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R1 RCM Inc. is seeking a Clinical Coding Appeals Nurse to review medical records and draft appeals for denied and underpaid claims. The role focuses on accurate coding using ICD-9/10, CPT, HCPCS, and NCCI guidance, and requires inpatient...

Pager Health℠ redefines how members navigate to care and wellness, validated by clinicians and powered by AI. We connect people to the right care at the right time, closing care gaps, reducing total cost of care, and...

Blood Cancer United is seeking a nurse to support patients pursuing clinical trials and educate families on diagnostic and treatment options. You will collaborate with the IRC and trial staff, maintaining a caseload and contributing to materials...

Experienced Nurse Opportunity Are you an experienced nurse with a strong understanding of MDS assessments and care planning? Join our team and play an important role in ensuring residents receive quality, individualized care.

Utilization Management Nurse Consultant (RN) Remote | Concurrent Review | Utilization Management Are you an experienced RN with utilization management or prior authorization experience looking to make an impact beyond bedside care?

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Part Time Southborough, MA, US Salary Range: $38.00 To $40.00...

Humana is seeking a Pre-Authorization Nurse 2 to review requests for medical necessity and level of care, using clinical judgment and guidelines. The role supports education of providers and data entry in clinical systems, with opportunities to...

BH experience required. Must be licensed in OH or have a complact license. The Care Review Clinician will provide prior authorization for behavioral health services for the OH Medicaid population. Strong behavioral health...

ATC Candidate Medical Clearance Coordinator Serves as a member of a multidisciplinary team to provide assessment, planning, implementation, coordination, evaluation and monitoring of ATC Candidates throughout the medical clearance...

Telephonic Registered Nurse 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 colleagues who care...

WelbeHealth PACE helps seniors stay in their homes and communities by providing comprehensive medical care and community-based services. We serve the most vulnerable seniors with better quality and compassion in a value-based model.The Case...

Atrius Health, part of the Optum family, seeks a Registered Nurse to deliver effective care within a specialty, adhering to nursing standards. The role emphasizes education, care coordination, and EMR documentation, with remote work flexibility...

Stanford Health Care in Palo Alto is seeking an Oncology Nurse Navigator to coordinate care from diagnosis through survivorship. As a licensed RN with oncology experience, you will partner with physicians, social workers, nutritionists, and...

Job Category: Nursing - Registered Nurse Work Shift/Schedule: 8 Hr Morning - Afternoon Northeast Georgia Health System is rooted in a foundation of improving the health of our communities. About the...

Nurse Case ManagerPosition Type: Full-Time Contract RoleLocation: Work from homeWork Type: Remote Est. Pay Range: $35.00/hour – $38.46/Hour on W2 (USD) (all inclusive)Schedule: Mon-Fri 8am-5pm ESTRegistered Nurse with active state license in...

Job Description: The Hospitalist Coordinator RN plays a vital role in supporting the delivery of safe, efficient, and patient-centered care for hospitalized patients at St. Mary's Regional Hospital. Serving as a key partner to physicians, care...

Family Advocate Support Care - Senior Clinical Admin 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...

The Veterans Health Administration at the Charleston VA Medical Center seeks a Nurse Manager (RN) to lead and supervise designated units within Community Care. The role emphasizes staff development, evidence-based practice, and collaboration with...

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving...

Cancer Nurse Navigator Do you have a passion for the highest clinical quality and patient happiness? Would you like to use your expert clinical competencies with an organization known nationally for excellence in cancer treatment,...

Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude...

Highpoint Health Sumner is seeking a Registered Nurse (RN) Clinical Documentation Specialist to join as a remote FT (days). You'll contribute by applying plan-of-care interventions and driving patient-care innovations with advanced technology.

Job Profile Summary Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's...

aitrainer is seeking a Remote Registered Nurse (RN) to conduct health screenings for a health study. This role involves remote assessments, eligibility determination, and scheduling onsite sessions, all while ensuring HIPAA compliance.

Forensic Registered Nurse (RN) Scheduled Weekly Hours: 36 Work Shift: Days/Afternoons (United States of America) Summary of Primary Function The Forensic Registered Nurse (RN) is a highly specialized professional who...