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Healthcare Management Solutions, LLC is seeking experienced CHSD Audit reviewers to conduct independent medical record reviews for the STS CHSD program. This remote, part-time role focuses on data accuracy, source verification, and adherence to...

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

The Case Management Utilization RN works collaboratively with physicians to coordinate patient admissions and discharges, ensuring appropriate levels of care and compliance with regulations. This role is ideal for those who excel in a fast-paced...

Job Description Provides support for clinical facility site reviews. Under the supervision of leadership, uses clinical judgement within appropriate scope to independently conduct reviews and other monitoring activities for primary care...

*Job Summary and Responsibilities* As our surgical services nurse at Glendale Memorial Medical Center you will prepare patients for surgical procedures and assist in the operating room to ensure they receive excellent nursing when they are at...

Registered Nurse 5% FTE, day/evening shift. Varied shifts between 07:45am and 9:00pm, this position including a weekend and holiday rotation. Must work at least 18 hours in a 6 week period, with minimum of 5 hours being on the weekend or...

University Health is seeking a Utilization Management Nurse RN for UH Truman Medical Center in Missouri. The role manages resource use, supports care transitions, and advises care teams on documentation and discharge planning to improve patient...

Pride Health is seeking an experienced Registered Nurse (RN) with Utilization Management experience to support clinical quality review and AI model development for prior authorization use cases. The ideal candidate will review records, apply...

52272794 Overview Remote Registered Nurse (RN) DH Direct Triage Part-Time, 20 hours per week Position Summary The RN - DH Direct Triage provides high-quality,...

Registered Nurse (RN) - Utilization Review | Remote | California License Required Position: Registered Nurse (RN) - Utilization Review (UM RN) Location: Torrance, CA (Remote Position)...

Job description RN'S NOW HIRING! All SHIFTS! We are looking for a qualified nursing supervisor to oversee patients and manage the nursing team of our facility. Our ideal candidate has solid experience as a registered...

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.

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...

Health Screener The primary responsibility of the Health Screener is to provide coverage in the field ensuring that health screenings are completed accurately and on time. Maintain a safe and professional environment for clients and...

Job Requirements Education & Experience Bachelor's Degree in Nursing (BSN) – Preferred Acute care facility experience – Preferred Previous hospital/acute care nursing experience...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse. The Utilization Review Nurse is...

The Nurse Care Coordinator (RN) is an integral member of Clarity Pediatrics' interdisciplinary care team.This role ensures seamless care delivery for children with chronic conditions and serves as a primary point of contact for families,...

Registered Nurse I (RN I) Kedren Community Health Center, Inc. is seeking a compassionate and dedicated Registered Nurse I (RN I) to provide professional nursing care to patients in an acute psychiatric setting. Working as part of...

Mobile health, remote monitoring, and ambulance services. Over 5,000 health professionals with tech-driven care. Position Overview: Remote nurse coordinating employee health compliance programs.

Redesigning heart health via virtual cardiac rehab for older adults. Mission-driven team of clinicians and engineers. Responsibilities: Review EMRs to determine eligibility and create orders.

CEI is seeking an RN/Managed Care Coordinator in Columbia, SC. The role trains onsite for 4 weeks, then remote work is possible under a hybrid model. W2 contracting with pay of $34/hour plus optional benefits. Responsibilities include...

Fully Remote : Clinical Documentation Specialist Job Description Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers.

What You'll Do As an Enrollment Nurse, your primary responsibility is enrolling patients in a chronic care management program. You'll call eligible patients, educate them about the program, answer questions, and assist interested patients...

Humana is seeking an experienced Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical services and benefit determinations. You will work with providers, members, and care teams...

JR0059223 Tele-Health Nurse (Remote/LPN) (Open) Full-time McKesson requires new employees to be fully vaccinated for COVID-19 as defined by the CDC, subject to applicable, verified accommodation requests. McKesson is in...