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Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.)...

The Clinical Quality Specialist (RN) plays a key role in advancing the quality, safety, and effectiveness of the member experience at Included Health. This position focuses on evaluating and improving how members engage with care across all...

What You'll DoMake outbound calls to eligible Medicare patientsExplain Shield Health's care management programs in a clear, patient-friendly mannerAnswer patient questions and address common concernsBuild rapport and trust with patients over the...

Payrate: $60.00 - $62.00/hr. Summary: The main function of the nurse is to provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and...

Job Posting Location: 6595 Springfield Center Drive, Springfield, VA, 22150, United States Base Pay: $51.77 / Hour Job Category: RN Employee Type: SCA- Full Time Required Degree: 4 Year Degree Travel: 5%...

Supervisor of Nursing Clinical Research (RN)Providence Saint John's Cancer Institute (SJCI), located in Santa Monica, CA, pioneers drug discovery, therapeutics, and clinical trials. This full‑time, day‑shift role (8 hour days, no weekends)...

Sixty million Medicare seniors live with chronic disease. The care system sees most of them twice a year. Cadence is building the infrastructure to support them every day. Cadence is a clinical AI company that delivers continuous, proactive...

Post-Discharge Patient Outreach Coordinator Inspire health. Serve with compassion. Be the difference. Responsibility for initiating phone contact with discharged patients from specified units, conducting query on patient experience...

Staff Field Nurse (RN) Senior Helpers of Northern Queens is looking for a dedicated and compassionate Field Nurses (RN) to oversee the work of the LPN and Caregiver team on client assessments and while working with clients in the home.

Job Description The RN TeleNurse is responsible for triaging incoming patient calls. Promotes and demonstrates leadership within the department. Promotes the philosophy of wellness; serves as a resource person, educator, and patient...

Utilization Management Registered Nurse The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the coordination, documentation and communication of medical services and benefit administration...

About the Job Registered Nurse Clinical Reviewer / AIMS - Remote (#25299A) Location: Remote. Employment Type: Full-time. Hourly Rate: $50/hr.

Start the day excited to make a difference...end the day knowing you did. Come join our team. Job Summary: The Virtual Registered Nurse (VRN) is responsible for providing professional nursing care with collaboration from the...

Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical...

Annual Salary$82,162 to $120,122; $92,373 to $135,051; $98,031 to $143,341. A 2.75% bonus may be paid upon proof of professional nursing certification by a professional organization that is relevant and applicable to the duties performed. Some...

• Position: 36 hours per week • Shift: Afternoons 12 Hour Shifts • Every other weekend and Holiday Rotations • Benefits: Full time benefit package MUST be within driving distance of Elijah McCoy building in...

Registered Nurse Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland. The Center for...

Remote Registered Nurse Position Join a stable work-from-home team! This is a great opportunity for a local remote position. There is no communication with patients. This position supports all units/staff (commercial, behavioral health,...

Choices Case Management, Inc. is seeking a Medical Case Manager to work from home while providing care coordination in workers' compensation cases. This is a training position for Registered Nurses without prior workers' comp experience, requiring...

Chamberlain University is seeking Part Time Clinical Instructors for its Bachelors of Science in Nursing program in Irwindale, California. Ideal candidates will hold a Master's Degree in Nursing and have at least two years of direct patient care...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

The Registered Nurse in the Operating Room provides safe and effective care of the perioperative patient. The OR RN is responsible for assessing the patient, planning and implementing care specific to each patient's needs. The OR RN coordinates the...

$82,162 to $120,122; $92,373 to $135,051; $98,031 to $143,341A 2.75% bonus may be paid upon proof of professional nursing certification by a professional organization that is relevant and applicable to the duties performed. Some positions require...

Prospective Review RN Department: Utilization Management Location: Children's Health- Trinity Towers Shift: Full-time, Monday through Friday Job Type: Remote, with some occasional onsite attendance required Why...

Description The Quality Management Nurse is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with healthcare standards and regulations. This role involves evaluation clinical practices, identifying areas...