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Evaluating medical necessity and appropriateness for claims, the full-time State Licensed Legal Nurse will review liability demand packages, analyze medical records, and support negotiation and litigation efforts in a remote environment.Key...

Telephonic After-Hours Call - Evenings, Nights & Rotating Weekends Required Full-Time (40 Hours) Active and unrestricted license NP license is required in one of the following states: New York, New Jersey, Connecticut, Maine, New...

Austin Regional Clinic Telephone Nurse Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years! We are one of central Texas' largest professional medical groups with 35+ locations and we are...

Our Mission We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to...

A company is looking for a Telehealth Good Faith Exam Nurse Practitioner.Key ResponsibilitiesProvide Good Faith Exams for patients in licensed states according to protocolsSend in prescriptions as per protocol under Medical DirectorsField 8x8...

Clinical Grievances Nurse 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...

Staff Nurse-Surgical Oncology, Gynecology and Urology 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...

Leading a team of Utilization Management Nurses, the full-time California Licensed Utilization Management Nurse Lead will review inpatient and prior authorization requests, ensuring timely processing and high-quality medical outcomes while working...

Requisition number: 2366096 Job category: Nursing Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team...

Licensed Practical Nurse This 0.8 FTE role provides safe, high-quality care to a variety of age groups. The LPN plays a vital role in delivering primary care services to infants, children, and adolescents in our school-based health...

A company is looking for a Nurse Case Manager (WC and PIP).Key ResponsibilitiesNegotiate fees and coordinate referrals with rehabilitation and medical case management vendorsGather, analyze, and report service data significant to clients and...

Licensed Practical Nurse In Home Health The Licensed Practical Nurse in Home Health is responsible for providing quality patient care and performing technical skilled care in the patient's home. Primary Responsibilities: ...

Nurse Practitioner, Advanced Practice Provider We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate...

A company is looking for a Virtual Primary Care APP (Nurse Practitioner or Physician Assistant).Key ResponsibilitiesProvide virtual primary care visits, including assessments, chronic disease management, and acute care interventionsDiagnose and...

Clinic Nurse- Hematology and Acute Leukemia Clinic 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...

A company is looking for a Utilization Management RN to ensure efficient healthcare resource use while promoting quality patient care.Key ResponsibilitiesCoordinate with healthcare teams to assess and monitor the delivery of healthcare...

A company is looking for a Nurse Care Coordinator to provide proactive utilization management services for high-risk members.Key ResponsibilitiesDeliver exceptional service to members and coordinate care with interdisciplinary teamsManage daily...

RN Clinical Consultant, a full-time remote position, provides clinical expertise in reviewing disability claims, assessing medical conditions, and collaborating with healthcare providers to enhance treatment outcomes.Key ResponsibilitiesReview and...

A company is looking for a Utilization Review Clinician - Behavioral Health.Key ResponsibilitiesEvaluate member's treatment for mental health and substance abuse to ensure medical appropriatenessPerform prior authorization reviews and concurrent...

Seeking a remote California RN/LVN Utilization Management professional, the full-time nurse will review prior authorization requests for medical necessity across inpatient and outpatient services, applying CMS guidelines and Milliman Care...

A company is looking for a Psychiatric NP Supervisor (Remote).Key ResponsibilitiesProvide direct clinical care to patients while supervising a team of 6-8 cliniciansConduct comprehensive intake evaluations and develop patient-centered treatment...

Remote Nurse Patient Access Specialist (RN/LPN), this full-time role serves as the primary contact for patients and providers, facilitating access to therapy through benefit investigations, insurance verification, and support for prior...