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RN Clinical Appeals Nurse 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...

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...

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 health organization is seeking a RN Coordinator for Utilization Management in Wisconsin. This full-time position involves reviewing authorization requests for medical necessity and collaborating with various departments. Applicants...

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...

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...

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...

A leading healthcare company seeks a Qualified Rehabilitation Consultant RN in Saint Paul, MN. This full-time role involves providing case management services for workers' compensation. Key qualifications include 3+ years of case management...

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...

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...

Description Location: UCHealth Anschutz Inpatient Pavilion - Aurora Department: Virtual Health Center - Quality program This position is an onsite role and does not offer a hybrid or remote option Work Schedule: Full Time, 72.00 hours per pay...

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...

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...

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...

Quality Assurance Position Contract-to-hire details and pay: $34/hr for a 520-hour contract-to-hire, long term opportunity. Compensation: listed below, fixed rates (no opportunity for negotiation). Training schedule: MondayFriday, 46...

Anticipated End Date: 2025-12-24 Position Title: Remote Care Manager RN Job Description: Shift: Option of 5 8?hour shifts OR 4 10?hour shifts per week Location: Candidates in Texas,...

Lead Registered Nurse Evaluator (Hybrid Remote-NY) Job Locations US-NY-New York | US-NY-Manhattan | US-NY-Jamaica | US-NY-Staten Island | US-NY-Hauppauge | US-NY-Brooklyn | US-NY-Bronx Requisition ID 2024-97703 Posted Date 2 hours ago(2/12/2024...

Quality Assurance Position Contract-to-hire details and pay: $34/hr for a 520-hour contract-to-hire, long term opportunity. Compensation: listed below, fixed rates (no opportunity for negotiation). Training schedule: MondayFriday, 46...

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...

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...

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 leading nursing advocacy organization seeks a committed Nursing Practice and Policy Specialist to drive nursing practice, collective advocacy, and healthcare policy initiatives. The role demands a passion for patient care, strong analytical...

Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This position is remote. Candidates must be local...

Overview 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.