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Remote - Candidate is required to reside in California. The RN School Support Manager is responsible for the clinical oversight of the designated medical care needs per the district contract. This oversight includes support of care...

Working remotely in a full-time capacity, the Registered Nurse Clinical Auditor will conduct clinical audits and reviews related to fraud, waste, and abuse, analyzing care services, coding requirements, and resource utilization while collaborating...

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 guidelines, insurance policies, and...

Medical Review RN IV – Commercial Appeals & Grievance Nurse Location: Remote – Candidate Must Reside in California Duration: 6+ Months Contract-to-Hire Schedule: Monday-Friday | 9:00 AM – 5:00 PM Pay Range:...

The Clinical Documentation Specialist is responsible for the evaluation of physician documentation utilizing their clinical expertise to ensure the patients' severity of illness is accurately portrayed in the medical record for specificity of...

The Clinical Documentation Specialist is responsible for the evaluation of physician documentation utilizing their clinical expertise to ensure the patients' severity of illness is accurately portrayed in the medical record for specificity of...

Staff RN USC is a smoke-free environment USC is an equal opportunity, affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation,...

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,...

Employment Type: Full time Shift: Description: ESSENTIAL FUNCTIONS Our Trinity Health Culture : Knows, understands, incorporates &...

Clinical Appeals RN 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...

Salary : $50,877.84 - $55,193.52 Annually Location : Los Angeles County, CA Job Type: Full time Job Number: Y5101L Department: HEALTH SERVICES...

Job Title Full Job Description Responsibilities: Provide skilled professional nursing care to patient/family/caregivers Oversee and provide primary care, including all clinical care, palliative care, and...

Duration: 8 months contract (with possible extension) Job Summary The Clinical Reviewer, Precertification RN, is a licensed Registered Nurse that is expected to function independently in her / his role...

Appeals and Grievances Nurse Specialist RN II Job Category: Clinical Department: CSC Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00...

Become a part of our caring community The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration...

Job Description: Mount Saint Mary's University invites applications for a full-time, tenure-track Assistant or Associate Professor of Nursing. As a University founded by the Sisters of St. Joseph of Carondelet, we seek...

Job Description RN Utilization Review - Remote. This position is Per Diem and will work 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA...

Clinical Research Registered Nurse (RN) Infusion Registered Nurse (RN) to support the execution of clinical trials in a fast-paced research environment. This role combines direct patient care with clinical research responsibilities,...

Registered Nurse – Utilization Review (Remote) Contract Length: 13 Weeks (Extension Possible) Facility: Providence Medical Center Location: 4101 Torrance Blvd, Torrance, CA 90503 Shift: Days – 5x8-Hour (08:00 AM – 04:30 PM)...

Excel. Empower. Advance. Shine. Belong. Explore. Flourish. Champion. Make It Happen At Hopkins! Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins...

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...

Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team. Job Title: Clinical Medical Review Nurse.

Join a mission-driven team transforming senior mental health care with compassion, flexibility, and support. Work remotely from your home and on your own hours. Sailor will take care of finding patients to you so that you can focus on providing...

Registered Nurse Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland. The Center for...

RN - Clinic Nurse Out-patient clinic nurse City: Los Angeles State: CA Start Date: 01/06/2025 End Date: 04/07/2025 Duration: 13 Week(s) Shift: 5X8 Days Shifts Per Week: 5 Scheduled...