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CareFirst BlueCross BlueShieldColumbus,OH
Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The...
MaximusColumbus,OH
Description & Requirements Be part of something great Maximus is a global organisation that specialises in providing health and employment services to millions of people every year. Here in the UK we employ...
Providence Health & ServiceColumbus,OH
RN Utilization Review Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review medical records daily during admission for all payers, as required by the...
TEKsystemsColumbus,OH
*Quality Assurance Registered Nurse - 100% Remote* Contract duration: 520 hour contract to hire Training Schedule: M-F, 4-6 weeks *Contract Details* * *Contract Duration:* 520-hour contract-to-hire, long term opportunity *...
UnitedHealth GroupColumbus,OH
Provide high-quality clinical services within scope of practice and infection control standards. Coordinate care with other members of the patient/client's care team from admission to discharge. Complete clinical nursing assessments per...
Ohio State UniversityColumbus,OH
The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute?s (OSUCCC-James) mission is to improve health in Ohio and across the world through innovation in research, education, and patient care. The...
Home Care Association of AmericaColumbus,OH
A healthcare organization in Atlanta, Georgia is seeking a Registered Nurse (RN) to create care plans and perform evaluations for clients. Responsibilities include reviewing charts, ensuring quality care, and communicating with various...
Fuze HealthColumbus,OH
A healthcare innovator in California is seeking a Registered Nurse to provide remote care as part of a telehealth team. Responsibilities include conducting assessments, educating patients, and ensuring compliance with healthcare regulations.
AccessNurseColumbus,OH
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...
Elevance HealthColumbus,OH
A prominent healthcare provider is seeking a Nurse Reviewer I for a virtual position responsible for conducting reviews of diagnostic imaging services. The ideal candidate should possess an AS in nursing and clinical nursing experience, alongside...
CoxHealthColumbus,OH
Facility: CoxHealth South: 3801 S National Ave, Springfield, Missouri, United States of America, 65807 Department: 1651 Virtual Care Command Center Scheduled Weekly Hours: 24 Hours:...
Westside Family HealthcareColumbus,OH
Job Type Full-time Description WESTSIDE IS LOOKING FOR A NURSE / RN TO JOIN THE VIRTUAL NURSE TEAM! SIGN ON BONUS OFFERED! LOAN PAYOFF PROGRAMS...
BOSTON PUBLIC HEALTH COMMISSIONColumbus,OH
Carries out communicable disease surveillance, prevention, and control measures for the City of Boston. Investigates reports of communicable diseases including pathogens of public health importance, reported outbreaks, or other...
SedgwickColumbus,OH
A leading healthcare services company is seeking an RN for pharmacy utilization management in Boston. Responsibilities include performing clinical assessments and evaluating drug usage for safety and quality standards. Ideal candidates will...
HealthMap Solutions LLCColumbus,OH
Registered Nurse, Quality Assurance Reviewer The Registered Nurse, Quality Assurance Reviewer will work in conjunction with the Quality Manager and will be responsible for completing quality reviews for the Clinical Services and Provider...
IntelycareColumbus,OH
Registered Nurse Endocrinology - Albany, NY If you are looking for a Hybrid RN II position, full time, this could be your opportunity. Here at St. Peter's Health Partner's, we care for more people in more places. This position will be...
Yale New Haven HospitalColumbus,OH
A leading healthcare organization in Stratford, Connecticut, is seeking a Nurse Home Visitor to provide home visiting services to families with newborns. The role involves health assessments, supporting parents with community resources, and...
Sentara HealthcareColumbus,OH
City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health is currently hiring for a Utilization Review Nurse- Remote in VA! Status: Full-time, permanent...
Georgia StaffingColumbus,OH
Clinical Documentation Specialist 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...
Beth Israel Lahey HealthColumbus,OH
Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This position is remote. Candidates must be local...
Mass General Brigham Health PlanColumbus,OH
A healthcare provider is seeking a Medicare UM Case Manager, RN, to perform utilization management activities for Medicare Advantage. This remote role focuses on reviewing authorizations for various services and requires an Associate's Degree in...
US Tech SolutionsColumbus,OH
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...
OpenLoopColumbus,OH
A telehealth organization is seeking a compassionate Registered Nurse (RN) for a part-time Telemedicine RN position based in Honolulu, HI. You will support patient care by assessing needs, offering medical advice, and ensuring optimal health...
Remote StaffingColumbus,OH
Care Manager 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 virtual health platform is...
Ohio State UniversityColumbus,OH
The Clinical Research Finance & Compliance (CRFC) Department plays a vital role in supporting the financial infrastructure of oncology clinical trials. CRFC is responsible for the full spectrum of financial operations, including project budgeting,...

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