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RN Coordinator Utilization Management The RN Coordinator Utilization Management will review submitted authorization requests for medical necessity, appropriateness of care, and benefit eligibility. This position reviews applicable...

*Job Summary and Responsibilities* As our surgical services nurse at Glendale Memorial Medical Center you will prepare patients for surgical procedures and assist in the operating room to ensure they receive excellent nursing when they are at...

Utilization Management Policy Initiatives Nurse RN II The Utilization Management Policy Initiatives Nurse RN II, under the purview of the Utilization Management (UM) Department Leadership Team, is responsible for managing, reviewing,...

Nurse Appeals Location: Nashville Tennessee (This role is open only to residents of Tennessee). Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum...

Job Description The Peer Review RN is responsible for facilitating the design, implementation and the ongoing evaluation of the physician peer review program and nursing peer review process in collaboration with physician...

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end...

Please make sure to complete all the questions in the application and continue through to the end in order to sign and submit it. The preferred work hours are 8:30 am / 9 am - 5 pm / 5:30 pm central time...

Clinical Nurse, Medical Management/Utilization Management Saratoga Medical is hiring for a Clinical Nurse, Medical Management/Utilization Management in Falls Church, Virginia. Package includes competitive rate, paid time off and benefit...

Summary Home Telehealth Care Coordinator (HTCC) Registered Nurse (RN) demonstrates leadership - experience - and creative approaches to management of complex patient care. The HTCC is responsible for coordination of health care for a...

Nurses - are you looking for a change? Want to work no nights, and no holidays? Check out Hines & Associates! ABOUT US: Hines is a nationwide, independent leader in personalized managed health care,...

At Curana Health, we're on a mission to radically improve the health, happiness, and dignity of older adults-and we're looking for passionate people to help us do it. As a national leader in value-based care, we offer senior living...

Care Manager Care Manager will manage Community Health Choice (Community) members with chronic disease and medically complicated needs through comprehensive evaluation and through coordination of Community resources. The Care Manager will...

HCSC is seeking a registered nurse or licensed clinician to provide care coordination to members via telephonic and field-based care management. You will educate members on health care programs, discuss goals, and support clinical operations with...

Our client, a Health Insurance company, is looking for a Registered Nurse-Review Analyst for their Remote location. Responsibilities: Perform prospective, concurrent, and retrospective review of inpatient,...

Sentara Health Plans seeks a Clinical Claims Reviewer RN for remote work. You will perform utilization management, review pre/post payment claims and authorizations for inpatient/outpatient cases, and address provider inquiries with appropriate...

JOB DESCRIPTION - REGISTERED NURSE (A) Job Summary: The Registered Nurse provides patient care on a supplemental basis to our client facilities. With the delivery of safe, quality patient care as...

Immediate need for a talented Utilization Management RN - Prior Authorization. This is a 12+ Months Contract opportunity with long-term potential and is located in US (Remote). Please review the...

Exceptional care starts with exceptional people. For us, this is more than a job– it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you...

RN Care Manager *F/T Variable* Santa Monica, California Full Time RN Care Manager with our Care Management Team at our Cedars-Sinai Tarzana Medical Center in Tarzana, CA. This is a full-time position that will work 8-hour...

Position Title Care Management Nurse Days - Full Time Broadmoor Campus, Remote Position Summary / Career Interest: The Care Management Nurse provides intervention for patients...

Acentra Health seeks a Case Manager (LPN or RN) to join our growing team in a remote role open to residents of Oregon. You will coordinate care across social, medical, and behavioral services, ensuring high-quality, compliant care planning and...

Job Summary: Provides case management services to a limited caseload of low-risk patients. Coordinates with patients and their caregivers to evaluate needs, goals, and current services. Determines initial eligibility,...

Responsible for utilization review work for emergency admissions and continued stay reviews Responsibilities Review and evaluate electronic medical records of emergency department admissions and screen for medical...

*Job Summary and Responsibilities* As our Nurse Shift Manager, you'll oversee a department of frontline nurses caring for patients. Every day you will advocate for your fellow nurses as you support them in reaching their full potential,...

Explore opportunities with Amedisys, part of the Optum family of businesses. We provide home health, hospice and community-based services that help people receive quality care where they feel most comfortable: at home. Rooted in personalized care,...