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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...

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...

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,...

The Bed Control Coordinator RN oversees patient throughput in the hospital(s). The key roles and functions of this position are to optimize hospital bed capacity by matching patients' clinical needs with available patient care units, coordinating...

Job Description JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the...

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...

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...

Prior Authorization RN - Contract Role Location Requirement: Candidate must reside in NJ, PA, NY, CT, or MD Work Model: WFH, but must be able...

Registered Nurse (RN) - IRIS Self-Directed Personal Care (SDPC) No weekends, no afterhours support, no holidays Are you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live...

RN Clinical Manager / Clinical Consultant (RN or MSW) – California Pay Rate: $52.50–$53.00/hr Position Type: Special Projects – 12-Month W2 Contract (renewal based on performance, project continuation, and health plan needs)...

Overview The Legacy/OHSU Interventional Radiology practice provides services at four locations (EMC, GSMC, MHMC and MPMC) including ambulatory clinics at each site. The IR team cares for both adult and pediatric patients with...

POSITION SUMMARYThe RN Certified Diabetes Care and Education Specialist has experience in diabetes care and education. The RN will contribute to developing, reviewing, and revising all diabetes education material. The RN promotes self-management...

Case Management Coordinator We are currently hiring for a Case Management Coordinator to join BlueCross BlueShield of South Carolina. In this role, care management interventions focus on improving care coordination and reducing the...

Utilization Review NurseWork Location: Los Angeles, CAJob #: 30315Work Hours: Monday-Friday 8am-4:30pmEmployment Type: 4 – Staff- LimitedDuration: 6 monthsSalary Range: $74.16–107.75 hourlyPosted Date: May 15, 2026Bargaining Unit: CNA –...

Remote Rn Mds Consultant-Full Time Engage Consulting is seeking an experienced Registered Nurse (RN) with strong MDS, Case Mix, and Quality Measure experience to join our team. This is a fully remote opportunity for a detail-oriented...

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...

Registered Nurse Risk Manager Aptive is seeking a registered nurse risk manager. IHSC's mission is to provide medical care to maintain the health of individuals in the custody of ICE through an integrated health care delivery system,...

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'...

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...

Telephonic RN Case Manager Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people...

Working remotely in a full-time capacity, the RN Clinical Documentation Specialist will review medical records to enhance the accuracy of clinical documentation, ensuring it reflects the patient's severity of illness and risk of mortality while...

Description Location: UCHealth Anschutz Outpatient Pavilion - Aurora, CO Department: Hospital Based Sub-Specialty Work Schedule: Full Time, 80.00 hours per pay period (2 weeks) Shift: Days Pay: $38.91 - $60.31 / hour. Pay is dependent on...

Job Title This is a remote position but will need onsite training in Mishawaka Indiana. Shift: PRN/Days - 8 hr shift Considering local candidates only!!! Why Choose Saint Joseph Health System? At Saint Joseph Health...

Clinical Denial Management Nurse Work remotely with a collaborative enterprise denials team focused on reimbursement accuracy and revenue recovery. Work Style: Remote Location Requirement: Must reside in an authorized state (FL,...

The Clinical Nurse Partner is responsible for assigned patient care tasks under the direct supervision of licensed care providers. Transports medications and requests to and from Pharmacy/ Nurse on a non-routine basis when necessary. Job...