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A healthcare service provider is seeking a Registered Nurse to deliver nursing care to patients in their homes. This role emphasizes coordinating care with other health professionals, ensuring high-quality clinical services, and completing...

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

JOIN TEAM TRILOGY: At Trilogy, you'll experience a caring, supportive community that values each team member. We prioritize meaningful relationships, genuine teamwork, and continuous growth. With the stability of...

Job Description: • Participates in the development and ongoing implementation of QM Work Plan activities. • Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet...

Registered Nurse - 100% Remote TEKsystems Contract?to?hire position: 520?hour contract with a 4?to?6 week training period (MondayFriday, 8?AM5?PM CST). 100% remote work based out of Chicago, IL. Compensation:...

Remote Rn Care Coach This is a remote role. CircleLink Health is looking for passionate, tech savvy registered nurses to work remotely and serve patients enrolled in Medicare's Chronic Care Management Program. In this part time role...

Telephonic Case Manager At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions...

Introduction The Department of Health Services (DHS) Division of Quality Assurance (DQA), Bureau of Education Services & Technology (BEST) is recruiting for a Nursing Home Nurse Consultant. DQA is responsible for protecting and...

A healthcare technology firm is seeking a Nurse Consultant with experience in adult health. This hybrid position involves creating detailed patient medical records and building relationships with providers. Ideal candidates possess at least three...

A workforce solutions company is seeking a Registered Nurse-Case Review Specialist to provide support for Federal Occupational Health. This remote position requires extensive nursing experience and strong communication skills to ensure timely...

Overview Join our Chronic Care Management (CCM) team within Avance Care, a leading network of 37 practice locations across the Triangle Area...

Description Leads the alignment, standardization and ongoing improvement of ministry length of stay for designated patient populations. Serves as designated ministry liaison with providers and ministry Care Coordination teams, to move patients...

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to...

Job Description: Job Title: Clinical Review Nurse - Prior Authorization Location: Remote (CST) Duration: 6 months (Possible Extensions) Training Schedule: 8 AM - 5 PM CST Position...

SUMMARY: Promotes the development of high quality patient care in the most effective setting, balancing patient/hospital advocacy. Knowledgeable of third party payor issues. Brown University Health employees are expected to...

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position. ESSENTIAL...

Deep Roots. Solid Growth. Caring People. Rooted in Wyoming! We are Blue Cross Blue Shield Wyoming: a not-for-profit health insurer with offices throughout the state. Ever since a small group of caring,...

CVS Health Aetna Case Manager RN At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health...

A health services provider is seeking a full-time remote Registered Nurse (RN) for a contract position in Chicago. The role involves validating medical necessity and appropriateness of treatment plans, focusing on claims review for medical...

Become a part of our caring community and help us put health first Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. This position reviews the clinical appropriateness of prior...

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

A leading healthcare solutions company seeks a Care Manager-Registered Nurse in New York. This role involves coordinating care for members with chronic conditions and implementing individualized care plans. Candidates must hold a current New York...

Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The...

If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One! We strive to be an employer of choice and establish a reputation for being a talent rich organization where Associates can grow...

Remote Registered Nurse (RN) Case Manager Join to apply for the Remote Registered Nurse (RN) Case Manager role at PharmaCord We are looking for dedicated nurses to provide patient support services from the comfort of...