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Job Description Under broad direction from the Centralized Utilization Management Manager, is responsible for the hospital-wide Utilization Management Programs in a general acute care hospital which serves infant, pediatric,...

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...

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...

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...

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 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...

Requirements Qualifications / Experience Current multi-state RN license with no restrictions; nurses currently holding a single-state RN license must obtain a multi-state license prior to being made a job...

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...

Job Summary Provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical...

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...

Entity: Owensboro Health Regional Hospital | Department: Virtual Care | Work Hours: 7P - 7:30A | Weekend Requirements: One | 0.9 FTE Job Summary: Provides direct nursing care in accordance with established policies,...

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...

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...

The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable guidelines regarding payment and coverage, and makes...

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...

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...

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...

A healthcare organization in Montana seeks a fully remote Utilization Management Specialist responsible for reviewing admissions, ensuring compliance, and collaborating with healthcare providers. The ideal candidate is an RN or Social Worker with...

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...

Care Review Clinician Inpatient Review Bh The care review clinician inpatient review bh will provide prior authorization for outpatient and inpatient services for the ky medicaid behavioral health population. Strong post-acute level of...

Where You'll Work From primary to specialty care, as well as walk-in and virtual services, CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy. We offer more than 20...

Responsibilities Part time: 24 Hours Per week (Sat & Sun) 8am-8pm MST. The Phone Triage Registered Nurse provides skilled nursing telephone triage for participants experiencing medical concerns during...

Research Nurse (Per Diem) - Lexington, MA Illingworth Research Group provides a range of patient focused clinical services to the pharmaceutical, healthcare, biotechnology and medical device industries. These include mobile research...

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...

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...