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Clinical Review Nurse Duals Program Details- Brand new program of 2026 for Centene Duals = Medicare + Medicaid line of business. Members have one combined card and one authorization covering both benefit types. The duals...

We believe everyone should have confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care...

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...

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...

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...

ResPro Health is dedicated to providing our partners in the respiratory space with the tools and resources needed to implement meaningful programs like remote patient monitoring and chronic care management in their pulmonary practices. With a...

Summary The Greater Los Angeles VA Health Care System is seeking 1 experienced Licensed Vocational Nurse's (LVN) in Nursing Service for their Community Living Center 215-3 for Day Shift. Located in Los Angeles, CA. Responsibilities This position...

Details Client Name CSMN - 1102080 - TACRI Clinical Job Type Travel Offering Nursing Profession RN Specialty...

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'...

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.

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...

Requisition Details GENERAL REQUISITION INFORMATION EEO Statement: UNMC is an Equal Employment Opportunity Employer, including an equal opportunity employer of protected veterans and...

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...

Description Location: UCHealth UCHlth Yampa Valley Med Center, US:CO:Steamboat Springs Department: YVMC Med Surg FTE: Full Time, 0.900, 72.00 hours per pay period (2 weeks) Shift: Nights Pay: $35.29 - $54.71 / hour. Pay is dependent on applicant's...

Anticipated End Date: 2026-07-01 Position Title: Nurse Appeals-RN (California) Job Description: Nurse Appeals RN Locations: Woodland Hills, CA and Costa Mesa, CA ...

Scion Nonprofit Staffing has been engaged to conduct a search for a Registered Nurse (RN) - Research for a mission-driven clinical research organization advancing equitable healthcare access and innovative treatment...

Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and quality improvement services for more than 50 years. We...

Your Future Role At A Glance Location: Remote - Must be within 1 hour of Milwaukee, WI Department: Transfer Center Schedule: Night shift | 7pm - 7am | Full Time Salary: $40.41 - $57.05 (per hour) Life At...

Admissions Nurse Salary Range: $48 - $51 / Hourly Job Description Why Hospice? Why VITAS? Have you ever considered hospice as a clinical specialty—one that blends clinical expertise with deep human connection?

Staff RN USC is a smoke-free environment USC is an equal opportunity, affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation,...

Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical...

CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to...

Clinical Review Nurse - Remote ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to join a...

Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit,...

Job Title : Registered Nurse (Navy Nurse Corps) Category / Component : Officer • Both Overview Navy Nurse Corps officers deliver professional nursing care to service members, families, and global communities in leading edge military medical...