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Make written and oral reports/recommendations to the attending physician, Medical Director, or the DON concerning the status and care of the residents. • Agree not to disclose resident's protected health information and promptly report...

Elevance Health is seeking an experienced nurse to review complex cases for medical necessity, applying clinical guidelines and nursing judgment. The role involves collaboration with physicians, case managers, and Medical Directors to optimize...

Cambia Health Solutions is seeking an Appeals Clinician I to work from home within Oregon, Washington, Idaho or Utah. You will complete the clinical component of all appeal types to resolve member and/or provider appeals, leveraging nursing...

A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and...

HealthEdge is seeking a motivated Utilization Review RN to join our team. You will perform prospective, concurrent and retrospective reviews of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, length of stay...

Seaport Scripps Home Health is seeking an experienced OASIS Review Nurse (RN) to support clinical quality, regulatory compliance, and documentation integrity in a home health setting. The role focuses on reviewing OASIS assessments and ICD-10...

DescriptionYour Role 100% Remote. You will triage calls from our clients in the following manner: 1) assess the needs utilizing injury algorithm guidelines; 2) give appropriate care advice, and 3) disposition to the appropriate...

Beth Israel Lahey Health is seeking a Per Diem PAT Nurse for Milton Hospital. The role, initially on-site for orientation, moves to a fully remote schedule with flexible shifts. You will perform pre-admission assessments and coordinate...

Clinical Documentation Integrity Specialist IIThe Clinical Documentation Integrity Specialist II (CDI) is responsible for utilizing independent clinical judgement in facilitating the integrity, overall quality, accuracy, and completeness of...

Hone is a virtual medical clinic for men's/women's health, hormones, weight loss, and longevity.We are remote-first and fast-growing, focused on candid communication and joy.The Role:You will manage patient-doctor communications and clinical...

Not specified is seeking a registered nurse to support patient care within a healthcare network that prioritizes quality, collaboration, and innovation. The role focuses on coordinating telehealth services and ensuring effective remote care...

The Connection Center Virtual Registered Nurse (RN) delivers high-quality, patient-centered care remotely through telephonic and video interactions, covering the full nursing process from assessment to evaluation. Works with interdisciplinary...

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...

Cohere Health is seeking a Clinical Review & Correspondence RN to support utilization management by conducting medical necessity reviews and delivering compliant clinical determinations. You will collaborate with Medical Directors and...

Allegheny Health Network is seeking an RN Clinical Document Specialist to support remote work from Pennsylvania within 50 miles of Pittsburgh or Erie. The role focuses on improving documentation accuracy to optimize reimbursement, with extensive...

Job ID: 33628 Description Join UCLA Health's Nuclear Medicine team and play a critical role in delivering cutting-edge diagnostic and therapeutic services to both adult and pediatric patients. As a Registered Nurse...

GQR Healthcare is seeking a travel nurse Correctional for a travel nursing job in Commerce, California. Job Description & RequirementsSpecialty:...

Army Public Health Nurse Job Overview As an Army Public Health Nurse, you'll assess health risks and implement programs to monitor the spread of disease. You'll promote wellness for Soldiers and their families while also informing policy and...

Provides direct nursing care including assessments, care plan, education, and evaluation for assigned patients. Performs patient duties necessary to maintain the flow of...

Ssbv Clinical Claims Review RnOptum 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 people with the...

Health Care Service Corporation seeks a Quality of Care (QOC) Nurse to review and investigate potential quality of care issues in a timely manner. This role supports QA activities in line with CMS and NCQA requirements, under the supervision of...

Summit Healthcare Staffing LLC is seeking a compassionate bilingual Registered Nurse (RN) to join the Intake team for a growing home health organization in Brooklyn, NY. The role starts on-site with potential to move to a remote role based on...

U.S. Army Family Nurse Practitioners perform the highest level of quality care for Army Soldiers, retirees, and their families. If you are looking to combine your skills as a family nurse practitioner and your passion for...

CHOICES Case Management, Inc. is seeking an Administrative Assistant to support our Nurse Case Managers in a fast-paced healthcare environment. This role serves as the operational backbone, ensuring details are handled, communication flows...

Description: FAMILY NURSE PRACTITIONER JOB SUMMARY Provides continuous and comprehensive services necessary for the promotion of optimal health, prevention and treatment, in an underserved community clinic. To perform a variety of advanced clinical...