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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...

Remote Clinical Review Nurses Urgent hiring for "Remote Clinical Review Nurses". Job Description: Review approximately 20 cases a day for medical necessity. Advocate for and protect members from unnecessary...

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients. Job Summary Our client is seeking a Nurse Navigator to guide patient journeys within...

In this role, you will provide direct nursing care, infusion therapy and documentation to patients in the Community Oncology Practice. Major functions include: patient assessment, patient evaluation and preparation and administration of...

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health...

Personal Health Nurse CCCS uses a holistic approach to medical management. The Personal Health Nurse (PHN) works within a team to move the member through the continuum of medical management with the goals of facilitating quality health...

Overview As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of...

Job Category: Executive Leadership, Revenue Cycle Work Shift/Schedule: 8 Hr Morning - Afternoon Northeast Georgia Health System is rooted in a foundation of improving the health of our communities. ...

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 simple home treatment...

As an integral part of the interdisciplinary team, the Registered Nurse utilizes the nursing process to provide therapeutic care to patients. The Registered Nurse is accountable for the coordination of patient care and education to the patient and...

Description Location: UCHealth Anschutz Outpatient Pavilion - Aurora, CO Department: Hospital Based Sub-Specialty Work Schedule: Full Time, 80.00 hours per pay period (2 weeks) Shift: Days Pay: $38.91 - $60.31 / hour. Pay is dependent on...

**For QUICK APPLY ---> Please reach out to (210) 624-7008** Job Details Job Title: RN Nurse Manager (REMOTE) Facility Location: Somerville, MA Shift: Days, 8Hx5 (8 AM - 5 PM)...

UnitedHealth Group is seeking a Field-Based RN in Fort Worth, Texas. This role involves assessing and managing care plans while advocating for patients. Candidates should have at least 2 years of community health experience, a current RN license...

Behavioral Health Case Manager Responsible for providing telephonic and e-referral case review and authorization of services utilizing established mental health and substance abuse medical necessity criteria to provide quality care...

Harris Health System is seeking a Utilization Management Review Nurse (UMRN) to assess the necessity and appropriateness of medical services. The UMRN utilizes clinical expertise to ensure care aligns with industry standards, works with healthcare...

Emory Healthcare Utilization Review Specialist Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership...

CLINICAL DOCUMENTATION EDUCATOR PRN - REMOTE Camden, NJ Job ID 63306 Job Type Per Diem Shift Day Specialty HIM/Coding Apply Save About us At Cooper University Health Care , our commitment to providing...

The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nations top hospital systems for best...

Rose Senior Living - Avon is seeking a Nursing Unit Manager to oversee patient care activities and nursing personnel in Los Angeles, California. This role involves coordinating with the Director of Nursing and ensuring compliance with Standards of...

Description The Quality Management Nurse is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with healthcare standards and regulations. This role involves evaluation clinical practices, identifying areas...

Nurse 3 Job Number: 364864 Category: Administrative Description: Job Title: Nurse 3 Location: Redondo Beach, CA Zip Code: 90278 Pay Rate: Up to $65.09/hr. Schedule: 9x80 A Start Date:...

Surgical Nurse Accountable for the assessment, planning, treatment and evaluation during the pre operative, intra operative and post operative phases of nursing care. Assists the physician during surgery and procedures by functioning in...

Overview Performs inpatient chart review to determine appropriate DRG assignment and assures appropriate documentation in the chart to support clinical care provided, including severity of illness and risk of mortality which...

We are recruiting for a mission-driven RN Educator, Clinical Documentation Integrity - Must Reside in Colorado to join our team! We're with you for life's journey. At Denver Health, purpose isn't just something we believe in-it's something...

" Licensed Psychiatric Nurse Practitioner Wage: Up to $196.58/hour Did you know that you can build a flexible...