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Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and quality improvement services for more than 50 years. We...

Clinical Auditor Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes.

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...

Quality Improvement Project Manager Apply improvement methods to achieve successful outcomes: Use evidence-based structured improvement methods for all quality improvement projects. Promote the use of improvement methods and science...

Nurse Reviewer - Itemized Bill Review 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...

Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical...

Details Client Name California Hospital Medical Center Job Type Travel Offering Nursing Profession RN...

Become a part of our caring community $10,000 SIGN ON BONUS We are excited to expand our leadership team and are seeking experienced, motivated Clinical Managers to join our growing home health branches in Westbury, Hauppauge, and Riverhead, NY!

SIGN ON BONUS - $5,000 RELOCATION BONUS: (for those outside of San Diego County) - $5,000 - Bonus Available if Started prior to 06.31.2027 Job Announcement Position Title:...

To support clinical auditing efforts, the full-time RN Clinical Auditor will perform retrospective chart reviews on Readmission and Place of Service Claims, utilizing clinical guidelines and proprietary systems while maintaining productivity and...

City/State Norfolk, VA Work Shift Multiple shifts available Overview: Sentara Health Plansis hiring a Quality Improvement Coordinator /Registered Nurse (RN) - Remote in Virginia! ...

Nurse Investigator- Atlanta Conduct investigations (clinical mortality review) of deaths of individuals with developmental disability services. Interview witnesses, complainants, and persons of interest to obtain information...

Patient Family Liaison Clinical - RN Overview: Clinical Patient Family Liaison, Registered Nurse Location: Glendale, CA Find Your Passion and Purpose as a Full-Time Clinical...

Clinical Review Nurse Duals Program Details- Brand new program of 2026 for Centene Duals = Medicare + Medicaid line of business. Members have one combined card and one authorization covering both benefit types. The duals...

Pay: $3019 weekly gross for 40 hours, ($27/hr on W2 with $1939 weekly stipend) Job Description: Tittle: RN-Case Manager Location: West Hollywood, CA 90048...

Utilization Review Nurse Health Plans - Case Management US:NM:Alamogordo | Utilization Management | Full Time This position has a remote option for those living close and will be able to come into the hospital as needed.

Employment Type: Full timeShift: Day Shift Description: Purpose Work Remote Position (Pay Range: $36.8795-$47.8193) The...

Location Address: 9521 San Mateo NEAlbuquerque, NM 87113-2237 Compensation Pay Range: Minimum Offer $27.92Maximum Offer $42.63 Summary: Build your Career. Make a Difference. Presbyterian is hiring a...

Key Responsibilities Provide day-to-day leadership and oversight of Intensive Case Management (ICM) and Utilization Management (UM) programsSupervise and mentor a multidisciplinary team including Registered Nurses, Social Workers, and care...

We are recruiting for a mission-driven RN Educator, Clinical Documentation Integrity - Must Reside in Colorado to join our team! We're with you for life's journey. At Denver Health, purpose isn't just something we believe in-it's something...

The Case Manager Care Coordinator coordinates the care and service of patient populations from admission through discharge. The Care Coordinator clinically assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet...

Description Manages specific patients throughout their admission to ensure the availability of sufficient clinical and medical center resources. Communicates on a daily basis with medical staff, medical center personnel and...

Company Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable,...

Job InformationRN JobShift: Full TimePay Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.)Location: Los Angeles, 90017Job DescriptionThe Lead Appeals and Grievances RN is responsible for assisting with the development of a...

Summary VA Greater Los Angeles Healthcare System (VAGLAHS) is seeking to hire experienced Registered Nurse to work as our Chief Nurse of Acute Care Units. As Chief Nurse, you will provide program management to ensure coordination of care,...