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The Licensed Vocational Nurse is responsible for providing direct or indirect nursing care to patients who present with urgent, emergent, or potential health problems;...

To support coding accuracy and clinical documentation integrity, the fully remote HCC Clinical Documentation Specialist will validate chronic conditions, perform prospective reviews of medical records, and utilize Epic to ensure accurate HCC...

Job SummaryWorks collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical...

Peraton is seeking a Nurse Reviewer for SafeGuard Services (SGS) to conduct medical record reviews and apply clinical judgment to claim payment decisions. The role includes researching Medicaid claims data, developing cases for potential...

Join Us! With 37+ years of experience, Amergis is committed to putting patient care first while supporting our nurses with work-life balance, flexible scheduling, and clear career growth opportunities. Join a stable, nationally recognized...

A Licensed Vocational Nurse, who under the supervision of the Clinical Director, coordinates the functions of the clinical services as it relates to efficient intake of...

Providing clinical review support on an as-needed basis, the part-time PRN Clinical Review Nurse (RN) will review medical records for medical necessity, authorization compliance, and payer guideline alignment while supporting appeal submissions...

The Registered Nurse (RN) Case Manager provides care coordination which emphasizes positive partnerships with nursing, physicians and other key disciplines in order to pace...

To ensure the highest quality and integrity of peer review case reports, the full-time Remote RN Clinical QA Coordinator will perform quality assurance reviews, verify compliance with client specifications and regulatory standards, and support the...

The RN Clinical Educator, Ancillary Services is an advanced clinical expert in Cath Lab and procedural-based services who supports...

Responsible for collaborating with healthcare providers and physicians for problem solving, prioritizing and facilitating patient care objectives, the coordination and...

The Lead, RN Case Manager is an experienced RN Case Manager who provides clinical and operational support to the Care Management leadership team. In addition to performing the full scope of an RN Case Manager, the Lead is...

Responsible for independently utilizing the nursing process to safely, therapeutically and efficiently care for a group of patients based on policies and procedures.

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The Ambulatory Case Manager, LVN is responsible for providing comprehensive care coordination and case management services to members,...

PIH Health is seeking an LVN Medication Refill Nurse to process refill requests and verify appropriateness against practitioner orders and established protocols. The role includes educating patients about refill policies and identifying barriers...