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Utilization Review Nurse Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization Review Nurse, you'll play an important role in helping us offer customized, self-funded...

Job Requirements Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the patient's need...

PIH Health in Whittier, CA is seeking a Licensed Vocational Nurse to provide direct or indirect nursing care to patients presenting with urgent or potential health concerns in the medical office setting. Under the direction of a practitioner, the...

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...

Case Manager Utilization RNWorks collaboratively with an MD to coordinate and screen for the appropriateness of admissions and continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the...

Job Title: Remote Prior Authorization Registered NurseJob Description We are seeking experienced Registered Nurses (RNs) to join a remote Prior Authorization team supporting Dual Eligible (Medicare and Medicaid)...

Saint Luke's Hospital of Kansas City in the United States is seeking an experienced Registered Nurse for our Primary Care Shoal Creek location. The role features a Monday through Friday schedule, 8:00 am to 4:30 pm, with no nights, weekends, or...

UCLA Healthcare Careers is seeking an LVN Supervisor to serve as a clinic level supervisor, performing a variety of clinical and administrative duties related to clinical management of practice and patient care.Under the general direction of the...

Job Tittle: Healthcare - Clinical Appeals Nurse (RN) Location: Location: Remote - Must reside in **AZ, FL, GA, ID, IA, KY, MI, MS, NE, NM, NY (outside Greater NYC), OH, SC, TX, UT, WA (outside Greater...

Registered Nurse In An Outpatient Clinic Join our team as a Registered Nurse in an Outpatient Clinic, where you'll provide essential care in a dynamic environment. What You'll Be Doing Provide nursing care in an...

Job Description Utilization Review RN - Remote. This position is Per Diem and will work 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA...

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 will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...

CVS Health Corporation is seeking a RN-qualified professional to lead quality improvement initiatives and performance measurement within POSC, aiming to meet HEDIS and CAHPS goals. The role involves analyzing clinical workflows, implementing...

Title: Family Nurse Practitioner Base Salary Range: $142,000 - $145,000 plus benefits FTE: Full -Time - Exempt We are seeking a dynamic and experienced Family Nurse...

The University of Rochester is seeking a Proficient Licensed Practical Nurse to join the Urology team in Canandaigua, NY. This full-time position covers patient care in ambulatory/office settings with occasional travel to other offices.Requires NY...

Find your calling at Mercy! Position Details: Primary Care Nurse RN or LPN Mercy Clinic Primary Care - Watonga Monday-Friday, 40 hours per week *This is a hybrid remote...

Concurrent Review Registered Nurse (RN) Location: Fully remote. Our client is seeking an experienced Concurrent Review Registered Nurse (RN) to join its Utilization Management team. In this role, you will perform concurrent...

Nursing QA Specialist The primary function of the Nursing QA Specialist is to review and audit Home Health Agency visit notes for documentation consistency with the patient's Plan of Care and adherence to the quality of care guidelines...

Workers' Compensation Telephonic Nurse Case Manager The Workers' Compensation Telephonic Nurse Case Manager is responsible for evaluating and expediting appropriate, cost-effective medical treatment of injured employees with the goal of...

1:1 School LVN Setting: Schools Job Type: Contract - Part Time Pay: $33 / Hour Hours: 20.00 Location: El Monte,...

Job Summary and Responsibilities As our Public Health Program Specialist you will be responsible for developing, Implementing, and coordinating health-related services for pregnant and postpartum women and their families,...

JOB DESCRIPTION Job Summary Work Location: California - Ability to work remote, but selected candidate must reside in the state of California. This position requires California RN Licensure. Candidates must...

Registered Nurse Outpatient Clinic CSMN - 1101290 - ENT 590W Day 5x8-Hour (08:00 - 17:00) No 04/28/2025 13 1 2847897 Stephanie Straka [email protected]...

Registered Nurse Specialist Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Nights, Variable Job Description Join a team...

Company Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable,...