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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 recommendations to meet...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: The Virtual Mental Health Intake RN is a Registered Nurse who provides competent and...

A leading healthcare provider in Virginia is seeking a Registered Nurse Case Manager (RN) to join the team. The role is full-time, focusing on patient discharge planning, data analysis for care continuity, and collaboration with healthcare...

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:...

Part-Time Utilization Review Nurse Remote (Nevada License Required) Location: Remote (Reporting to Carson City, NV) Schedule: MondayFriday, 8:00 AM12:00 PM PST Compensation: $40,000$45,000 annually (part-time, 20 hours/week)...

Description Leads the alignment, standardization and ongoing improvement of ministry length of stay for designated patient populations. Serves as designated ministry liaison with providers and ministry Care Coordination teams, to move patients...

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people...

Nurse Manager The Ohio State University Medical Centers mission is focused on integrating quality patient care, education, and research; the Nurse Manager leads a team of professional health care providers cultivating collaboration,...

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 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...

A healthcare management firm is seeking a Medical Review and Appeals RN. This remote role involves reviewing and authorizing medical service requests, ensuring compliance with regulations, and implementing discharge planning. Candidates must have...

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...

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...

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 reach millions of...

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...

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...

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 services organization is seeking an Operations Leadership Support Specialist to provide onsite or remote support based on agency needs. The candidate must have current RN licensure and at least 1 year of experience in home health...

Day to Day Responsibilities Triage and review cases as needed, working on prior authorisation cases following medical policy utilizing resources as needed Required Skills (top 3 non-negotiables):...

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...

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...

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...

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...