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Join Our Caring Community and Prioritize Health! The Nurse for Utilization Management Appeals plays a critical role in the coordination, documentation, and communication of medical services and benefit determinations. This position...

Job Description RN Utilization Review at Irvine, CA. This position is Part- time and will work Remote 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern...

Join BoldAge PACE and Make a...

Salary: $70,779.53 Annually Location : Homebased, GA Job Type: Full-Time Salaried Job Number: 2020-02252 Division: Healthcare Facility Regulation...

This is a remote work from home role anywhere in the US with virtual training. American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/ CVS Health. Founded in 1993, AHH is URAC accredited in Case...

Description Location: UCHealth Anschutz Inpatient Pavilion - Aurora Department: Virtual Health Center - Quality program This position is an onsite role and does not offer a hybrid or remote...

Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This position is remote. Candidates must be local...

This is a remote role. CircleLink Health is looking for passionate, tech savvy registered nurses to work remotely and serve patients enrolled in Medicare's Chronic Care Management Program. In this part time role...

Department WMH FRIMA-RHC - 259441Worker Sub Type RegularWork Shift First Shift (United States of America) Pay Grade Job Description Job...

Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris™ revolutionizes the path from life...

20 miles from Boston - surrounding areas (Only QUALIFIED Healthcare Professionals accepted) Case Manager - Are you ready to make a real difference in people's lives while enjoying a schedule that suits your lifestyle? We're on the lookout...

Posting Date 01/26/2026 5276 Blanding BlvdSuite 26, Jacksonville, Florida, 32210-8176, United States of America RN Case Manager - Position Highlights Location: Hybrid - Remote This is a...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for individuals facing the most complex and costly health challenges. By bridging gaps in the fragmented health care system, we...

Salary range: $95,139 - $130,811 annually, based on qualifications. This exempt remote-hybrid position is eligible for a comprehensive benefits package which includes medical, dental, vision, a 403(b) retirement account, and a generous...

The Registered Nurse Care Manager provides case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare continuum. The Care Manager...

Discover. Achieve. Succeed. #BeHere Location: US:WI:MENOMONEE FALLS at our CP-NORTH HILLS HEALTH CENTER facility. This job is ON - SITE. FTE: 0.400000 Standard...

Position Purpose The Transfer Center & Virtual Care RN provides leadership, accountability, and comprehensive nursing services to ensure optimal patient care, resource utilization, and seamless patient flow. This role is challenged...

Description Who we are Founded in 1999 and headquartered in Central Ohio, we're a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity...

Job Summary: The Utilization Management Policy Initiatives Nurse RN II, under the purview the Utilization Management (UM) Department Leadership Team, is responsible for managing, reviewing, updating and creating...

Department BSD OBG - Gyn Onc About the Department The Section of Gynecologic Oncology is a part of the Department of Obstetrics and Gynecology. The Section is comprised of 12 faculty physicians, 7 advanced practice...

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...

Nurse Case Manager Position Type: Full-Time Contract Role Location: Work from home Work Type: Remote Est. Pay Range: $35.00/hour $38.46/Hour on W2 (USD) (all inclusive) Schedule: Mon-Fri 8am-5pm EST...

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position. ESSENTIAL...

The range for this role is $25 - $34.13 Actual base pay will be determined based on a successful candidate's work location, skills/abilities, experience, and education. Interested applicants...

Overview Registered Nurse (RN), Clinical Decision Unit Rockville Centre, NY Explore a career with Mercy Hospital, a 375-bed not-for-profit hospital and member...