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You will ensure medical necessity and appropriate levels of care to support quality and financial outcomes.You will collaborate with liaisons, physicians, and revenue cycle teams.Responsibilities:Conduct daily admission and continued stay reviews...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: The Virtual Mental Health Intake RN is a Registered Nurse who provides competent and...

ICM Nurse LeadWork Location: Los Angeles, CA, USAWork Schedule Monday-Friday, 8AM-5PMSalary Range: $150,858 - $198,986 annualEmployment Type 2 - Staff: Career Duration Indefinite Job # 33185Primary Duties and ResponsibilitiesThe ICM Nurse Lead...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing, and evaluating the care of patients. The staff RN utilizes the nursing process by use of...

Home Health Registered Nurse (RN) Build a Career. Make a Difference. Love Where You Work. As a Home Health Registered Nurse, you'll deliver skilled nursing care in the comfort of patients' homes, creating individualized care plans,...

Details Client Name Providence Saint Joseph Medical Center - Burbank Job Type Travel Offering Nursing Profession Registered Nurse...

To support a growing healthcare organization, the full-time Remote LVN/RN Delegation Oversight Auditor will conduct Utilization Management (UM) and Case Management (CM) audits, ensuring compliance with regulatory and operational standards while...

Responsibilities SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

13 weeks - DAYS 5x8s - 8 weeks **Locals Accepted** Bachelor's degree in nursing (BSN) required. EXPERIENCE / TRAINING: One year of clinical nursing experience required (preferably with geriatric populations) with at least...

CareHarmony is seeking an experienced Licensed Practical Nurse (LPN) to join our care coordination team in a fully remote, full-time role. You will work with providers to deliver value-based care and focus on closing gaps in chronic care...

Clinical Appeals Nurse We are seeking an experienced Clinical Appeals Nurse to support the appeal and grievance processes by analyzing and responding to adverse coverage decisions. This role involves clinical judgment, regulatory...

Category : Customer Service/Support As a Healthcare Customer Support Specialist, you will serve as a primary point of contact for our clients, managing inbound and outbound communications with professional excellence. Utilizing a suite of...

Home Health | Hospice | Care Giving | Pharmacy | Transportation | Remote Patient Monitoring |Primary Care |Podiatry | Mobile PhysicianBillet Health is looking for LICENSED PRACTICAL NURSES who have the passion and heart for total patient care. Our...

Registered Nurse - Compliance Partner Position Type: Full Time, Employee. Salary: $110,000 to $120,000 annually, DOE. Location: This is a field-based position that requires regular travel to...

As a Clinical Documentation Review Specialist (RN), you will help medical staff clarify patient records to ensure appropriate reimbursement and reflect care complexity. You will perform concurrent reviews and engage with physicians...

JOIN OUR FULLSHIFT STAFFING TEAM!Facility Information:Our facilities are Intermediate Care Facilities for individuals with disabilities (ICF/DD-H and ICF/DD-N)Caregiver (DSP) to people supported ratio is usually 1:3, sometimes as high as 1:1...

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...

Registered Nurse Los Angeles VA is looking for qualified LVN's for their Ambulatory Care Center located in Ventura, Santa Barbara, and Santa Maria area. Benefits/Perks Flexible Scheduling Competitive...

Optum is seeking a remote IRR Clinical Claim Review Nurse to perform clinical review of claims against medical records and guidelines. The role requires an active RN license, 2+ years of acute care clinical experience, and 1+ year in claim review...

General Purpose The primary purpose of your job position is to provide each of your assigned residents with routine daily nursing care and services in accordance with the resident's assessment and care plan, and as may be directed by...

Oak Street Health is hiring a Care Coordinator for Utilization Management to oversee UM operations, optimize workflows, and ensure efficient patient care delivery. The role involves collaborating with UM physicians, payers, and vendors in a remote...

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the "12...

UW Hospital and Clinics seeks a Nurse Case Manager (RN) to join our multidisciplinary team; remote work options available with flexible shifts. The role emphasizes utilization management, patient status assessment and collaboration with care teams...

At Avanta Care, we prioritize the well-being of our employees. Our culture is built on the foundation of compassion, respect, and teamwork. We believe that when our employees feel valued and supported, they are better equipped to provide the...

Pay Range: $34.21 - $51.31 A successful candidate's actual pay rate will be based on several factors including relevant experience, skills, training, certifications and education. Hospital Sisters Health System (HSHS) is...