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Work Mode: Fully remote position Responsibilities: Perform utilization review activities, including concurrent and retrospective reviews of inpatient cases using...

Knowtion Health seeks an Appeals Nurse to review medical records and support denials appeals for Medicare, Medicaid, and other payers. You will craft detailed analyses and letters, aligning criteria with payer policies to secure appropriate...

Ssbv Clinical Claims Review RnOptum 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 will directly improve health outcomes by connecting people with the...

Job ID: 33022 Description Take on a key role within an award-winning health system. Help improve patient experiences as part of a world-class healthcare team. Take your career in an exciting new direction. You can...

CVS Health is seeking an Oncology Nurse Consultant (RN) for a 100% remote role spanning the contiguous U.S. You will lead clinical care coordination and utilization management within the Oncology Care Model, guiding members through diagnosis,...

Elevance Health is seeking a Nurse Case Manager I in Latham, NY, to perform care management for members with complex chronic needs, assessing, developing, implementing, coordinating, monitoring, and evaluating care plans. Roles may be telephonic...

Community Care Cooperative (C3) is seeking a Licensed Care Manager for our hybrid float pool in Boston, MA. You will conduct comprehensive assessments, coordinate care, and support patients with chronic conditions across care settings. The...

Job TitleHigh signal to noise ratio, make the content beautiful.Job DescriptionHelpTotal Rewards of a Allied Health ProfessionalDirect Patient CareProvides advanced assistance with activities of daily living (ADLs), including hygiene, toileting,...

Under the supervision of the RN Patient Scheduler Manager, provides timely, efficient, and accurate triage response and documentation. Evaluates patient needs and performs triage within the contact center setting, operating within...

General Hours of Work:4 PM to 10 PM, with night shift availability Exempt/Nonexempt: Non-Exempt (hourly) Department/Unit:Avel eCare Senior Care Hours/FTE:24 hours weekly/ 0.6 FTE...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing and evaluating care of patients. The staff RN utilizes the nursing process by use of...

A leading virtual care organization is seeking a Work-From-Home Nurse Practitioner to support its telehealth services. This role offers a flexible schedule and the opportunity to provide virtual care assessments for various acute issues. Qualified...

We believe everyone should have confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care...

Description: FAMILY NURSE PRACTITIONER JOB SUMMARY Provides continuous and comprehensive services necessary for the promotion of optimal health, prevention and treatment, in an underserved community clinic. To perform a variety of advanced clinical...

National Care Advisors seeks a Nurse Case Manager based in Portland to oversee case management for special needs and eldercare, coordinating with families, attorneys, financial planners, and trustees to improve quality of life. The role requires...

Fire Department Nurse Educator, Per Diem – Emergency MedicineWork Location: Los Angeles, CAJob #: 28350Work Hours: Varies depending on departmental needsEmployment Type: 6 – Staff- Per DiemDuration: IndefiniteSalary Range: $34.6-70.91...

Asure Wound Solutions is seeking a Clinical Specialist, Wound Care Supplies in the Boston area. This is a remote position you must live in; travel up to 2 hours is required. Active nursing license and 3+ years in long-term care are needed, wound...

The Virtual Nurse, RN at MUSC Center for Telehealth coordinates and delivers professional clinical services to patients via virtual care. This role supports pre-visit, during visit, and post-visit planning and assists with referrals and care plans...

Review claims files to detect potentially fraudulent billing practices.Use medical terminology and coding to assess payment appropriateness.Write investigative summary reports and provide expert testimony.Requirements:Active RN license and 2+...

To support care management functions, the full-time Health Services Intake Specialist will facilitate eligibility and benefit verification, authorization status inquiries, and documentation processes, initially training onsite before becoming...

Summary Join the VA Greater Los Angeles Healthcare System and serve those who served! As a Nursing Assistant on the night shift at our West Los Angeles Community Living Center 215-2 - you'll work alongside licensed nursing staff to...

IntellaTriage is seeking an experienced registered nurse (RN) to perform after-hours hospice triage by phone. The role emphasizes compassionate care, timely interventions, and coordination of care with on-call teams while working remotely.

UnitedHealth Group is seeking a Secondary Review Nurse to evaluate HCBS and Medicaid requests, ensuring medical necessity, cost-effectiveness, and alignment with member service plans. This remote role is open to Indiana residents and offers...

Inova Health System is seeking a Registered Nurse (RN) for Virtual Acute Care in Virginia. This full-time role requires a 36-hour work week with a rotating schedule and four weekend shifts every six weeks. After six months, eligible for one remote...

WellSense Health Plan in Massachusetts is seeking a Remote Prior Authorization Clinician to review hospitalization and outpatient services for medical necessity using InterQual guidelines, ensuring timely and appropriate care for members. This...