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Utilization Management RN IL Regional Office - Springfield, Illinois Overview Position Type: Full-Time Job Shift: Day Education Level: Bachelor's Degree Category: Nursing Professional & Support Description...

Details Client Name Kaiser Permanente Los Angeles Medical Center Job Type Permanent Offering Nursing Profession Nurse...

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,...

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...

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...

Clinical Case Manager Opportunity Are you ready to bring your expert clinical skills to a world-class facility recognized as one of the top ten in the United States? Do you have a passion for the highest quality and patient happiness?

Annual Salary Range: $108,805.00 - $175,760.00 per yearThe FBCM Manager is responsible for overseeing the operational aspects of the FBCM team across all levels of facility-based care, including admissions at Torrance Memorial Medical Center...

Ssbv Clinical Claims Review Rn 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...

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...

Nurse Reviewer Appeals and Hearings- Remote 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...

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...

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,...

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...

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource...

Remote in California onlyAre you ready to make a lasting impact and transform the healthcare space? We are one of Southern California's fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth.Who Are We?

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...

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

Overview Who We Are Because health is personal. That's why Personify Health created the first and only personalized health platform-bringing health plan administration, holistic...

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...

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...

Position Title: Registered Nurse, Case Manager & Care Coordinator Team LeadLocation: Los Angeles, CA 90022DescriptionGrow HealthyIf you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At...

Job Opportunity Seeking a compassionate and driven Registered Nurse (RN) Care Manager to join our team in a role designed for nurses who are ready to expand their impact beyond the traditional clinical setting. This position offers the...

About the Opportunity We are seeking an experienced Case Management RN to coordinate patient care, discharge planning, and utilization review in a hospital setting. This role is ideal for nurses who enjoy...

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,...

OverviewAt Centinela Hospital Medical Center, our dedicated team of professionals are committed to our core values of quality, compassion, and community. As a member of Prime Healthcare, a Top-15 hospital system in the United States, Centinela...