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Home Infusion Registered Nurse – Accredo Specialty Pharmacy Join Accredo Specialty Pharmacy, part of Evernorth Health Services, and bring your nursing expertise to patients where they feel most comfortable—their homes. As a...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse. The Utilization Review Nurse is...

Job Title: Clinical Quality Assurance Nurse Pay: see below Registered Nurse - $28.50/hr (Non-negotiable) LPN/LVN- $26.50/hr (non-negotiable) Regular Schedule after training: M-F 11:30am...

This position represents 3 openings#SRNJob Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in...

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...

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...

Certified Nursing Assistant in DTLAHospital in Downtown Los Angeles is looking for a certified nursing assistant to join their team! CA CNA license is required. This is an opportunity to work in a fast-paced environment and gain extensive hospital...

Remote Nursing OpportunitiesAre you looking for an exciting way to utilize your nursing skills and expertise to deliver quality nursing care in a remote setting? AccessNurse, where technology meets compassionate care, is looking for professional...

LPN/LVN Utilization Management Nurse Integra is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will play a key...

Secondary Review Nurse 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.

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...

Job Summary and Responsibilities As our 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...

Medlivo is seeking a Nurse Practitioner Clinic Family Practice for a local contract job in Lynwood, California. Job Description & RequirementsSpecialty: Family...

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...

RN Utilization Review Review patient medical records to assess the appropriateness and medical necessity of hospital admissions, continued stays, and services, while coordinating with providers and payers to ensure compliance with...

To ensure clinically appropriate hospital stays and optimize resource use, the full-time Maryland Licensed Utilization Review Nurse will conduct initial, concurrent, and retrospective chart reviews while coordinating with third-party payers 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...

Salary : $107,352.48 - $160,692.96 Annually Location : Los Angeles County, CA Job Type: Full time Job Number: PH5230H Department: PUBLIC HEALTH...

Sherman Oaks Hospital Job Opportunity At Sherman Oaks Hospital, our dedicated team of professionals are committed to our core values of quality, compassion, and community. As a member of the Prime Healthcare Foundation, Sherman Oaks...

Appeals Nurse Consultant 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...

***There is a separate BR for locals*** ***Flu Vaccination Required (no declinations o exemptions)*** JOB REQUIREMENTS: - Experience: 1 year of outpatient clinic experience - CA LVN - Certs: BLS (AHA or ARC only), IV and Blood withdrawal...

UM Review Nurse - Texas Astrana Health is looking for a Utilization Review Nurse with a Texas LVN license to assist our Health Services Department in reviewing a high volume of outpatient and inpatient cases. This position will require...

Review claims files to detect potentially fraudulent billing practices.Use medical terminology and coding to assess payment appropriateness.Write investigative summary reports and provide expert testimony.Requirements:Active RN license and 2+...

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

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...