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JOB SUMMARY The Utilization Review (UR) Nurse is a registered nurse who provides clinical review against nationally recognized medical necessity criteria for the purpose of evaluating medical necessity or hospitalization...

Description 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...

Fully Remote JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include gathering, analyzing and providing date...

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...

Summary As a leader in eldercare for nearly 70 years, we are always looking for qualified people to join the Stella Maris team. Unique opportunity to join the dynamic, collaborative and well-established Admissions...

Job Summary: The Intake Nurse - RN is responsible for assessing potential new members for eligibility for the program and for explaining the program to them and their families. Responsible for knowing required outreach activities...

NCCC offers competitive salaries, medical and dental benefits to qualified employees and opportunities for growth and advancement. Hiring a full-time RN. Flexible schedule availability including daytime and evening hours Monday - Saturday...

Job Description We are seeking experienced Psychiatric Mental Health Nurse Practitioners (PMHNPs) to join a growing outpatient telehealth practice focused on delivering high-quality psychiatric care to adult and geriatric...

Join the Patient Management Unit at a key moment in our history as we strengthen our clinically-driven, patient-centered preadmission pathway for DSH patients! Under direction of the Chief Psychologist of the Patient Care Coordination...

Location: BROOKLYN HEIGHTS Biweekly Hours: 80.00 Shift: Day/Evenings 7:00 AM-730 PM, 9:00 AM-9:30 PM, 11:00 AM-11:30 PM-Rotating weekends/holidays The MetroHealth System is redefining health care by going...

Description As a Hospice Registered Nurse Case Manager (RN) you will be called to care when you're needed most. As part of Interim HealthCare, you'll support a full range of patient services to bring comfort and dignity to our...

Our Utilization Management RN (Registered Nurse) evaluates efficiency, appropriateness, and medical necessity for medical services, and procedures for our Health Plan. This role uses clinical knowledge to provide judgment to...

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.Join HCSC and be part of a...

Job Description Are you a registered nurse ready to take your career in an exciting new direction-one where your expertise truly makes a difference? Join Pennsylvania's premier Quality Improvement Organization and step into a...

Job Description Position Summary: We have an exciting opportunity to join our team as a Telehealth Nurse - Access Center - Boynton Beach, Florida. In this role, the successful candidate carries...

Job Summary This position is responsible for pre-authorization reviews in accordance with the medical contract and regulations, medical criteria, utilization review, and quality of care.Required Job Qualifications LPN with valid, current,...

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of...

Location: Work from home (Pennsylvania) Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: Yes Job...

Job Description Summary The Utilization Review Registered Nurse is responsible for reviewing medical services to ensure they meet evidence-based guidelines and member benefit plans. This includes...

Summary Summary Independently plans and provides excellent professional nursing care for patients in accordance with physician orders, established hospital and departmental policies and procedures, American Nurses...

Nurse Practitioner | Family Practice Location: Alaska Employer: Opportunity Healthcare Pay: Competitive weekly pay (inquire for details) Start Date: ASAP About the Position Family Nurse Practitioner job in Nome Census Area, AK — offering up to...

What You'll Do: The Ohio Department of Health / Complex Medical Help program is looking for an experienced nursing leader to oversee statewide public health nursing programs, guide policy development and ensure consistent,...

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...

Schedule: PRN - as needed coverage No set hours or consistent days This position is fully remote, however the selected candidate must reside in a state that Rogers currently operates in - (WI, MN, IL, PA, TN, FL, GA, CO, CA, WA,...

Competitive Compensation & Benefits Package! Position eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and...