Atlanta StaffingColumbus,OH
Quality Assurance (2 Openings) Responsibilities: Perform quality assurance review of peer review reports, correspondences, addendums, or supplemental reviews. Ensure clear, concise, evidence-based rationales are...
Posted December 8, 2025
HumanaColumbus,OH
A leading health insurance provider is seeking a Utilization Management Nurse 2 to support coordinated care for members healing at home. The ideal candidate will have an Associate Degree in nursing, a valid RN license, and at least three years of...
Posted December 10, 2025
CorVelColumbus,OH
A national risk management provider is seeking a remote Utilization Review Case Manager. This role involves gathering clinical information, certifying medical necessity, and managing stakeholder communications. Ideal candidates will have a nursing...
Posted December 12, 2025
Washington StaffingColumbus,OH
Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...
Posted December 12, 2025
Molina HealthcareColumbus,OH
JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...
Posted December 4, 2025
Council of State and Territorial EpidemiologistsColumbus,OH
We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because...
Posted December 12, 2025
AscensionColumbus,OH
A leading healthcare organization seeks an experienced individual to manage utilization review processes remotely. This role requires a Registered Nurse with leadership experience to oversee operations and collaborate with medical teams to ensure...
Posted December 11, 2025
Aurora HealthcareColumbus,OH
A healthcare provider is seeking a Case Management Coordinator for their Home Health division. This role involves functioning as a clinical liaison with managed care customers, collaborating with external case managers, monitoring service...
Posted December 8, 2025
Iowa StaffingColumbus,OH
Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...
Posted December 7, 2025
Medical Solutions LTCColumbus,OH
Medical Solutions LTC is seeking a local contract nurse RN Long Term Acute Care for a local contract nursing job in Columbus, Ohio. Job Description & RequirementsSpecialty:...
Posted December 1, 2025
SharecareColumbus,OH
Job Description: Sharecare is the leading digital health company that helps people - no matter where they are in their health journey - unify and manage all their health in one place. Our comprehensive and data-driven...
Posted December 11, 2025
Community Health SystemsColumbus,OH
Join us as a Registered Nurse (RN) - Quality Coordinator RN position at Lower Keys Medical Center Unit: Quality Coordinator RN (2+ years of quality experience preferred) Shift: Remote or onsite Mon-Fri 8AM-4:00...
Posted December 12, 2025
Elevance HealthColumbus,OH
Anticipated End Date: 2025-12-15 Position Title: Nurse Appeals RN Job Description: Nurse Appeals RN Location: Ohio-Cincinnati, Columbus, Mason, or Seven Fields (Must be within...
Posted December 9, 2025
National Church ResidencesColumbus,OH
Director of Nursing Inniswood Village located in Westerville, OH is an independent living, assisted living and memory care community with a team of health care professionals that is unmatched in the area! We are owned and...
Posted December 11, 2025
Arizona StaffingColumbus,OH
Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities, ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...
Posted December 12, 2025
Providence Health and ServicesColumbus,OH
Description RN Care Managers, in the acute care setting, provide a variety of services to appropriately help progress patients through the continuum of care. Key services include screening for post-acute needs; transition...
Posted December 11, 2025
UnitedHealth GroupColumbus,OH
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...
Posted December 8, 2025
Wisconsin StaffingColumbus,OH
Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...
Posted December 8, 2025
Soleo HealthDublin,OH
Job Type Full-time Description Soleo Health is seeking a Nursing Operations Manager, Provider Services in Dublin, OH. Join us in Simplifying Complex care! Soleo Health...
Posted December 8, 2025
Mount Carmel Health SystemWesterville,OH
*Employment Type:* Full time *Shift:* 12 Hour Night Shift *Description:* Qualified applicants may submit a resume to Senior Talent Acquisition Partner, Tonya Globlek at ...@mchs.com for expedited consideration. *Position Purpose: * The...
Posted December 9, 2025
Georgia StaffingColumbus,OH
Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...
Posted December 10, 2025
CVS HealthColumbus,OH
At CVS Health, were building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nations leading health solutions company, we reach millions of...
Posted December 12, 2025
integrated resourcesColumbus,OH
Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has...
Posted December 2, 2025
Lakeland CareColumbus,OH
We're growing - Join our award winning culture as we serve members in your area! The position will work with members in the WI Rapids, Stevens Point and Marshfield areas.
Posted December 3, 2025
Henry Ford Health SystemColumbus,OH
A leading healthcare provider in Michigan seeks a qualified Registered Nurse to manage and facilitate patient transfers efficiently. Candidates must have a Bachelor of Science in Nursing and at least two years of clinical experience. Strong...
Posted December 9, 2025