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Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through...

A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The...

Registered Nurse In Labor And Delivery Make a difference every single day! When the work you do every single day has a crucial impact on the lives of others, every effort, every detail, and every second matters. This shared culture...

Providing clinical review support on a full-time remote basis, the RN Clinical Review Specialist will review medical records for medical necessity, authorization compliance, and payer guideline alignment, while preparing high-quality appeals and...

Humana is seeking to fill the Compliance Audit Nurse role to audit care management activities and documentation for regulatory compliance. The position involves independent determination of appropriate courses of action, data collection and...

JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member...

Mist Registered Nurse (Rn) – Position Summary The Multidisciplinary Inbasket Support Team (MIST) Registered Nurse is a highly skilled ambulatory care nurse who provides comprehensive, remote clinical support to primary care patients and...

At Amped HQ, we're on a mission to connect top talent with opportunities that drive real impact. We're constantly expanding our global network, seeking the best and brightest to join our team and contribute to our partners' success. With...

About Us At Prenuvo, we are on a mission to flip the paradigm from reactive "sick-care" to proactive health care. Our award-winning whole body scan is fast (under 1 hour), safe (MRI has no ionizing radiation), and...

A health care provider organization is seeking a Case Management Nurse to coordinate care for members. This role requires a Nursing Diploma and direct clinical experience, along with the current Michigan RN license. Responsibilities include...

RN opportunity with out the bedside burnout + sign on bonus. This Jobot Job is hosted by: Dexter Dionio Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $80,000 -...

Guidehealth is seeking a Care Manager to guide patients and families through complex health journeys. This remote role blends clinical expertise with holistic care to address medical, behavioral, and social needs. You will build...

Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical Nurse - Work from Home! Get AI-powered advice on this job and more exclusive features.Direct message the job poster from BroadPathGlobal Talent Attraction...

Job TitleCHA Hollywood Presbyterian Medical Center is committed to serving local multicultural communities with quality medical and nursing care. With more than 500 physicians representing virtually every specialty, HPMC strives to distinguish...

A prominent healthcare organization is seeking a Telephone Triage Nurse Line Advisor in Saint Paul, Minnesota. The role requires a current Minnesota RN License and 3+ years of RN work experience. You will independently triage patient calls and...

A leading Health Insurance company is seeking a talented RN Care Management Coordinator for a remote contract position. The role involves applying critical thinking and medical knowledge to determine case appropriateness and collaborating with...

A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities...

Job Description 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,...

Self Fund Health Nurse Navigator Remote · Full time The Nurse Navigator is a remote WI-based RN who acts as the member's single point of contact through the healthcare system — coordinating care, advocating for patients, and steering...

Description Position at BAART Programs Part Time Dispensing Nurse - LPN/LVN BAART Program is looking for a detail oriented and empathetic Licensed Practical Nurse / Licensed Vocational Nurse to dispense...

UnitedHealthcare is seeking a field-based Care Coordinator (RN) to coordinate care for medically complex members primarily within Medicare/Medicaid. You will apply clinical knowledge to identify needs, educate members, and ensure access to...

Nurse Navigator Triages new patient appointments to the appropriate provider(s) and assures timely scheduling of initial appointments. Reviews outside medical records for appropriate scheduling. Assess barriers to care and refers to...

Job Overview The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring that medical services are used efficiently and appropriately. They review medical records, treatment plans, and patient...

Winning Assistants is seeking a Medical Virtual Assistant - Registered Nurse to provide support for a healthcare practice. The role entails submitting prior authorizations, managing referrals, and maintaining patient communications while ensuring...

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...