on prior authorization requests for HealthHelp's specialty programs, including Diagnostic Imaging, Cardiology, Musculoskeletal, Physical...

Case Manager RNBurbank, CA$2537 /Weekly Gross**Estimated pay package. Does not include taxes, insurance, or other deductions that may occur8H Days26 Weeks40Short Term Acute Care Hospital368EPICRequirementsAt least 2+ years' experienceEither an...

Job Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost-effective care to the members. Providence caregivers are not...

Job Summary and ResponsibilitiesAs our Educator in Critical Care Emergency, In accordance with our mission and core values of integrity, compassion, collaboration, and excellence, this position is established to serve as a consultant/resource...

CareHarmony's Care Coordinators (LPN) (NLC) (LVN) work comprehensively with providers to deliver value-based care management initiatives for their patients. CareHarmony is seeking an experienced Licensed Practical Nurse – LPN Nurse (LPN)...

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...

RN Career Transition Opportunity – Nurse Case Manager Are you an RN seeking a rewarding career shift that uses your clinical skills and compassion — without the physical demands of bedside care? QuestPro has the exclusive...

Position Summary Help us elevate our patient care to a whole new level! Join our team as an industry leader in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members.

Case Manager Utilization RNWorks collaboratively with an MD to coordinate and screen for the appropriateness of admissions and continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the...

JOB DESCRIPTION - REGISTERED NURSE (A) Job Summary: The Registered Nurse provides patient care on a supplemental basis to our client facilities. With the delivery of safe, quality patient care as...

Clinical - Clinical Review Nurse - Concurrent Review Immediate need for a talented Clinical - Clinical Review Nurse - Concurrent Review. This is a 06+months contract opportunity with long-term potential and is located in U.S(Remote).

Job Description Clinical Quality Assurance Nurse (RN/LPN) - Remote | $26.50/hr Title: Clinical Quality Assurance Nurse (RN/LPN) - Remote Location: Remote (U.S.-based)...

Description RN- Registered Nurse - Case Manager Specialty: Case Manager Location: Los Angeles,CA,00000 Start Date: 2026-10-19 End...

Job TitleFacilitates, in collaboration with the Manager of Quality Management accurate, timely and consistent clinical data to public reporting databases and agencies, including The Joint Commission (Oryx), and CMS. Reviewing paper and electronic...

Anticipated End Date: 2026-11-20 Position Title: Manager II Medical Management, Grievance and Appeals CA RN required Job Description: Manager II Medical Management, Grievance and Appeals CA RN required Anticipated job Posting End Date: 11/13/2026...

Job DescriptionJob DescriptionBilingual Remote LPN/LVN - Clinical Interviewer100% Remote | $25-$26/hour | Monday-Friday 11:30 - 8 PM EST (Can reside anywhere in the U.S. to be considered)**Must be bilingual and hold an active LPN/LVN license to be...

Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies and...

POSITION SUMMARY The Quality Assurance Registered Nurse is a professional and responsible for all the quality activities of the organization. The Quality Assurance Registered Nurse has accountabilities for the monitoring,...

Medical Services Manager - RN/LVNSalary Range $100,000.00 - $112,000.00 Salary/yearDescriptionTitle of Position: Medical Service ManagerLocation: Percy VillageExempt/Non-Exempt: ExemptUnion/ Non-Union: Non-UnionSupervisor: Program DirectorGateways...

RN Case Manager This is a 13-week contract position. Monday - Friday, 8:00 AM - 4:30 PM The RN Case Manager coordinates management of care and ensures optimum utilization of resources, service delivery, and compliance with...

Overview St. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who count on the...

Company OverviewAcentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.Lead the Way is our rallying cry at...

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...