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Immediate need for a talented Utilization Management RN - Prior Authorization. This is a 12+ Months Contract opportunity with long-term potential and is located in US (Remote). Please review the...

Piper Companies is seeking a Clinical Appeals Nurse to join a leading health insurance organization for a contract remote opportunity located in North Carolina. The Clinical Appeals Nurse will serve as a clinical...

Clinical Nurse Professional Development Educator Advanced How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At...

Job Description Join a team that's shaping the future of pediatric care. Children's Hospital Los Angeles is consistently ranked among the top 10 children's hospitals in the nation, delivering world-class care through more than 350...

American Health Plans Franklin, TN 37067, USA Description American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for...

Aesthetic Registered Nurse $50/hr base + $5/hr weekend differential Fixed schedule No overnights You'll be the clinical expert patients trust to achieve results they didn't think were possible without surgery —...

Nurse Consultant I (NS) The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health,...

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management). *** Candidate must be authorized to work in USA without requiring sponsorship...

CorVel Corporation seeks a Care Advocate Nurse for a remote role focused on assessing injury severity, reviewing medical data, and supporting the Claims Management department as a nurse consultant. The position requires clinical nursing...

OverviewAs our Educator, RN in Periop, you will serve as a consultant/resource professional by providing staff development expertise as an educator, facilitator, change agent, leader, and researcher, ensuring educational initiatives are...

CVS Health is seeking a Nurse Consultant for Utilization Management in a 100% remote role. You will apply clinical judgment and evidence-based criteria to review inpatient and outpatient services, collaborate with providers to authorize care, and...

Molina Healthcare of California is hiring a Transition of Care Coach LVN/LPN . This role is remote; however, candidates must have a valid and unrestricted California LVN/LPN licensure. The hours will be Monday through Friday from...

RN Utilization Management Nurse Consultant (Medicare – Joint Procedures) 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...

Salary : $105,247.44 - $157,542.24 Annually Location : Los Angeles County, CA Job Type: Full time Job Number: PH5230H Department: PUBLIC HEALTH...

Sanford Health Careers Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland. Facility:...

Clinical Appeals Specialist The Clinical Appeals Specialist completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The Clinical Appeals Specialist utilizes...

Lead Care Coordinator The Lead Care Coordinator will provide hands-on expertise to other team members as needed to help ensure that every patient receives the right type of care, at the right time in the right setting, every day. The Lead...

VitaCare Living - Mount Horeb, WI seeks an experienced Registered Nurse (RN) Consultant to support our assisted living and memory care communities in Mount Horeb. This contracted role focuses on clinical oversight, regulatory compliance, staff...

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...

Clinical Patient Family Liaison, Registered Nurse Location: Glendale and Los Angeles, CA Find Your Passion and Purpose as a Full-Time Clinical Patient Family Liaison, Registered Nurse Salary: $50 - $60 / hour Schedule: M-F...

Staff Education RNCollaborates with Education Consultants, Managers, CNS staff and Physicians to develop, design, deliver and evaluate/improve education strategies and special projects/programs based on clients departmental goals and needs, as...

Case Management Nurse The Case Management Nurse delivers comprehensive, client-centered case management services across the continuum of care, ensuring that each individual receives the most appropriate level and type of health, medical,...

MPHI, a Michigan-based public health institute, seeks a Nurse Consultant for Tuberculosis to coordinate clinical and educational TB elements across the state. The role requires a master's degree in nursing, public health, or a health field, with...

Optum is seeking a Clinical Consultant RN, Medical Policy Writer for a remote role within the United States. You will lead clinical oversight of product medical policies, develop utilization guidelines, and support COE network criteria. The...

Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET Medix is supporting a healthcare technology organization that is adding experienced RNs to its clinical...