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About This Role The Case Management Utilization RN works collaboratively with physicians to coordinate patient admissions and continued stays, ensuring appropriate care levels and safe discharge plans. This role is ideal for those who thrive in a...

*Job Summary and Responsibilities* As our Nurse Shift Manager, you'll oversee a department of frontline nurses caring for patients. Every day you will advocate for your fellow nurses as you support them in reaching their full potential,...

SCAN Health Plan is hiring a registered nurse for clinical review of medical claims and post-service appeals. You will analyze pre/post payments, perform audits, and apply CMS guidelines to determine medical necessity and appropriate care.

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 millions of people for the better. Come build the health care system...

Sedgwick is seeking an RN Field Case Manager to join our nationwide team in a remote, home-based role with occasional travel. You will work with injured workers and medical providers to coordinate care, advocate for treatment, and support timely...

Humana, Inc. is seeking an Utilization Management Nurse 2 to coordinate, document, and communicate medical services and benefit determinations for our members. You will interpret clinical information to support recommendations and care...

We are seeking to hire a Treatment Nurse - Licensed Vocational Nurse to join our team! We are a skilled nursing facility looking for dynamic associates to join our clinical team and provide our residents with a best-in-class care experience.

Sagility is seeking a Senior Care Specialist (Registered Nurse) to work from home. The role focuses on telephonic health assessments, personalized care plans, and coaching for Medicare/Medicaid populations. Ideal candidates will hold an...

Tryfacta, Inc. is seeking an LVN-LPN Urgent Care clinician for a 13-week contract in Playa Vista, CA 90094. The role requires 1 year Urgent Care/ER experience and 2 years outpatient experience. Work schedule is Day Shift—4×10 hours with a pay...

Virginia Mason Franciscan Health is seeking a Virtual Pre-Admit RN to perform comprehensive pre-operative assessments, collect patient histories, and review diagnostics to ensure patients are ready for anesthesia and surgery. You will...

$38-$52 per hour Fullerton, CA Contract Duration: 05 Months Job Description: We are seeking compassionate and dependable Registered Nurses (RNs) to join our nationwide...

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 deeply, innovate with purpose, hold...

JOB DESCRIPTION Opportunity in Southern California for an experienced Managed Care Leader to join our health plan in California. Candidates must have a minimum of 7 years of healthcare experience, 3 of those should be with a Managed Care...

*Job Summary and Responsibilities* As our Director Nursing Perioperative Services at California Hospital, you will be responsible for Surgical Services including Main OR, Pre-Op, PACU, GI, and SPD. We have 7 operating rooms and a robust surgical...

68C Practical Nursing Specialist Job Overview: You will play a pivotal role in delivering top-tier medical care to our patients. Collaborating with a team of world-class physicians, you will...

BlueCross BlueShield of South Carolina, Palmetto GBA Medical Review team, seeks an RN Medical Reviewer II to apply clinical guidelines and protocols for medical reviews and payment determinations from a home office. This full-time role emphasizes...

Licensed Vocational Nurse (LVN) – OB/GYN SpecialtyNoor Staffing Group is seeking a dedicated and experienced Licensed Vocational Nurse (LVN) with a focus in OB/GYN for a reputable healthcare facility in Los Angeles, CA. This role offers the...

Job Description SummaryThe Certified Nursing Assistant is responsible for caring for the personal needs and comfort of residents. The Certified Nursing Assistant performs routine duties within the limits of training and certification in caring for...

Description: Job Summary: Collaborates with other educators, managers, physicians, and other healthcare providers to develop, design, deliver and evaluate/improve education strategies and programs/classes based on member/patient...

BJC HealthCare is seeking a Clinical Documentation Quality Coordinator to perform second-level reviews, address mortalities, prebill checks, and staff education. The role requires 2 years CDI and nursing experience, RN licensure, and CCDS...

Serenity Cove MHRC in Los Angeles, CA is seeking a Licensed Vocational Nurse / Licensed Practical Nurse (LVN/LPN) for a NOC shift to join our caring healthcare team. You will deliver a full range of nursing care under the direction of a...

Seeking a full-time LVN who is passionate about mental health. This position is specifically for 6.30am- 7pm.Who We Are:Since 2000, Clearview Treatment Programs has offered individualized evidence-based treatment for adults suffering from mental...

Elevance Health, Inc. is seeking a Nurse Case Manager I (RN) to perform telephonic care management for members with complex and chronic care needs. The role supports assessment, development, implementation, coordination, monitoring and evaluation...

Buena Vista Home Health, Palliative Care & Hospice (BV) is seeking an experienced OASIS Review Nurse (RN) for a remote, part-time QA role. The RN will ensure OASIS assessments are accurate, complete, and compliant with CMS regulations and state...

Conduct prospective, concurrent, and retrospective reviews for medical necessity and appropriateness of services. Collaborate with UM Medical Director on reviews and final determination. Draft denial language to ensure...