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GHR Healthcare - PH DivisionColumbus,OH
GHR Healthcare - PH Division is seeking a travel nurse RN PACU - Post Anesthesia Care for a travel nursing job in Columbus, Ohio. Job Description & Requirements Specialty: PACU - Post Anesthesia...
Mount Carmel Health SystemWesterville,OH
*Employment Type:* Full time *Shift:* 12 Hour Night Shift *Description:* Qualified applicants may submit a resume to Senior Talent Acquisition Partner, Tonya Globlek at ...@mchs.com for expedited consideration. *Position Purpose: * The...
Good Samaritan SocietyColumbus,OH
A leading not-for-profit health system is seeking a nursing educator for a remote position in Wisconsin. The role involves developing and coordinating educational programs for new and existing clinical staff, enhancing patient education...
StrykerColumbus,OH
A leading health solutions company is seeking a Care Manager-Registered Nurse in Connecticut. This role requires developing and coordinating care plans for members with multiple chronic conditions while ensuring effective telephonic engagement.
Mass General Brigham Community PhysiciansColumbus,OH
A healthcare provider is seeking a part-time Registered Nurse for remote work. The role involves client assessments, modifying treatment plans, and preparing families for discharge. Candidates should have an ADN or BSN and active RN Licensure,...
Ohio StaffingColumbus,OH
Job Summary The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies...
MN Home CareColumbus,OH
A healthcare services provider is seeking an Inpatient Care Management Nurse to evaluate health services usage and improve member health outcomes. This role requires an active RN license and 3+ years of clinical nursing experience, preferably in...
Innovative Systems GroupColumbus,OH
A health services provider is seeking a full-time remote Registered Nurse (RN) for a contract position in Chicago. The role involves validating medical necessity and appropriateness of treatment plans, focusing on claims review for medical...
Mount Carmel Behavioral HealthColumbus,OH
Mount Carmel Behavioral Health is hiring Admissions RN's! Available Shifts And Hours 7p-7a with rotating weekends Sign On Bonus Full Time Night:...
UST HealthProofColumbus,OH
A healthcare management firm is seeking a Medical Review and Appeals RN. This remote role involves reviewing and authorizing medical service requests, ensuring compliance with regulations, and implementing discharge planning. Candidates must have...
Network HealthColumbus,OH
A healthcare provider is looking for an RN Coordinator Utilization Management to evaluate authorization requests and ensure proper care procedures. The position requires a current nursing license in Wisconsin and a minimum of four years of...
Medical Edge Recruitment, LLCLancaster,OH
Medical Edge Recruitment, LLC is seeking a local contract nurse Correctional for a local contract nursing job in Lancaster, Ohio. Job Description & Requirements Specialty: Correctional Discipline:...
Elevance HealthColumbus,OH
A leading health services provider is looking for a Clinical Fraud Investigator II to work virtually full-time. The role includes conducting in-depth investigations on healthcare claims, ensuring compliance with guidelines, and collaborating with...
CareFirst BlueCross BlueShieldColumbus,OH
Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The...
Advocate Aurora HealthColumbus,OH
Collects data pertinent to the healthcare consumer's health or the situation from telephonic contacts and/or related EMR information available. Analyzes the data to determine the issues and available resources to seek effective resolution.
AxelonColumbus,OH
Location: REMOTE - Must Work EST ( Required: NC license or Compact license ) SHIFT: Monday-Friday 8 am-5pm EST; No OT expectations Duration: 1 year (Possible contract to Hire) Job Description: Process authorization requests for TP product, will...
Virginia StaffingColumbus,OH
Explore Opportunities With Agency Name As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each...
TIBCO SoftwareColumbus,OH
HEDIS EXPERIENCE IS A MUST The HEDIS nurse will review patient charts and abstract data points based on Medicaid NCQA guidelines. The HEDIS nurse will toggle between 2 screens to enter patient health information into Electronic Medical Record...
WorkCareColumbus,OH
Workers' Compensation Case Manager - RN - Fully Remote in the US WorkCare, Inc. is seeking a full?time RN to serve as Workers' Compensation Case Manager, supporting our occupational health initiatives across the United States.
Delaware StaffingColumbus,OH
Registered Nurse As a Registered Nurse you will make an impact by performing advanced level work related to clinical denial management and managing clinical denials from Providers to the Health Plan/Payer. The comprehensive process...
Gold Coast Health PlanColumbus,OH
A healthcare organization in California is seeking an RN, Clinical Care Manager I to enhance member care through assessment and coordination. Applicants should have a Bachelor's Degree in a health-related field and an active RN license. The role...
UNC HealthColumbus,OH
A healthcare organization is seeking a Recovery Audit Contractor (RAC) Coordinator (RN) to manage denial and recovery audit requests. This role involves coordinating approvals and denials and ensuring proper policy implementation. The ideal...
Boston StaffingColumbus,OH
Telephonic Case Manager At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions...
Centene CorporationColumbus,OH
A healthcare organization is seeking a candidate in South Carolina to improve HEDIS performance among providers. This full-time position involves educating providers on compliance measures and data management. The ideal candidate will have a...
BlueCross BlueShield of South CarolinaColumbus,OH
A leading health insurance provider is seeking a Managed Care Coordinator I to evaluate medical or behavioral eligibility for benefits. This entry-level position involves clinical assessments, coordination of services, and patient support. The...
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