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Complex Medicare Claims Review Complex Medicare claims/prior authorization requests require the review of medical record documentation to determine the reasonableness and necessity of the billed service in accordance with Medicare rules...

Extraordinary Careers. Endless Possibilities. With the nation's largest home infusion provider, there is no limit to the growth of your career. Option Care Health, Inc. is the largest independent home and alternate site...

Care Management Nursing Consultant Job No: 540542 Work Type: Full-time Location: REMOTE OPTIONS, PHOENIX Categories: Healthcare/Medical Professional Level, Healthcare/Medical Support...

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an...

Nurse Consultant II (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,...

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a...

Nurse 3 Job Number: 364864 Category: Administrative Description: Job Title: Nurse 3 Location: Redondo Beach, CA Zip Code: 90278 Pay Rate: Up to $65.09/hr. Schedule: 9x80 A Start Date:...

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients. Job Summary Our client is seeking an Infusion Registered Nurse (RN) specialized in...

Nurse Navigator Join an innovative startup health plan based in Wisconsin that is revolutionizing healthcare and empowering companies to combat the relentless rise in healthcare costs. Our mission is to provide accessible, high-quality...

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.

Responsible for the delivery of patient care through the nursing process of assessment, diagnosing, planning, implementation and evaluation. Responsible for directing and coordinating all nursing care based on established clinical nursing care for...

CareHarmony's Care Coordinators (LPN) (NLC) (LVN) work comprehensively with providers to deliver value-based care management initiatives for their patients. CareHarmony is seeking an experienced Licensed Practical Nurse – LPN Nurse (LPN)...

$40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical...

The CTRC is a research environment that cares for research participants on clinical trials. The clinical trials may be phase I trials, gene therapy, radioligand investigational products or investigational devices. The CTRC nurse practitioner will...

Description The Quality Management Nurse is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with healthcare standards and regulations. This role involves evaluation clinical practices, identifying areas...

Optum Care At Home Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an...

DISTRICT SCHOOL NURSE - OPEN AND PROMOTIONAL at Torrance Unified School District Share on X - Application Deadline 6/30/2026 4:00 PM Pacific Date Posted 6/16/2026 Contact HR Recruiter Number of Openings 1 Salary Pay Range $62,926 - $127,632 Annually...

JOB DETAILS Job Summary The Nursing Home Physician / Nurse Practitioner Regulatory Consultant serves in a non-clinical, advisory consulting role providing physician-level or advanced practice expertise...

Job Title Opportunity for a TX licensed RN, residing in Texas, with experience functioning as a Care Manager working with Complex/Intensive cases assisting with Disease Management. Telephonically you will complete assessments...

After Hours - Hospice Nurse Case Manager PRN | Philadelphia, PA Overview: Interested in learning about hospice, seeking more money as a second job and/or love working in the night? Read on!

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh...

Job Summary and ResponsibilitiesThe Assistant Nurse Manager (ANM) provides clinical and operational leadership support for assigned perioperative and procedural patient care areas, including Pre-Op / ACC and GI / Endoscopy services. The role is...

Licensed Vocational Nurse at Pasadena Unified School District Share on X - Application Deadline 6/30/2026 11:55 PM Pacific Date Posted 6/16/2026 Contact Ana Maria Apodaca Number of Openings 1 Salary Pay Range $3,850.00 - $5,175.00 Monthly Length of...

Job Description Additional Information About the Role The Answer Line provides after-hours exchange and nurse triage services for about 250 subscribing community pediatricians in St. Louis and surrounding areas. The exchange is a 365/24/7...

Registered Nurse Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout...