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Denials Case Manager, RN The Denials Case Manager, RN appeals all denials using InterQual criteria and medical necessity. Collaboratively works with all members of the revenue cycle team and all types of payers to resolve denials,...

AMN Healthcare Revenue Cycle is seeking a travel Utilization Review for a travel job in Woodland Hills, California. Job Description & RequirementsSpecialty: Utilization...

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Professional Review Nurse The Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical...

Professional Nursing Care 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...

Nurse Educator The Nurse Educator is responsible for providing support to ensure safe, effective and appropriate use of PROVENGE® (Sipuleucel-T) from enrollment to completed infusion for commercial accounts prescribing the Product and...

Note - Travel Experience RequiredJob Summ aryThe Registered Nurse – Case Manager plays a pivotal role in coordinating and managing patient care throughout the healthcare continuum. This position focuses on ensuring patients receive appropriate...

Care Manager The Care Manager is responsible for providing care management to a group of health plan members, creating the Person-Centered Service Plan (PCSP), coordinating services, and documenting care in accordance with health plan...

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We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

Utilization Management Nurse RIHS Austin Regional Office - Austin, TX 78727 Overview Position Type Full Time Description Primary Responsibilities The Utilization Management Nurse will determine the...

The position is work from home with field visits. JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include...

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted,...

Jobtailor in Los Angeles, CA is seeking an RN with case management experience to perform care management for members with complex and chronic conditions. The role involves assessing needs, developing and coordinating care plans, and interfacing...

Job Details: Location: Northridge, CA 91325. Position Type: Part Time. Salary Range: $55.00 - $62.00 hourly. Travel Percentage: Negligible. Job Category: Nursing.Job Summary This position is responsible for performing regulatory testing,...

Grow HealthyIf you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted, allowing you to...

Job Title : Registered Nurse (RN) Disease ManagerJob Overview :The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of patients with chronic or complex health conditions. This role...

Payment Integrity Nurse – Medicare Advantage We are currently hiring for a Payment Integrity Nurse – Medicare Advantage to join BlueCross BlueShield of South Carolina. In this role as a Payment Integrity Nurse, you will...

Company : Highmark Inc. Job Description : JOB SUMMARY This job has primary ownership and oversight over a specified panel of members that range in health status/severity...

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...

RN - Case Manager Case managers work to facilitate patient care by assessing patient needs, evaluating treatment options, creating treatment plans, coordinating care, and gauging progress. The overall goal for case managers is to improve...

Lakeview Hospice is presently seeking a full time Registered Nurse Case Manager to join our growing Hospice care team.Our Registered Nurse Case Managers enjoy a dynamic environment that focuses on quality end-of-life care delivery. Benefits...

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Director of Nurse Case Management based in the United States. Lead a high-performing clinical...

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus — a rejuvenating place for associates...

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los...