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Clinical Claims Review 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.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions...

Business (Non-Clinical) General Summary: Under minimal supervision, reviews and screens the appropriateness of services, the utilization of hospital resources and the quality of patient care rendered. Combines clinical, business,...

2536 Remote?: 0 Highlights (Bonus, shift, relocation, info for job): Monday through Friday, 8-5 with hour lunch, no weekends, no on-call, with paid holiday time off and paid...

Anticipated End Date: 2025-12-02 Position Title: Nurse Care Manager II - Incident Management Reporting, Ohio Job Description: Nurse Care Manager II Location: Ohio ...

Scope of Position: The Associate Director of Nursing for Ambulatory Services provides strategic and operational leadership for Non-Oncology Infusion Services, Clinical Research Center, and McCampbell Hall OBGYN clinics and associated...

Job Opportunity: Registered Nurse Schedule: Monday to Friday - Eastern Time Location: Remote About the Role As a Registered Nurse, you will make an impact by performing advanced level work related to clinical denial...

Job Details Job Location Carriage Court of Grove City - Grove City, OH Position Type Full Time Salary Range $36.06 - $36.54 Hourly...

Utilization Review - Fully Remote This role involves performing precertification and medical necessity reviews for designated referrals and targeted outpatient procedures, services, and inpatient admissions. The position requires...

Become a part of our caring community and help us put health first The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and...

Become a part of our caring community and help us put health first Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed medical care and services against...

Description Role Snapshot Our Utilization Management RN (Registered Nurse) evaluates efficiency, appropriateness, and medical necessity for medical services, and procedures for our Health Plan. This role uses...

Description Clinical Program RN at Providence St. Joseph Hospital Orange in Orange, CA. This position is Full- time and will work 8-hour, Day shifts. St. Joseph Hospital is four-time designated for...

ResCare Community Living Join a team of passionate and caring clinicians who make a difference in people's lives. Our nursing group focuses on compassion and meeting the needs of our clients in a variety of settings such as Home...

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 system...

Battelle delivers when others can't. We conduct research and development, manage national laboratories, design and manufacture products and deliver critical services for our clients-whether they are a multi-national corporation, a small start-up...

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 uncover...

Extraordinary Careers. Endless Possibilities. With the nation's largest home infusion provider, there is no limit to the growth of your career. Option Care Health, Inc. is the largest independent home and alternate site infusion...

Remote position, however, candidates must reside in the State of TX or State of IL. This position is a contract for about 9 months. Pay: $41/hour Job Responsibilities: RN working in the insurance or managed...

Remote Registered Nurse (RN) Nurse Triage The RN Nurse Triage provides high-quality, patient-centered care through telephone triage and clinical assessment. This role is 100% hands-on, responsible for assessing patient symptoms,...

Nurse Case Manager II Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work. The...

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...

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...

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...

Job Description Director of Nursing - Long-Term Care / Home Health | Full-Time | Competitive Compensation & Benefits About the Opportunity: A respected healthcare organization is seeking an...