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To support healthcare revenue solutions, the full-time Remote Clinical Review Nurse will analyze denied insurance claims, draft persuasive appeal letters, and collaborate with legal teams to optimize patient care revenue without direct patient...

Medical Review Nurse (RN) Remote position, however, candidates must reside in the State of TX or State of IL This position is a contract for about 9 months. Pay: $41/hour RN working in the insurance or managed care...

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 Clinical Care Coordinator At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the...

AltaMed Nurse (RN) Case Manager/Care Coordination Team Leader If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed –...

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...

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...

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...

Job Opportunity Home Health Care, Hospice Care, Palliative Care, Long Term Care, Rehab No weekends, no afterhours support, no holidays Job Summary Are you seeking a unique nursing position that gives you a great...

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...

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,...

Clinical Specialist The Clinical Specialist is a resource for the execution of the Medication Delivery Solutions value-added clinical business strategy. The role implements clinical programs and initiatives that differentiate the MDS...

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...

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,...

JOB DESCRIPTION Nestled between Burbank and Pasadena, Adventist Health Glendale is one of the area's leading healthcare providers. We are comprised of a 515-bed hospital, two urgent cares, home care services, comprehensive cardiology...

Nurse Consultant - Remote in California It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know...

Clinical Documentation Integrity Specialist/Consultant The Clinical Documentation Integrity (CDI) Specialist/Consultant serves as a trusted advisor to client organizations, providing expert guidance in clinical documentation practices...

Position SummaryThe Care Navigator will be responsible for case management specific to kidney health management. The Care Navigator will complete activities for the continuum of care to facilitate and promote high quality, cost-effective outcomes...

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...

Job Title: Medical Claims Review Nurse Duration: 6 Months Location: Remote Payrate: $43.39/hr. on W2 Description 100% Remote (CANDIDATES MUST LIVE IN ONE OF THE PREFFERED 17 STATES (SC, MS, AZ,...

WHO WE ARE We are VITAS Healthcare, the nation s leading end-of-life care provider since 1978. Our hospice organization kickstarts careers in caring, promotes from within, and provides a nationally recognized best-in-class...

Harris Health System is seeking a Utilization Management Review Nurse (UMRN) to assess the necessity and appropriateness of medical services. The UMRN utilizes clinical expertise to ensure care aligns with industry standards, works with healthcare...

Registered Nurse - Case Management Duration:13 Weeks Start:03/10/2025 Job Type: Travel Minimum Guaranteed Hours: 40 Jobs Notes: Day Shift, inpatient RN CM Acute hospital experience,...

Grievances And Appeals Nurse Pride Health is hiring a Grievances and Appeals Nurse for a well-known client! (Remote Contract) Schedule: 5x8s Day shift Contract: 6 months Pay Rate: 40-45/hr Primary...

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