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The Clinical Research Nurse (CRN) will provide direct patient care to patients enrolled in or considering a clinical trial. The CRN, in collaboration with the satellite physician(s), is responsible for the implementation and evaluation of clinical...

Navitus Health Solutions is seeking a Telehealth Registered Nurse to join the Clinical Engagement Center (CEC). The RN will perform telephonic comprehensive medication reviews and consult with members to improve adherence, close therapy gaps, and...

Company: Highmark Inc. Job Description: JOB SUMMARY This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate...

Navitus Health Solutions is expanding its Telehealth Registered Nurse team. The RN, Telehealth conducts telephonic comprehensive medication reviews and consultations to improve patient adherence and support CMS/HIPAA regulations, collaborating...

Overview St. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who...

JOB DESCRIPTION Job Summary Provides 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...

Who We Are Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard...

Job Description Responsibilities Review and evaluate electronic medical records of emergency department admissions and screen for medical necessity using InterQual or MCG criteria Apply evidence-based...

Ambulatory Chronic Care Manager (RN) To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect,...

At UK King's Daughters, we're not just a healthcare facility - we're a family of dedicated professionals who share a passion for making a meaningful difference in the lives of our patients. We're more than just a place to work; we're a place to...

To support timely and compliant care decisions, the full-time Utilization Management Nurse RN will review medical necessity requests, apply evidence-based criteria, and document determinations while working Monday to Friday, 8:00 AM-5:00 PM...

Registered Nurse II Job Title: Registered Nurse II (8 hour) - Per Diem: 1 shift per week, On-Call, weekend availability required Base Rate: $51.88 to $76.28 Job Summary: Responsible for the provision and coordination of...

Registered Nurse I (RN I) Kedren Community Health Center, Inc. is seeking a compassionate and dedicated Registered Nurse I (RN I) to provide professional nursing care to patients in an acute psychiatric setting. Working as part of...

Humana, Inc. is seeking a Behavioral Health Nurse for Utilization Management, coordinating medical services and benefit determinations in a remote-capable role based in Indiana. You will interpret criteria and policies to support member...

Registered Nurse (RN), Non-Invasive Cardiology, Full Time, Days Responsible for performing safe and effective cardiac stress tests (i.e., treadmills, thallium treadmills, pharmacological stress tests, stress echocardiograms, pharmacologic...

Schedule Available: 9:00 AM to 5:00 PM, Monday - Friday * With additional hours during evenings, weekends, and on-call; as needed. Benefits Include: Low patient-to-nurse...

Job Summary and ResponsibilitiesAs our Critical Care/Emergency Educator, and in accordance with our mission and core values of integrity, compassion, collaboration, and excellence, you will serve as a consultant and resource professional by acting...

ComForCare Home Care is seeking a Registered Nurse in Texas to conduct client assessments, create personalized care plans, implement interventions, and coordinate referrals. You will administer medications, maintain detailed records, and update...

Leading MLTC in the NY area is seeking experienced REMOTE Care Managers CANDIDATES MUST RESIDE IN THE METROPOLITAN NEW YORK ARE Responsibilities Perform assessments of members' medical, psychosocial, physical and spiritual...

As an integral member of the patient care team, the Registered Nurse supports the Chief Nursing Officer in leading the patient care team in providing for the safety, recovery and comfort of patients by implementing the nursing process (assessment,...

Clinical Reviewer – Registered Nurse (RN) Comagine Health | Washington State | Remote / Work From Home This is an excellent opportunity for an experienced Registered Nurse who wants to transition from direct patient care into a...

Registered Nurse - Ohio Location: Remote (must be located in Ohio) Tuesday Health is a value-based palliative care provider group dedicated to transforming serious illness and end-of-life care. We deliver goal-centered care focused...

Overview Who We Are Because health is personal. That's why Personify Health created the first and only personalized health platform-bringing health plan administration, holistic...

Registered Nurse - Review Analyst | Remote | Contract Walker Healthforce is seeking a Registered Nurse - Review Analyst with 2-4 years of clinical experience to provide clinical utilization reviews, evaluate medical...

Optum is seeking an experienced Behavioral Health Integration Nurse Case Manager to serve as a clinical liaison between OptumCare/Care Delivery and the clinical network. This role coordinates assessments, plans, and services to meet members'...