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Program Integrity Clinical Compliance AuditorOptum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers.

Job OverviewPay Range: $46.76hr - $51.76hrRequirement/Must Have5+ years Clinical nursing experience.2+ years Care Management.Bachelor's Degree in Nursing.In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required...

Clinical Documentation Integrity Specialist IIThe Clinical Documentation Integrity Specialist II (CDI) is responsible for utilizing independent clinical judgement in facilitating the integrity, overall quality, accuracy, and completeness of...

Self Fund Health Nurse Navigator Remote · Full time The Nurse Navigator is a remote WI-based RN who acts as the member's single point of contact through the healthcare system — coordinating care, advocating for patients, and steering...

To support Oregon Medicaid, the full-time Oregon Licensed Utilization Review Clinician will conduct clinical reviews and assessments related to mental health and substance abuse services, ensuring medical appropriateness for both inpatient and...

Trusted is seeking an experienced nurse for this exciting travel nursing assignment. Trusted has streamlined the travel nursing experience by enabling nurses to apply directly to jobs without the need for recruiters. This unique approach provides...

Review NurseThis is a contract assignment that will start right away and end on April 30th 2024Summary Description:The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and...

Job Title: Nurse, Clinical Medical Review Location: Columbia, MD (Primarily remote, but hybrid) Duration: 6 Months Contract PURPOSE: We are seeking a qualified RN or LPN with experience supporting HEDIS reporting and abstraction processes in a...

At Virtua Health, we exist for one reason – to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced...

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...

Conduct nursing assessments and enroll patients in chronic care management.Develop care plans and coordinate transitions across healthcare settings.Collaborate with teams to improve quality and value-based outcomes.Requirements:Active RN license...

Psychiatric / Behavioral Health Nurse Job Overview As a Psychiatric / Behavioral Health Nurse, you will help provide comprehensive mental health care for Soldiers, their families, and military retirees. You will also care for those in emotional...

Job Summary: Collaborates with Education Consultants, Managers, CNS staff and Physicians to develop, design, deliver and evaluate/improve education strategies and special projects/programs based on clients departmental...

Work From Home Nurse Practitioner (PMHNP - Telehealth - Flexible Schedule)Join to apply for the Work From Home Nurse Practitioner (PMHNP - Telehealth - Flexible Schedule) role at NPHireBase pay range$175,000.00/yr - $200,000.00/yrAbout the RoleA...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.Patient...

Registered Nurse Navigator - Cancer Center Exams - 10 Hour Days Do you have a passion for the highest clinical quality and patient happiness? Would you like to use your expert clinical competencies with an organization known nationally...

We are seeking Registered Nurses with at least 5 years of clinical experience to join our internal data annotation team.You will review agent conversations spanning primary care, chronic disease management, care management, medication adherence,...

Case Manager Brighton Health Plan Solutions (BHPS) provides Case Management services to its clients. Cases are maintained by Case Managers. The employee reports directly to the Supervisor, Case Management (LCSW). In addition, the role...

Hone is a virtual medical clinic for men's/women's health, hormones, weight loss, and longevity.We are remote-first and fast-growing, focused on candid communication and joy.The Role:You will manage patient-doctor communications and clinical...

Provide a full range of nursing practice guided by the American Nursing Association's (ANA) Nursing Scope and Standards of Practice (2004) and dependent upon...

Registered Nurse Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Evenings Job Description Join a team that's shaping the...

Job Title: Registered Nurse (Navy Nurse Corps) Category / Component: Officer • Both Overview Navy Nurse Corps Officers deliver professional nursing care to service members, families, and global communities in leading edge military medical centers,...

Manage CMS and State Administering Agency audits for PACE compliance.Ensure audit readiness and serve as point with audit teams.Champion compliance culture across the organization.Key Responsibilities:Monitor audit universe data and review...

Requisition Details GENERAL REQUISITION INFORMATION EEO Statement: UNMC is an Equal Employment Opportunity Employer, including an equal opportunity employer of protected veterans and...

*Job Summary and Responsibilities* As our Registered Nurse (RN), you will be a pivotal healthcare professional, delivering compassionate, high-quality care that truly impacts our patients' well-being and recovery. Every day, you will...