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Job Description: • Participates in the development and ongoing implementation of QM Work Plan activities. • Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet...

Job Description JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical...

Company Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable,...

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving...

This position is available fully remote in Washington state. Who we are Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All...

POSITION DESCRIPTION JobTitle: Wellness Nurse Supervisor:Health Services Director FLSAStatus:Hourly,...

Position Purpose The Transfer Center & Virtual Care RN provides leadership, accountability, and comprehensive nursing services to ensure optimal patient care, resource utilization, and seamless patient flow. This role is challenged...

Job Description RN Utilization Review at Irvine, CA. This position is Part- time and will work Remote 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our...

Registered Nurse, Quality Assurance Reviewer The Registered Nurse, Quality Assurance Reviewer will work in conjunction with the Quality Manager and will be responsible for completing quality reviews for the Clinical Services and Provider...

The Student Nurse is responsible for providing a variety of direct and indirect patient care activities as supervised and directed by the Registered Nurse. Care is provided in collaboration with the patient, family, and other members of the patient...

THIS IS A REMOTE POSITION Part Time/Contract Position DUTIES: -Assess patient health problems over the phone and via secure video -Schedule appointments and refer patients -Advise and monitor...

As our Telephonic Nurse Care Manager, you will coordinate all aspects of patient care for high-risk individuals. You will evaluate each patient while directing treatment plans, discuss claims, benefits, and eligibility, and manage resources while...

Job Purpose: Ensuring all projects follow Case Management Standards of Practice Promotes and restores individuals' health and wellbeing by completing "a collaborative process of assessment, planning, facilitation, care coordination,...

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...

Build What Matters Most-Families, Futures, and Your CareerEnjoy meaningful work while contributing to an organization that changes lives every day. US Fertility, the nation's leading partnership of physician-led...

The candidate for this role must live in these states: TX, LA, WA, FL or GA. At Houston Methodist, the Clinical Documentation Specialist is responsible for improving the overall quality and completeness of clinical documentation. This...

ChenMed is seeking a Registered Nurse (RN) Educator for a nursing job in Columbus, Ohio. Job Description & RequirementsSpecialty: EducatorDiscipline:...

At St. Luke's, our dedicated team of Remote Patient Management RNs are critical in providing exceptional, patient-centered care. We strive to foster an environment that embraces our employees' unique strengths, experiences and perspectives which...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: Aids patients in obtaining the correct level of care with the appropriate provider at...

ResPro Health is dedicated to providing our partners in the respiratory space with the tools and resources needed to implement meaningful programs like remote patient monitoring and chronic care management in their pulmonary practices. With a...

Company Details Berkley Medical Management Solutions (BMMS) provides a different kind of managed-care service for W.R. Berkley Corporation. We believe focusing on an injured worker's successful and speedy return to work is...

The Registered Nurse provides professional nursing care to patients within assigned areas utilizing the nursing process to assess, plan, implement and evaluate patients. What you will do Provides nursing...

Vetted is seeking a RN - Hospice Palliative Care for a travel job in Gahanna, Ohio. Must have 2+ years of experience. This contract pays approximately...

Role SnapshotOur Case Management RN (Registered Nurse) coordinates care and services of select member populations with complex health care needs across continuum of care. The primary focus of the...

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, innovate with purpose, hold...