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Cincinnati Children's is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and education within the Utilization Review department.

Utilization Management Nurse The primary role of the Utilization Management Nurse is to review and monitor members' utilization of health care services with the goal of maintaining high quality cost-effective care. The role includes...

*Job Summary and Responsibilities* As our Registered Nurse (RN), you will be a pivotal health care professional, delivering compassionate, high-quality care that truly impacts our patients' well-being and recovery. Every day you will...

Ansible Health Ansible Health is a virtual multi-speciality medical group that unites physicians, nurses, respiratory therapists, and tech experts from Columbia, Johns Hopkins, Google, Amazon, and other top institutions to revolutionize...

Medical Director Services PC is seeking compassionate RNs or LPNs for a remote hybrid role in patient monitoring. You will track vitals, review biometric data, and collaborate with providers to improve outcomes while visiting the facility twice a...

Oncology Nurse Shift: 4/10's M-F , No Weekends, no holidays Sign On: 10k Relo: case by case Must haves Oncology Certified- OCN Outpatient experience (no exceptions) 3+ years of experience OCS Job description: Do you have a passion for the highest...

OverviewAs our Educator, RN in Periop, you will serve as a consultant/resource professional by providing staff development expertise as an educator, facilitator, change agent, leader, and researcher, ensuring educational initiatives are...

WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant patient care. The role emphasizes adherence to HIPAA, state and federal regulations, and a...

Advocate Aurora Health, Inc. is seeking a part-time RN for Transitional Care Management in a fully remote home-based role in Wisconsin. Duties include discharge assessments, care planning, and coordination with inpatient and community teams.

Job Profile Summary Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's...

Registered Nurse (RN) Full Time Del Amo Behavioral Health System, a subsidiary of UHS, offers a safe and compassionate environment for individuals looking for hope and healing from emotional, psychiatric and addiction issues. Del...

UW Hospital and Clinics seeks a Nurse Case Manager (RN) to join our multidisciplinary team; remote work options available with flexible shifts. The role emphasizes utilization management, patient status assessment and collaboration with care teams...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. LVN Full Time Clerical Beverly Hills, CA, US 3 days ago Requisition...

TEKsystems seeks a Clinical Quality Assurance Specialist (RN/LPN) for a 100% remote, full-time role in the United States. The position offers a competitive hourly rate and a four-day work week with comprehensive benefits for full-time employees.

Job Description Registered Nurse - PRN (As Needed) - Home Health (Dillon County) Job Summary 1. Maintains a professional image and exhibits excellent customer relations to...

Blackbird Health is hiring a Registered Nurse (RN) for a 100% virtual role to support pediatric behavioral health care. You will coordinate patient care, manage appointments and medication refills, respond to crisis calls, complete prior...

Job Description The Peer Review RN is responsible for facilitating the design, implementation and the ongoing evaluation of the physician peer review program and nursing peer review process in collaboration with physician...

Cleveland Clinic is seeking an LPN Central Admissions role based in Independence, Ohio. This remote role includes on-site training at the Business Operations Center and a 9:00 am–5:30 pm weekday schedule, with weekends every 5th and two holidays...

At R1, we're transforming how healthcare works by combining nearly two decades of revenue cycle expertise with advanced technology, including analytics, AI, intelligent automation and workflow orchestration. We pair that technology with the...

Telephonic Insurance Case Manager (RN) | ARIZONA RESIDENTS ONLY Insight Global is seeking a Telephonic Insurance Case Manager (RN) to join a growing and well-established organization focused on helping injured employees navigate their...

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...

Details Client Name PIH HEALTH Job Type Travel Offering Nursing Profession Registered Nurse Specialty...

Exceptional care starts with exceptional people. For us, this is more than a job– it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you...

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...

Concurrent Utilization Review (UR) Nurse The Concurrent Utilization Review (UR) Nurse is responsible for conducting real-time clinical reviews to ensure the medical necessity and appropriateness of healthcare services provided to members...