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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...

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...

A healthcare company is seeking a Care Management Nurse to provide telephonic care services to chronic patients. The ideal candidate will have a nursing license and 1-2 years of experience in clinical or telehealth settings. Responsibilities...

Details Client Name Cedars Sinai - The Angeles Clinic and Research Institute Job Type Travel Offering Nursing Profession RN...

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Ssbv Clinical Claims Review 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...

USRC's greatest strength in being a leader in the dialysis industry is our ability to recognize and celebrate the differences in our diverse workforce. We strongly believe in recruiting...

Job Title This position is fully remote, however, you must reside in the State of Texas The position is a contract for about 6 months. RN working in the insurance or managed care industry using medically accepted criteria to...

Nurse Navigator Department: ECM Outpatient Care Management Location: Children's Health- Dallas Shift: Part-time working Monday, Wednesday, and every other Friday 8:00a to 4:30p or 8:30a to 5:00p. Job Type: Remote, but...

Clinical Review Nurse - Remote ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to join a...

Admissions Nurse Salary Range: $48 - $51 / Hourly Job Description Why Hospice? Why VITAS? Have you ever considered hospice as a clinical specialty—one that blends clinical expertise with deep human connection?

CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to...

Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account. Exemption Status: Exempt Hiring Range:...

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...

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families,...

RN / Medical Reviewer / Remote Job Details Professional Discipline : Registered Nurse Specialty : Utilization Review Employment Type : Full Time City :...

CAUnited States of AmericaOnsiteClinics – AmbulatoryHourly$47.56 - $73.72If you are interested, please apply online and send your resume to y [email protected] SummaryReporting to the Director, Ambulatory Services of Martin Luther King,...

Salary: See Position Description Location : North Central Community Health Center - St Louis County, MO, MO Job Type: Full-Time Remote Employment: Flexible/Hybrid...

Discharge Care Manager (Central or Eastern Region) 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...

RN Diabetes Educator 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. Facility: Bemidji...

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...

Complex Medicare Claims Review Complex Medicare claims/prior authorization requests require the review of medical record documentation to determine the reasonableness and necessity of the billed service in accordance with Medicare rules...

Remote Registered Nurse Position Join a stable work-from-home team! This is a great opportunity for a local remote position. There is no communication with patients. This position supports all units/staff (commercial, behavioral health,...

Itemization Review Nurse II The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position.

We are so glad you are interested in joining Sutter Health! Position Overview: Aids patients in obtaining the correct level of care with the appropriate provider at the right time. Provides advance clinical telephone...