Utilization review nurse near me

Urgent Hiring for "Remote Clinical Review Nurses" Job Description: Review approximately 20 cases a day for medical necessity. Advocate for and protect members from unnecessary hospital...

Tandem Clinical Research is a clinical research company dedicated to testing investigational medications and devices that cover a broad range of diseases and disorders. Our New Orleans clinic is located in Marrero, LA. We are currently seeking a...

A healthcare management firm is seeking a detail-oriented Utilization Management Reviewer for a fully remote position. The role includes reviewing care based on evidence-based guidelines, ensuring quality and compliance while upholding medical...

Registered Nurse - Case Review Specialist STGi is currently seeking a Registered Nurse-Case Review Specialist. The position is remote and open to candidates nationwide. Job Summary: Provides direct support...

Tandem Clinical Research is a clinical research company dedicated to testing investigational medications and devices that cover a broad range of diseases and disorders. Our New Orleans clinic is located in Marrero,...

A healthcare solutions firm is looking for a Clinical Supervisor - RN for a remote role. This position primarily involves overseeing utilization management processes and ensuring compliance with clinical standards. The ideal candidate will hold an...

A healthcare provider is seeking a Utilization Management Clinical Manager for analyzing medical service requests. The ideal candidate will possess an RN license and extensive experience in prior authorization in managed care. Responsibilities...

Become a part of our caring community and help us put health first The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or...

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...

A workforce solutions company is seeking a Registered Nurse-Case Review Specialist to provide support for Federal Occupational Health. This remote position requires extensive nursing experience and strong communication skills to ensure timely...

Provide high-quality clinical services within scope of practice and infection control standards. Coordinate care with other members of the patient/client's care team from admission to discharge. Complete clinical nursing assessments per...

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 Washington, DC, is seeking a qualified nurse for clinical review and care coordination. This role requires evaluating medical services and ensuring effective patient care while maintaining communication with various...

Description Location: UCHealth UCHlth Med Ctr of the Rockies, US:CO:Loveland Department: MCR Care Management Work Schedule: Full Time, 80.00 hours per pay period (2 weeks) Shift: Days Pay: $38.91 - $60.31 / hour. Pay is dependent on applicant's...

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...

Join a nationally recognized Health and Human Services Agency as a Utilization Manager, where your expertise will ensure compliance and quality in care delivery. This role involves conducting utilization reviews, supporting a diverse team of...

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...

A healthcare organization in Manchester, NH, seeks a Nursing professional to provide centralized medication access support. Responsibilities include reviewing medication requests, communicating with patients, and adhering to clinical guidelines.

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...

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...

Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This position is remote. Candidates must be local...

Description Location: UCHealth UCHlth Anschutz Inpt Pavilion, US:CO:Aurora Department: Emergency Dept Work Schedule: Full Time, 72.00 hours per pay period (2 weeks) Shift: Nights Pay: $35.29 - $54.71 / hour. Pay is dependent on applicant's...

RN Clinical Appeals Nurse 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...

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...

[Administrative Assistant / Remote] - Anywhere in U.S. / Up to $21 per hour - As an Administrative Document Reviewer at Cherry Bekaert, you will: Review and analyze various documents for accuracy and completeness; Maintain a high level of...

Part-Time Utilization Review Nurse Remote (Nevada License Required) Location: Remote (Reporting to Carson City, NV) Schedule: MondayFriday, 8:00 AM12:00 PM PST Compensation: $40,000$45,000 annually (part-time, 20 hours/week)...

Quality Assurance Position Contract-to-hire details and pay: $34/hr for a 520-hour contract-to-hire, long term opportunity. Compensation: listed below, fixed rates (no opportunity for negotiation). Training schedule: MondayFriday, 46...

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 leading health solutions company is seeking a fully remote Case Manager - Registered Nurse (RN) to join their National Medical Excellence team. The position involves assessing and coordinating care for members to enhance overall wellness.

Explore opportunities with Ochsner Home Health of New Orleans, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families...