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Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude...

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...

Care Manager At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build...

Utilization Management (UM) Claims Review Nurse RN II Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) L.A. Care Health Plan is an independent public agency created by the state of California to provide...

Direct Hire! Exceptional Benefits! Growth potential! Guaranteed interview with client! Benefits Offered: Medical, Vision, Life, Dental, 12...

Telehealth Nurse – Providing Virtual Clinical Support & Care Coordination Telehealth Nurse All Seniors Foundation Los Angeles, CA (Remote Possible) About Us: All Seniors Foundation embraces innovative...

NirvanaHealth Utilization Management Nurse Join us in our mission to transform healthcare! NirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees...

Company Overview: Join us in our mission to transform healthcare! nirvanaHealth (under RxAdvance Corp.) is committed to bringing the art of the possible to the payer and PBM industries. We invest in our employees at every stage...

Job Title Conducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital...

Telephonic Nurse Case Manager (Remote) Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location: Home United States...

Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in accordance with established standards of care, policies, and procedures. Demonstrates performance...

Workers' Compensation Telephonic Nurse Case Manager The Workers' Compensation Telephonic Nurse Case Manager is responsible for evaluating and expediting appropriate, cost-effective medical treatment of injured employees with the goal of...

AvonRisk Utilization Review Nurse AvonRisk is the nation's leading specialty risk manager for self-insured organizations, uniting respected regional leaders in workers' compensation, liability, managed care, and risk management across 32...

Certified Wound Ostomy Continence Nurse The Certified Wound Ostomy Continence Nurse is responsible for supporting the infrastructure necessary to develop and maintain a therapeutic environment for patients, families, and staff members.

Travel Clinic Registered Nurse (RN) - $2,106 - $2,340/wk per week in taxable pay and non-taxable stipend amount. Pay rates are subject to confirmation with tax free stipend determined for qualified candidates. KPG Healthcare is currently...

Utilization Review Nurse Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position, you will utilize your clinical judgement to approve or deny outpatient medical...

About the Job Job Description: All Care Home Health is currently seeking a Licensed Vocational Nurse (LVN) Care Coordinator to join our team supporting the Kaiser region. We...

Utilization Management Nurse The primary role of the Utilization Management Nurse is to review and monitor members' utilization of health care services with the goal of maintaining high quality cost-effective care. The role includes...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Job Profile Summary Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's...

Telephone Triage Nurses Remote Nurse - High Volume Claims Call Specialist Location: Remote (Work from Home) Hours: Full-time, 3Pm-11pmSA (Monday Friday) Must Reside in South Africa Overview: We are seeking a tech-savvy,...

Virtual Care Registered Nurse We are seeking a licensed Registered Nurse to deliver virtual care to patients on behalf of one of our partner organizations. This role involves delivering remote patient care, symptom triage, health...

AvonRisk is the nation's leading specialty risk manager for self-insured organizations, uniting respected regional leaders in workers' compensation, liability, managed care, and risk management across 32 states. With nearly 700 professionals and...

Clinical Review Nurse - Prior Authorization Various, NV Clinical Review Nurse - Prior Authorization Various, NV All On-site Location: Fully Remote – Prefer Candidates reside in NV, but can reside elsewhere if they...

Pediatrics Specialty Triage Phone LVN Join Our Dedicated Team! Glendale Pediatrics (physician-owned private practice) is seeking a Licensed Vocational Nurse (LVN) to join the team as a full-time Pediatric Triage Phone &...