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Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho or Utah *Please be advised that this role is part of our candidate pool, which allows us to identify and attract...

Regional MDS / PDPM / CMI / RAI Consultant Are you ready to make a change? We are seeking an experienced Regional MDS / PDPM / CMI / RAI Consultant to provide remote reimbursement, MDS, PDPM, Case Mix Index, and RAI support to our...

Complex Medicare Claims Review Complex Medicare claims/prior authorization requests require the review of medical record documentation to determine the reasonableness and necessity of the billed service in accordance with Medicare rules...

RN Case Manager Qualifications for RN Case Manager: The Case Manager is responsible for managing a continuum of care from admission through discharge for assigned patients. Partners with medical staff, utilizes...

The Registered Nurse (RN) Clinical Educator educates staff to competence according to standards, regulations, and best practice using a variety of teaching methods.

RN Health Care Facility Surveyor - Washington Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting...

OPCO Skilled Management – Relocation to Southern New Mexico is required. The Nurse Consultant/ Regional Director of Clinical Operations position is comprised of two essential objectives; to partner with facilities as the primary clinical...

Utilization Management Claims Review Nurse RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13077 Salary Range:...

Advanced Practice Nurse Work Location: Santa Monica, CA, USA Onsite or Remote Fully On-Site Work Schedule 4-day 10-hour shifts, 7:00am-5:30pm; may include weekends and holidays Salary Range: $65.53 - $84.75 Hourly...

Denial Prevention Nurse Position at Northwell Health PART TIME- 20 hours per week- Mon-Fri 8pm- 12am shift- Rotating weekends and holiday coverage expected! Northwell is the largest not-for-profit health system in the Northeast, serving...

Overview:Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Appeals and Grievance RN .*** Candidate must be authorized to work in USA without requiring sponsorship...

Registered Nurse (RN) - Clinical Documentation Specialist (Part Time) Remote The Clinical Documentation Specialist is responsible for the evaluation of physician documentation utilizing their clinical expertise to ensure the patients'...

City/State Doral, FL Work Shift First (Days) Overview: Sentara Health Plan AvMed is looking to hire an Integrated Case Manager, RN. This is a remote position; however, candidates...

Pharmacy Nurse Consultant - LPN or RN If your answer is "all of the above," consider joining our team at Consonus Pharmacy. It's a perfect opportunity for compassionate people dedicated to people's health and well-being. Consonus...

Job Description The Care Management Recovery Advocate (CMRA) is responsible for providing overall management and communication of clinically based appeals between Providence Health and Services, California Region (PH&S)...

Nurse Consultant I (NS) The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health,...

RN Health and Social Services Care Coordinator $5,000 Sign-on Bonus for External Candidates At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care.

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families,...

Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and quality improvement services for more than 50 years. We...

Benefits We Offer: Comprehensive health, prescription, dental, vision, life, and disability plansCompetitive pay ratesReferral opportunities ? Refer a friend & Cash in!Travel reimbursement and per diem...

Job Title The position is work from home with field visits. Job Purpose This position is responsible for conducting medical management and health education programs for customers on government health care programs.

Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical...

An employer is hiring a Remote Clinical Team Manager to help lead and develop our client's remote nursing team delivering Chronic Care Management (CCM) and Principal Care Management (PCM) services. You will be the right-hand person to the CEO and...

Utilization and Care Management Nurse Work from home within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are...

RN Utilization Mgmt Full-Time Day POSITION SUMMARY The RN Utilization Management (RN UM) functions as a support liaisons for a variety of UM functions which may include: the e-TAR process, denials management,...