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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...

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...

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...

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...

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...

At CVS Health, weu2019re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nationu2019s leading health solutions company, we reach...

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...

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

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...

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:...

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...

City/State Charlottesville, VA Work Shift First (Days) Overview: Sentara Martha Jefferson Hospital is hiring a Clinical Nurse Specialist for a Full-Time role in Charlottesville, VA. About the position: Reporting directly to the CNO, the Clinical...

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...

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...

Care Manager Sharecare is the leading digital health company that helps people unify and manage all their health in one place. Our virtual health platform is designed to help people, providers, employers, health plans, government...

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...

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 healthcare organization in Manchester, NH, seeks a Nursing professional to provide centralized medication access support. Responsibilities include reviewing medication requests, communicating with patients, and adhering to clinical guidelines.

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...

Description The Appeals Nurse examines medical records and claims information for first-level appeal cases to determine whether services provided were medically necessary and meet Medicare coverage guidelines in accordance with Medicare...

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...

Registered Nurse: Review and Evaluation Are you a registered nurse ready to take your career in an exciting new directionone where your expertise truly makes a difference? Join Pennsylvania's premier Quality Improvement Organization and...

Job Summary 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 company, we...

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...

A leading healthcare organization in California is seeking a Registered Nurse, Out-Patient Case Manager. This role involves coordinating care for patients with chronic diseases and leading a team of case managers. Candidates should have a valid RN...