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Utilization Review Nurse Health Plans - Case Management US:NM:Alamogordo | Utilization Management | Full Time This position has a remote option for those living close and will be able to come into the hospital as needed.

Utilization Review Registered Nurse Excel. Empower. Advance. Shine. Belong. Explore. Flourish. Champion. Make It Happen At Hopkins! Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns...

Pulse Clinical Alliance is hiring a Correctional Registered Nurse in Los Angeles, CA. Job Details: Contract: 20 weeks Pay Rate: $71/hr for locals -...

Fully Remote : Clinical Documentation Specialist Job Description Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers.

Pre-Payment Review Nurse Consultant- Wisconsin 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.

Join Equum Medical and be a driving force in revolutionizing acute care telehealth. As an innovative leader in the healthcare technology industry, Equum Medical is dedicated to transforming how patients access critical medical services.

School Nurse Published Date: Jun 8, 2026 Location: US Company: Los Angeles Unified School District SALARY DETAILS All Salary Tables located at School Nurse Salary Table - N Table APPLICATION FILING DATES...

DescriptionThe Utilization Management (UM) Nurse supports appropriate level‑of‑care determination, patient flow, and revenue cycle integrity across inpatient, partial hospitalization, and intensive outpatient programs. The UM Nurse functions...

Job Title Utilizes a collaborative review process of benefits, minimally necessary clinical information and evidence-based clinical guidelines to formulate decisions regarding medical necessity, pre-existing conditions, benefits and/or...

JOB DESCRIPTION Centered in the heart of Montebello, Adventist Health White Memorial Montebello has a 70-year history of providing quality healthcare to the community. We are comprised of a 192-bed hospital, wound care medical office...

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 Description 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)...

Care Manager—Registered Nurse 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...

A healthcare company is seeking a Care Management Nurse to provide telephonic care services to chronic patients. The ideal candidate will have a nursing license and 1-2 years of experience in clinical or telehealth settings. Responsibilities...

Job Summary and ResponsibilitiesAs a RN Care Coordinator, you will be a central figure in patient care, seamlessly navigating the healthcare journey to achieve optimal outcomes and an exceptional patient experience.Every day, you will...

Job Description: The Intake Coordinator is a Registered Professional Nurse who takes referrals and processes appropriate home care services. To maintain open lines of communication with referral sources and within Americare...

U.S. Citizenship is required for this position due to Department of Defense restrictions. Our Medical Review Nurse Analyst - Registered Nurse (RN) is responsible for reviewing medical records...

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to...

The Clinical Documentation Specialist is responsible for the evaluation of physician documentation utilizing their clinical expertise to ensure the patients' severity of illness is accurately portrayed in the medical record for specificity of...

Job Description: Job Summary: Responsible for patient focused programs which may include but is not limited to: collaborating with health care team in providing direction for maintaining high quality...

Nurse Navigator Department: ECM Outpatient Care Management Location: Children's Health- Dallas Shift: Part-time working Monday, Wednesday, and every other Friday 8:00a to 4:30p or 8:30a to 5:00p. Job Type: Remote, but...

*This position is located in Fort Wayne, Indiana it is is NOT a remote role. Summary Independently plans and provides excellent professional nursing care for patients in accordance with physician orders,...

Registered Nurse (RN) - Clinical Documentation Specialist (Part Time) Remote The Clinical Documentation Specialist is responsible for the evaluation of physician documentation utilizing their clinical expertise to ensure the patients'...

Clinical Review Clinician 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...

Clinical Nurse Specialist At Aspirion, our mission is simple and meaningful: to help healthcare providers get paid accurately, quickly, and transparently for the care they deliver. By combining deep human expertise with advanced...