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JOB DESCRIPTION Job Summary Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically...

Job Description Under broad direction from the Centralized Utilization Management Manager, is responsible for the hospital-wide Utilization Management Programs in a general acute care hospital which serves infant, pediatric,...

In order to have an accurate count of participants, we need you to register for the Recruitment Fair on the District's website. Please select "apply for this position" under the heading to the right labeled "Apply Now". Interviews slots will fill up...

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...

HJ Staffing is partnering with Impresiv Health, a specialized healthcare consulting partner, to find a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN). This critical...

Current Employees: If you are currently employed at any of the Universities of Wisconsin, log in to Workday to apply through the internal application process. Job Category: Academic Staff...

Salary: $70,779.53 Annually Location : Homebased, GA Job Type: Full-Time Salaried Job Number: 2020-02252 Division: Healthcare Facility Regulation...

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to...

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...

Summary We are currently hiring for an Appeals Analyst to join BlueCross BlueShield of South Carolina. In this role as Appeals Analyst, you will research the substance of complex appeal or retrospective review requests...

*Quality Assurance Registered Nurse - 100% Remote* Contract duration: 520 hour contract to hire Training Schedule: M-F, 4-6 weeks *Contract Details* * *Contract Duration:* 520-hour contract-to-hire, long term opportunity *...

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic...

We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only). Our Department of Defense contract requires US citizenship and a...

Description Join PeaceHealth in advancing compassionate, mission-driven care from wherever you are. PeaceHealth is looking for a skilled and motivated Registered Nurse Utilization...

Facility: CoxHealth South: 3801 S National Ave, Springfield, Missouri, United States of America, 65807 Department: 1651 Virtual Care Command Center Scheduled Weekly Hours: 24 Hours:...

Enjoy what you do while contributing to a company that makes a difference in people's lives. Shady Grove Fertility, one of the premier fertility centers in the United States, continually seeks experienced, compassionate, and dynamic team players...

A leading healthcare technology company in Royal Oak, MI is seeking a Telehealth RN Case Manager. This role involves coordinating patient care remotely, utilizing telehealth platforms to ensure effective healthcare delivery. The ideal candidate...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health is currently hiring for a Utilization Review Nurse- Remote in VA! Status: Full-time, permanent...

Sharecare is the leading digital health company that helps people no matter where they are in their health journey unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is designed to help...

A prominent educational institution in North Carolina seeks an Assistant/Associate Professor for Nursing to deliver student-centered teaching in undergraduate and graduate courses. Responsibilities include mentoring students, developing curricula,...

The Nursing Home Administrator provides leadership and direction for overall facility operations to provide quality patient care in accordance with all laws, regulations, and Life Care standards. Your duties will including overseeing key areas...

Job Summary: The Utilization Management Policy Initiatives Nurse RN II, under the purview the Utilization Management (UM) Department Leadership Team, is responsible for managing, reviewing, updating and creating...

A leading healthcare provider is urgently seeking experienced Clinical Documentation Specialists for remote positions. Ideal candidates must be RN graduates from an approved nursing program and possess prior CDI experience, preferably in acute...

Become a part of our caring community and help us put health first Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At...

Pre-Access Utilization Management Registered Nurse Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health insurance clients. This person will be responsible for...