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Job Description JOB CATEGORY: REGISTERED NURSE / COMMUNITY HEALTH CENTER / WELLNESS REMOTE ELIGIBLE AFTER 90 DAYS POSITION SUMMARY: This position works directly...

Become a part of our caring community and help us put health first Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. This position reviews the clinical appropriateness of prior...

AMN Healthcare Nursing is seeking a travel nurse RN Med Surg for a travel nursing job in COLUMBUS, Ohio. Job Description & Requirements Specialty: Med SurgDiscipline: RNStart Date:...

Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff...

Day to Day Responsibilities Triage and review cases as needed, working on prior authorisation cases following medical policy utilizing resources as needed Required Skills (top 3 non-negotiables):...

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. ESSENTIAL...

iDEAL Hire is seeking a travel nurse RN CVOR for a travel nursing job in Columbus, Ohio. Job Description & Requirements Specialty: CVOR Discipline: RN Start Date: 01/12/2026 Duration: 13 weeks 40 hours per week Shift: 10 hours, days Employment...

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...

Concentric is currently seeking candidates in Registered Nurse profession with focus in Registered Nurse (Clinic) for a week contract in the Dublin, OH area. Concentric is a premier staffing firm dedicated to matching outstanding talent with...

A leading health care provider is seeking a Care Manager III based in Chicago, Illinois. This full-time position involves providing care coordination to members through telephonic and field-based management. Candidates must possess a valid nursing...

Job Description JOB SUMMARY Responsible for reviewing medical records to facilitate and obtain appropriate physician documentation for any clinical conditions or procedures to support the appropriate...

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 company, we reach millions...

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...

Job Title: Prior Authorization NurseJob Description The Prior Authorization Nurse plays a critical role in analyzing prior authorization requests to determine the medical necessity of services and the appropriate level of care. This position...

Job Description: Job Title: Clinical Review Nurse - Prior Authorization Location: Remote (CST) Duration: 6 months (Possible Extensions) Training Schedule: 8 AM - 5 PM CST Position...

Care Manager Sharecare is the leading digital health company that helps people unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is designed to help people, providers, employers,...

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...

ABOUT AUSTIN REGIONAL CLINIC: Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years! We are one of central Texas' largest professional medical groups with 35+ locations and we...

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...

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...

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...

Remote Rn Care Coach This is a remote role. CircleLink Health is looking for passionate, tech savvy registered nurses to work remotely and serve patients enrolled in Medicare's Chronic Care Management Program. In this part time role...

Entity: Owensboro Health Regional Hospital | Department: Virtual Care | Work Hours: 7P - 7:30A | Weekend Requirements: One | 0.9 FTE Job Summary: Provides direct nursing care in accordance with established policies,...

Make an hourly rate of up to $68 as a Registered Nurse (RN) in Grove City, OH (and the wider Columbus area), with the stability of W2 employment and...

Overview Mount Carmel Behavioral Health is hiring Admissions RN's! Available Shifts and Hours: 7p-7a with rotating weekends Sign on Bonus:...