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Job Title Utilizes a collaborative review process of benefits, minimally necessary clinical information and evidence-based clinical guidelines to formulate decisions regarding medical necessity, pre-existing conditions, benefits and/or...

How you'll change lives...

Find your calling at Mercy! Under the direction of the primary care operations team, the Primary Care Nurse works directly with Mercy Primary Care Providers to provide safe, timely, effective, efficient, equitable, patient-centered care in a...

About the Employer Welcome to Paramount Unified School District. Paramount strives to create a collaborative and supportive environment for our employees so that they may focus on our main goal to serve the needs and...

Chief Nurse Of Acute Care Units VA Greater Los Angeles Healthcare System (VAGLAHS) is seeking to hire experienced Registered Nurse to work as our Chief Nurse of Acute Care Units. As Chief Nurse, you will provide program management to...

(Only QUALIFIED Healthcare Professionals accepted) License Vocational Nurse - Are you looking for a new job? My name is Caroline and I'm a healthcare recruiter - I'm here to help! I'm working with an amazing private practice outpatient...

Start the day excited to make a difference...end the day knowing you did. Come join our team. Job Summary: The Virtual Registered Nurse (VRN) is responsible for providing professional nursing care with collaboration from the...

Registered Nurse – Clinic/Wellness/Immunization The Registered Nurse – Clinic/Wellness/Immunization works in a variety of either remote or clinic locations to serve a specific population's health and wellness needs. The Registered...

Job Title: Permanent -Licensed Vocational Nurses - multiple openings Number of positions: 4 Years of experience: One to three years Shift: Day and Night...

Job Description JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical...

Job Description The Clinical Appeals RN is responsible for the identification and resolution of technical and/or clinical based denials through appeals. The Appeals Nurse will work with Revenue Cycle staff, case management,...

Description The Care Management Recovery Advocate (CMRA) is responsible for providing overall management and communication of clinically based appeals between Providence Health and Services, California Region (PH&S) outside...

Working Nurse is seeking an RN Navigator to provide coordinated care for cancer patients in Los Angeles. This role involves collaborating with a team to support patients from initial referral through treatment and follow-up care.Candidates must...

Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit,...

Appeals Analyst 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 including...

Job Description: Job Summary: Responsible for patient focused programs which may include but is not limited to: collaborating with health care team in providing direction for maintaining high quality...

Job Summary and ResponsibilitiesAs a 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 experience.Every day, you will...

Providing clinical review support on an as-needed basis, the part-time PRN Clinical Review Specialist will review medical records for medical necessity, level of care, and authorization compliance while ensuring timely appeal submissions and...

RN - L&D Pulse Healthcare is currently seeking travel nurses for multiple positions in locations throughout the United States. Start Date: 07/06/2026 Duration: 91 days City: Los Angeles State: California Degree: RN Specialty: L&D...

Public Health Nurse Make a Difference in Your Community The Department of Public Health for St. Louis County Government is actively looking to hire a Public Health Nurse (PHN) to join their team. This nursing position will provide...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This position is remote. Candidates must be local to New England States for...

Nurse Reviewer – State of Illinois Location: Remote with on-site visits across Illinois We are currently seeking Nurses who reside in Central Illinois - preferably in McLean and Sangamon Counties. Position Overview...

CHA Hollywood Presbyterian Medical Center CHA Hollywood Presbyterian Medical Center (HPMC) is an acute care facility that has been caring for the Hollywood community and surrounding areas since 1924. The hospital is committed to serving...

Clinical Nurse Specialist At Aspirion, our mission is simple and meaningful: to help healthcare providers get paid accurately, quickly, and transparently for the care they deliver. By combining deep human expertise with advanced...

Benefits: 401(k) 401(k) matching Dental insurance Employee discounts Health insurance Vision insurance Building Stronger Communities At Joyous Ventures, we are committed to providing immediate...