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To support clinical auditing efforts, the full-time RN Clinical Auditor will perform retrospective chart reviews on Readmission and Place of Service Claims, utilizing clinical guidelines and proprietary systems while maintaining productivity and...

Utilization Management Nurse RIHS Austin Regional Office - Austin, TX 78727 Overview Position Type Full Time Description Primary Responsibilities The Utilization Management Nurse will determine the...

Clinical Claim Review Nurse Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people...

Job Description: Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical...

Registered Nurse Risk Manager Aptive is seeking a registered nurse risk manager. IHSC's mission is to provide medical care to maintain the health of individuals in the custody of ICE through an integrated health care delivery system,...

The Case Manager Care Coordinator coordinates the care and service of patient populations from admission through discharge. The Care Coordinator clinically assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet...

Become a part of our caring community $10,000 SIGN ON BONUS We are excited to expand our leadership team and are seeking experienced, motivated Clinical Managers to join our growing home health branches in Westbury, Hauppauge, and Riverhead, NY!

Working Nurse in Los Angeles is seeking a Clinical Policy Nurse RN II. This full-time position involves analytical research and assessment based on legislation affecting healthcare policies. The ideal candidate will translate regulatory impacts...

Health Plan Nurse Coordinator The Health Plan Nurse Coordinator is a Registered Nurse who supports one or more health services operational units, such as Utilization Management, Case Management, Enhanced Care Management, Disease...

Employment Type: Full time Shift: Day Shift Description: Purpose Work Remote Position (Pay Range: $36.8795-$47.8193) The Nursing...

Telephone Triage Nurse Line Advisor Apply today to join our 34,000+ employees and 5,000+ system providers working to build lasting relationships with the people we serve: our patients, our communities, and each other! Are you ready...

Description Position at Healthmap Solutions Company Background Healthmap Solutions is the future of specialty health management that focuses on progressive diseases, with a particular expertise...

Become a part of our caring community The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration...

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About the job Remote | Nursing Clinical Review Expert - $65-$95/hour We are sharing a specialised part-time consulting opportunity for nursing professionals experienced in patient care, clinical monitoring, medication administration,...

Care Navigator Position Position at Healthmap Solutions Company Background Healthmap Solutions is the future of specialty health management that focuses on progressive diseases, with a particular expertise in kidney health populations.

City/State Norfolk, VA Work Shift Multiple shifts available Overview: Sentara Health Plansis hiring a Quality Improvement Coordinator /Registered Nurse (RN) - Remote in Virginia! ...

Description Position at Northwell Health PART TIME- 20 hours per week- Mon-Fri 8pm- 12am shift- Rotating weekends and holiday coverage expected! Northwell is the largest not-for-profit...

Deliver direct patient care in an outpatient dialysis setting. Monitor patients, manage treatment plans, and respond to health changes. Collaborate with a supportive clinical team, including Patient Care Technicians. Educate patients and families on...

Description The Care Management Recovery Advocate (CMRA) is responsible for providing overall management and communication of clinically based appeals between Providence Health and Services, California Region (PH&S) outside...

yourcommission is looking for a Utilization Management Nurse responsible for overseeing patient care determinations across various programs. The role includes conducting utilization reviews, communicating with payors, and monitoring bed...

Case Management Coordinator We are currently hiring for a Case Management Coordinator to join BlueCross BlueShield of South Carolina. In this role, care management interventions focus on improving care coordination and reducing the...

Nurse Reviewer - Itemized Bill Review 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...

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. Minimum...

General Information Press space or enter keys to toggle section visibility Work Location: Los Angeles, CA, USA Onsite or Remote Flexible Hybrid Work...