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Job Description The Medicare Appeals and Grievances team is responsible for clinically reviewing member appeals and grievances that are the result of either a preservice, post service or claim denial. The Medicare Appeals and Grievances...

About Abby Care: Powering the Future of Care at Home for All of America Abby Care is building the leading AI-native platform for family-led care. America is facing a growing care crisis. Millions more people need care at home than ever.

" The Utilization Review Specialist is responsible for the assessment and review of the healthcare delivery system with a concentration on tasks that promote cost-effective quality care and cost containment in accordance with various federal...

If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One! We strive to be an employer of choice and establish a reputation for being a talent rich organization where Associates can grow...

# RN Case Manager – Surgery ServicesWork Location **Los Angeles,CA**Job **#29435**Work Hours **4-day 10-hour shifts, 7:00am-5:30pm; may include weekends and holidays**Employment Type **2 – Staff- Career**Duration **indefinite**Salary Range...

Trustaff is seeking a travel nurse RN Clinic for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: ClinicDiscipline:...

To support a growing team, the full-time remote Registered Nurse Bill Review will review facility and professional bills for accuracy, negotiate pre-surgical services, and provide expertise to claims staff while ensuring compliance with managed...

Work Location : Santa Monica, CA, USAFully On-SiteWork Schedule: 4-day 10-hour shifts, 7:00am-5:30pm; may include weekends and holidaysSalary Range : $65.53 - $84.75 HourlyEmployment Type: Indefinite DurationPrimary Duties and...

Clinical Record Reviewer - Full-Time Days (Remote) Manages and supports quality and performance improvement by assisting staff to implement strategies that identify, prioritize, measure, and improve key clinical processes and outcomes.

Consultant II Join the team that is revolutionizing health care – BayCare Health System. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of...

Job Description Pre-Authorization RN Compensation Salary Range: $90,000 - $108,000 per year Bonus / Commission (if applicable): This role is eligible...

Telehealth Nurse Practitioner Few roles offer the chance to bring real clinical impact to a population that rarely receives it. As a Telehealth Nurse Practitioner with Esperta Health, you'll deliver expert wound care to incarcerated...

Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS).

Bestica is seeking a travel nurse RN Med Surg for a travel nursing job in Glendale, California. Job Description & RequirementsSpecialty: Med SurgDiscipline:...

Health And Social Services 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...

Ssbv Clinical Claims Review Rn 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...

Slate Healthcare is seeking a travel nurse RN Clinic for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty:...

Utilization Management Team Member Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk...

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health...

Join our growing Collaborative Health team! We are excited to welcome a remote per diem Nurse Practitioner to our thriving behavioral health program, supporting our team of primary care providers, patients, and behavioral health care managers. In...

Itemization Review Nurse II The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position.

Research Nurse Healthy Brain Clinic in Long Beach is part of the Irvine Clinical Research site network, the largest of its kind on the West Coast. With 5 research centers in California, we are leaders in the search for new treatments in...

Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina. Summary: Serves as a virtual nurse to provide support to inpatient...

Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff...

Self Fund Health Nurse Navigator Remote · Full time The Nurse Navigator is a remote WI-based RN who acts as the member's single point of contact through the healthcare system — coordinating care, advocating for patients, and steering...