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Essential Duties and Responsibilities: Review requests for services including admission, discharges and continued stays for adherence to clinical criteria, state and federal policy, and related requirements. Issue...

Remote Nursing OpportunitiesAre you looking for an exciting way to utilize your nursing skills and expertise to deliver quality nursing care in a remote setting? AccessNurse, where technology meets compassionate care, is looking for professional...

Valeris is seeking a Patient Support Nurse to engage patients from enrollment through treatment, addressing barriers and supporting therapy initiation. You will educate on treatment, navigate insurance, and triage to additional services as needed.

Jobgether is seeking a Coding Consultant Outpatient – PRN based in the United States. This remote, part-time role focuses on accurate outpatient coding, review of documentation, and ensuring proper APC and reimbursement details. The...

Patient Safety Infection Control Specialist RN - Dental Falls Church is an independent city in the Commonwealth of Virginia with a population of approximately 15,000. Falls Church is included in the Washington metropolitan area. Falls...

Concept Rehab & Engage Consulting is seeking an experienced MDS Nurse (RN) Coordinator for a full-time remote role. You will manage MDS assessments, ensure accurate documentation, and support reimbursement workflows for skilled nursing facilities.

Mitchell International is hiring a Remote Medical Claims Consultant to analyze medical records and bills for relatedness and causality for clients. You will prepare medical evidence and organize case materials while reviewing chart status and...

hackajob is collaborating with Oracle to connect them with exceptional professionals for this role. About the team Responsible for driving the client through the design of clinical and business processes, solution and technology workflow, and...

Who We Are: Since 1985, BHCHP's mission has been to provide or assure access to the highest quality health care for all individuals and families experiencing homelessness in greater Boston. We care for over 11,000 homeless individuals each...

Bestica is seeking a travel nurse RN Research / Clinical Research for a travel nursing job in Fullerton, California. Job Description & RequirementsSpecialty: Research /...

CVS Health is seeking an Oncology Nurse Consultant (RN) for a 100% remote role spanning the contiguous U.S. You will lead clinical care coordination and utilization management within the Oncology Care Model, guiding members through diagnosis,...

About Us At Prenuvo, we are on a mission to flip the paradigm from reactive "sick-care" to proactive health care. Our award-winning whole body scan is fast (under 1 hour), safe (MRI has no ionizing radiation), and non-invasive (no...

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 you've honed your career in a fast-moving...

U.S. Army Family Nurse Practitioners perform the highest level of quality care for Army Soldiers, retirees, and their families. If you are looking to combine your skills as a family nurse practitioner and your passion for patient care with the desire...

JOB DESCRIPTION We are searching for six TX licensed RNs to work telephonically with our Medicaid members across the state. Three of the positions are open to RNs with at least two years of experience in in Behavioral Health or Substance...

Job Summary: Collaborates with Education Consultants, Managers, CNS staff and Physicians to develop, design, deliver and evaluate/improve education strategies and special projects/programs based on clients departmental...

CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant. The schedule is Monday–Friday, 9:00am–5:30pm in the candidate's time zone. This is a work-from-home role in a 24/7 operation with holiday/evening hours.

What You'll Do As an Enrollment Nurse, your primary responsibility is enrolling patients in a chronic care management program. You'll call eligible patients, educate them about the program, answer questions, and assist interested patients...

Northeast Georgia Health System seeks a CDI Specialist to enhance clinical documentation and ensure appropriate reimbursement for DRG-based payers. You will engage physicians, nursing staff, and coding teams to clarify documentation and improve...

Our client, a Medical Center facility under the aegis of a California Public Ivy university and one of largest health delivery systems in California, seeks an accomplished Infusion Referral Intake Coordinator NOTE- THIS IS 100%...

HealthHelp, a WNS company, seeks a Clinical Review Nurse for a fully remote role in the United States. You will perform prospective reviews for medical necessity on prior authorization requests across multiple specialty programs and refer...

Comagine Health is seeking a Clinical Reviewer (RN) to evaluate medical necessity, quality and appropriateness of services under the WA L&I contract. This remote role supports case reviews across inpatient, outpatient, and complex imaging by...

About Us At Prenuvo, we are on a mission to flip the paradigm from reactive "sick-care" to proactive health care. Our award-winning whole body scan is fast (under 1 hour), safe (MRI has no ionizing radiation), and non-invasive (no...

Advanced Health Institute is seeking a skilled MDS nurse to join our consulting team. The role can be Part Time with potential to become Full Time and offers a mix of Remote and On-site engagement with clients in the Minneapolis area. You...

Cambia Health Solutions is seeking an Appeals Clinician I who will work from home within Oregon, Washington, Idaho or Utah. You will leverage clinical expertise to complete the clinical component of all appeal types to resolve member/provider...