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Job Summary Provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical...

Description The Role: The Chief Nursing Officer (CNO) provides executive leadership for nursing, ancillary, and support departments while overseeing hospital operations. This dual leader partners with clinical and operational leaders, medical...

Chronic Care Manager (RN) Vitability Health of New Jersey Remote Position Our Mission At Vitability Health of New Jersey, we believe great care goes beyond checklists and...

Revolution Healthcare Services is seeking a travel nurse RN Clinical Document Improvement Specialist for a travel nursing job in Rochester, Minnesota. Job Description & Requirements Specialty: Clinical Document Improvement Specialist Discipline:...

Immediate Hiring for Remote Clinical Review Nurses Immediate hiring for remote clinical review nurses. Review approximately 20 cases a day for medical necessity. Advocate for and protect members from unnecessary hospital admissions.

Contracted Nurse Case Manager PrideStaff is looking to onboard a Nurse Case Manager, in a contingent role. We are looking for an IL licensed RN with 1-2 years of experience as a nurse case manager. This would be a short term...

Salary: $70,779.53 Annually Location : Walker, GA Job Type: Full-Time Salaried Remote Employment: Remote Only Job Number: 2020-02252...

*Employment Type:* Full time *Shift:* 12 Hour Night Shift *Description:* Qualified applicants may submit a resume to Senior Talent Acquisition Partner, Tonya Globlek at ...@mchs.com for expedited consideration. *Position Purpose: * The...

Overview Mount Carmel Behavioral Health is hiring Admissions RN's! Available Shifts and Hours: 7p-7a with rotating weekends Sign on Bonus:...

Job Title: Utilization Review Nurse Location: 100% Remote Duration: 3 Months+ (Possible Extension) Pay Rate: $43/hr. on (W2) Schedule: After 6 weeks of...

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

Position Summary: The ANM assists with the planning, organization, direction and evaluation of patient care operations for a designated area(s) on a 24-hour basis. The ANM is key in operationalizing the Medical Centers mission, vision,...

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...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh...

RN - Utilization Review Nurse | 3+ Years of Experience | Remote in IL | Contract Walker Healthforce is seeking a RN - Utilization Review Nurse with 3+ Years of Experience to support a Healthcare Payor Client based out of IL.

Summary We are currently hiring for a Quality Nurse Navigator to join BlueCross BlueShield of South Carolina. In this role as a Quality nurse Navigator, you will monitor/implement quality improvement/management activities,...

Location: Columbus, OH Pay Rate: Up to: 1977.42/Week Start Date: 02/23/2026 to 05/25/2026 Duration: 13 weeks Number of Positions: 1 Shift...

A healthcare organization is seeking a remote Case Manager I to coordinate case management services for members with complex healthcare needs. The successful candidate will be responsible for advocating on behalf of members, working with...

A leading healthcare provider is urgently seeking experienced Clinical Documentation Specialists for remote positions. Ideal candidates must be RN graduates from an approved nursing program and possess prior CDI experience, preferably in acute...

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...

Remote Rn Care Coach 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...

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 recommendations to meet...

We are more than a health system. We are a belief system.We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach...

Take advantage of flexible schedules and get paid up to $68 an hour as a Registered Nurse (RN) in Westerville, Ohio, and surrounding areas. Nursing...

Summary The Remote Patient Monitoring (RPM) Home Telehealth (HT) Nurse Case Manager executes position responsibilities that demonstrate leadership, experience, and creative approaches to the management of patient care. RPM-HT is a program that...