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Perform medical reviews on provider inquiries and member appeals. Works within Department of Labor and State guidelines. Adherence to all confidentiality regulations and agreements. Reviews and interprets Plan language appropriately. Utilizes...

Majestic Care of Columbus - Nurse, RN - Full-time Days & Nights / PRN Majestic Care of Columbus is looking for Registered Nurses to join our team's mission and believe in our core values! Our mission:...

Pyramid Consulting (Travel) is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Philadelphia, Pennsylvania. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 13 weeks 40...

A leading healthcare provider in Virginia is seeking a Registered Nurse Case Manager (RN) to join the team. The role is full-time, focusing on patient discharge planning, data analysis for care continuity, and collaboration with healthcare...

Registered Nurse (RN) | Cardiovascular Intensive Care Unit Location: Columbus, OH Agency: Coast Medical Service Pay: $2,331 per week Shift Information: Rotating - 3 days x 12 hours Contract Duration: 13 Weeks Start Date: 1/26/2026 About the Position...

About the Job Job Overview This position offers supplemental income as an Independent Contractor. Make your own schedule! Flexibility! QUEST Diagnostics is a leading...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities, ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

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...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Clinical Appeals Nurse The Remote Clinical Denials/Appeals Nurse will be directly responsible for securing pre-service approvals, and reviewing pre/post service denials, medical necessity review and completing appeals and/or coordinating...

Who Is Guidehealth? Guidehealth is a data?powered, performance?driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of...

Registered Nurse, Care Line We're unique. You should be, too. We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do...

A healthcare services provider is seeking a remote provider relations specialist in Columbia, SC. This role requires effective communication with providers about Medicare coverage and documentation. The ideal candidate must have relevant nursing...

A healthcare services provider is seeking an energetic RN Clinical Compliance Partner to join their Compliance Team. This full-time position is focused on supporting compliance in the Hospice environment, performing crucial audits, and analyzing...

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach...

Remote Rn Care Coach This is a remote role. CircleLink Health is looking for passionate, tech savvy registered nurses to work remotely and serve patients enrolled in Medicare's Chronic Care Management Program. In this part time role...

Focus Staff is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Columbus, Ohio. Job Description & Requirements Specialty: PCU - Progressive Care Unit Discipline: RN Start Date: 01/26/2026 Duration: 16 weeks 36 hours...

A large health service provider is seeking a Clinical Care Coordinator to ensure optimal continuity of care for patients in home health services. The role demands an Associate's degree, RN license, and at least 3 years of post-acute experience.

Employer Industry: Healthcare Why consider this job opportunity: Opportunity for career advancement and growth within the organization Work remotely from anywhere within New England Supportive and...

Remote Registered Nurse (RN) Case Manager Join to apply for the Remote Registered Nurse (RN) Case Manager role at PharmaCord Remote Registered Nurse (RN) Case Manager 1 month ago Be among...

Care Manager Sharecare is the leading digital health company that helps people no matter where they are in their health journey unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: Aids patients in obtaining the correct level of care with the appropriate provider at...

The VITAS Telecare RN is a member of the interdisciplinary team who is the pivotal person responsible for identifying the physical, psychological, social, and spiritual needs of those patients and families needing assistance after normal business...

Medical Review Nurse The Medical Review Nurse provides support for medical claim and internal appeals review activities ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and...

Facility: SRS City San Diego Department Job Status Regular Shift Variable FTE 0.6 Shift Start Time Shift End Time...