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Overview The Care Management Recovery Advocate (CMRA) is responsible for providing overall management and communication of clinically-based appeals between Providence Health and Services, California Region (PH&S) outside payers.

A leading health solutions company is seeking a fully remote Case Manager - Registered Nurse (RN) to join their National Medical Excellence team. The position involves assessing and coordinating care for members to enhance overall wellness.

Overview OhioHealth Rehabilitation Hospital Joint venture with Select Medical Position: Registered Nurse (RN) Location: Columbus, OH...

Graham Healthcare Group is seeking a Registered Nurse (RN) Quality Assurance for a nursing job in Remote, Remote. Job Description & Requirements Specialty: Quality Assurance Discipline: RN...

Registered Nurse (RN) | Correctional Location: Cleveland, OH Agency: Mindlance Health Pay: $2,213 per week Shift Information: 3 days x 12 hours Contract...

JOIN TEAM TRILOGY: At Trilogy, you'll experience a caring, supportive community that values each team member. We prioritize meaningful relationships, genuine teamwork, and continuous growth. With the stability of...

Make an hourly rate of up to $68 as a Registered Nurse (RN) in Grove City, OH (and the wider Columbus area), with the stability of W2 employment and...

Registered Nurse Full Time Columbus, OH AndHealth is a healthcare technology company created to help people reverse chronic disease. We are driven by the goal of making world-class specialty care accessible and affordable to...

A leading healthcare provider is seeking a Governmental Audit Reviewer to handle clinical documentation audits and appeals processes remotely. The ideal candidate will have an Associates degree in Nursing, LPN licensure, and at least one year of...

Overview Looking to join our dynamic team at Ohio State University Physicians where excellence meets compassion!? With over 100 cutting-edge outpatient center locations, dedicated to providing...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect...

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

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

TPAPT is seeking dedicated and knowledgeable Nursing School Admissions Coaches to help aspiring nursing students navigate the admissions process for competitive nursing programs. You will work one-on-one with students to provide...

TNAA TotalMed RN is seeking a travel nurse RN Radiology for a travel nursing job in Columbus, Ohio. Job Description & Requirements Specialty: Radiology Discipline: RN Start Date:...

RN Clinical Appeals Nurse Job Summary: The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory...

Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...

RN Clinical Appeals Nurse Job Summary: The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory...

A healthcare provider is looking for an RN Coordinator Utilization Management to evaluate authorization requests and ensure proper care procedures. The position requires a current nursing license in Wisconsin and a minimum of four years of...

Overview Sanctuary Hospice is thrilled to announce our expansion into the Columbus, OH market with the opening of a new location! With nine successful locations across Ohio and Illinois, we are excited to bring our...

A leading health solutions company is seeking a Care Manager-Registered Nurse in Connecticut. This role requires developing and coordinating care plans for members with multiple chronic conditions while ensuring effective telephonic engagement.

ORGANIZATION INFORMATION: Established in 1984, Equitas Health is a regional not-for-profit community-based healthcare system and federally qualified community health center look-alike. Its expanded mission has made it one of...

JOIN TEAM TRILOGY: At Trilogy, you'll experience a caring, supportive community that values each team member. We prioritize meaningful relationships, genuine teamwork, and continuous growth. With the stability of...

Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The...

Job Description: Responsible for specialty care management for assigned clinics/geographical areas and other appropriate referrals within the Intermountain system. Assess, plan, educate, and advocate for patients' health...