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Summary We are currently hiring for an Appeals Analyst to join BlueCross BlueShield of South Carolina. In this role as Appeals Analyst, you will research the substance of complex appeal or retrospective review requests...

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 with the care, pharmacy benefits, data...

Duration: 3+ Months (Possible contract to hire) Job Description: Onsite training - will last up to six weeks but could be extended. A typical day would like in this role: Process prior...

A leading not-for-profit health insurer is seeking an Appeals Nurse to analyze medical records and claims for appeals. The role requires an RN license and 1+ years in clinical settings. Responsibilities include determining medical necessity and...

RN Care Review Clinician The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical...

Carries out communicable disease surveillance, prevention, and control measures for the City of Boston. Investigates reports of communicable diseases including pathogens of public health importance, reported outbreaks, or other...

Job Summary The RN Utilization Management Care Review Clinician plays a vital role in supporting clinical member services by assessing the necessity and appropriateness of care based on established guidelines and regulations. You...

A healthcare company is seeking a part-time RN Triage Nurse to join their remote team in Charlotte, NC. Candidates should have at least 5 years of experience in nursing, ideally within emergency departments or triage settings, and possess strong...

GoTo Telemed seeks experienced, certified CRNAs for remote anesthesia consultation, patient education, and post-operative follow-up services. This 1099 independent contractor position provides flexibility while supporting surgical teams across...

Adecco Healthcare & Life Sciences is hiring Travel Nurse Educators! In this role you will work in per diem status. We're currently searching for RNs with a minimum of 4 years of recent critical care experience. This role begins in February 2026.

The range for this role is $25 - $34.13 Actual base pay will be determined based on a successful candidate's work location, skills/abilities, experience, and education. Interested applicants...

Deep Roots. Solid Growth. Caring People. Rooted in Wyoming! We are Blue Cross Blue Shield Wyoming: a not-for-profit health insurer with offices throughout the state. Ever since a small group of caring,...

Entity: Owensboro Health Regional Hospital | Department: Virtual Care | Work Hours: 7P - 7:30A | Weekend Requirements: One | 0.9 FTE Job Summary: Provides direct nursing care in accordance with established policies,...

Job Description Salary Range: $40 - $42/Hourly Why Hospice? Why VITAS? Have you ever considered hospice as a clinical specialty-one that blends clinical expertise with deep human connection?

Supplemental Health Care is seeking a travel nurse RN Rehabilitation for a travel nursing job in Dublin, Ohio. Job Description & RequirementsSpecialty:...

Building Location: South University Clinic Department: 1008190 RISK MANAGEMENT - EH SS Job Description: Seeking a Registered Nurse to serve as a...

A leading health services company is hiring a Clinical Review Nurse to conduct concurrent reviews and evaluate the health care provided to Iowa Medicaid members. The role allows remote work anywhere in the Central time zone and requires an Iowa or...

Facility: CoxHealth South: 3801 S National Ave, Springfield, Missouri, United States of America, 65807 Department: 1651 Virtual Care Command Center Scheduled Weekly Hours: 24 Hours:...

Location: Avera McKennan Hospital Worker Type: Regular Work Shift: Rotating days/evenings ights/weekends/holidays (United States of America) Pay Range: The pay range for...

Salary range: $95,139 - $130,811 annually, based on qualifications. This exempt remote-hybrid position is eligible for a comprehensive benefits package which includes medical, dental, vision, a 403(b) retirement account, and a generous...

Salary: $70,779.53 Annually Location : Homebased, GA Job Type: Full-Time Salaried Job Number: 2020-02252 Division: Healthcare Facility Regulation...

Join a Team Where Your Work Truly Makes a Difference! Safe Children, Stable Families, Successful Lives. At CMCS (Cardinal McCloskey Community Services), our mission is to...

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to...

Description & Requirements Be part of something great Maximus is a global organisation that specialises in providing health and employment services to millions of people every year. Here in the UK we employ...

JOB PURPOSE: Responsible for the oversight of clinical care management of community based long-term care population for PruittHealth Premier Dual Eligible Special Needs Plan (DSNP). Works to advise and coordinate clinical...