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JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Registered Nurse Utilization Managers (RNUM) Spectrum Healthcare Resources has a potential need for Registered Nurse Utilization Managers (RNUM). These will be completely remote positions, working entirely from the Nurse's home. The Nurse...

Job Title: Medical Claim Review Nurse Location: 100% Remote Duration: 3 to 6 months ( Opportunity for ext. / based off performance/evaluation and team needs/budget) Schedule: 40hr- Must work PST hours. Once trained and working independently,...

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, and the UM process. Coordinates care submission...

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...

Requisition #:215543 Location:Sherman Oaks, CA 91423 Category:Nursing Salary:$80,000.00 - $85,000.00 per year Position Details RN Case Manager - Clinical Supervisor Aveanna Healthcare is one of the nations largest home health care companies in the...

Utilization Management Registered Nurse The Utilization Management Registered Nurse uses clinical nursing skills to interpret and support the coordination, documentation and communication of medical services and benefit administration...

Responsive recruiter Benefits: Mileage Reimbursement Referral Bonus Bonus based on performance Company parties Competitive salary Donation matching Employee discounts Flexible...

Company : Highmark Inc. Job Description : JOB SUMMARY This job implements effective utilization management strategies including: review of appropriateness of health care services, application of...

LanceSoft is seeking a local contract nurse RN GI Lab for a local contract nursing job in Los Angeles, California. Job Description & Requirements Specialty: GI Lab Discipline: RN Start Date: 07/07/2026 Duration: 13 weeks 40 hours per week Shift: 10...

**A government contract requires that this position be restricted to U.S. citizens or legal permanent residents. You must provide documentation that you are a U.S. citizen or legal permanent resident to qualify. Provides...

Clinical Claim Review Nurse 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...

Job Description Ready for More Autonomy as an RN? Join Guthrie Home Health as an Admissions Nurse - Up to a $25,000 Sign-On Bonus! Guthrie Home Health is seeking a...

Regional Nurse Consultant (RN) - Assisted Living Americare Senior Living is seeking an experienced Regional Nurse Consultant (RN) to support our Assisted Living communities...

Company Description Chamberlain With more than 135 years of history in healthcare education and as the largest nursing school in the country, Chamberlain University is committed to delivering a high-value education...

At American Career College, we share a passion for students and transforming healthcare education! As a faculty member for a certified Great Place to Work, you will join a collaborative,...

The Clinical Documentation Specialist is responsible for the evaluation of physician documentation utilizing their clinical expertise to ensure the patients' severity of illness is accurately portrayed in the medical record for specificity of...

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...

Los Angeles, CA – Seeking Aesthetic Registered Nurse Join our team as an Aesthetic Registered Nurse (RN), where we are focused on outpacing aging...

Description Location: UCHealth UCHlth Anschutz Inpatient Pavilion, US:CO:Aurora Department: Cellular Therapies Unit Work Schedule: Full Time, 72.00 hours per pay period (2 weeks) Shift: Day and Night Rotation Pay: $35.29 - $54.71 / hour. Pay is...

Registered Nurse Remote within IL, TX, TN, NM, OK, MT Registered Nurse responsible for collaborating with healthcare providers, members, and business partners, to optimize member benefits, evaluate medical necessity and promote effective...

Find your calling at Mercy! Under the direction of the primary care operations team, the Primary Care Nurse works directly with Mercy Primary Care Providers to provide safe, timely, effective, efficient, equitable, patient-centered care in a...

Benefits: 401(k) Competitive salary Dental insurance Health insurance Paid time off Signing bonus Training & development Vision insurance Outpatient Case Management West Los Angeles VAMC 11301...

Requisition number: 2368763 Job category: Nursing 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...

SCHEDULE: Looking for someone to work every Monday plus Friday, Saturday, or Sunday each week. 10-20 hr a week. An Infusion Nurse II is a licensed registered nurse who coordinates and provides intermediate direct patient care to patients in the home,...