Utilization review nurse near me

Position Title: Clinical Review Nurse - Prior Authorization Work Location: Remote- LA Can be sourced nationally, must have a multi-state license. Team does work within CST standard hours; the...

Description AbsoluteCare offers concierge health services using a risk-bearing, PCP-driven care model. We treat the most clinically complex and vulnerable members of the communities we serve, many of whom...

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...

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...

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)...

Registered Nurse (RN) | Utilization Review Location: Alexandria, LA Agency: GQR Healthcare Pay: $1,638 per week Shift Information: Days Start...

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...

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...

The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring that medical services are used efficiently and appropriately. They review medical records, treatment plans, and patient information to determine the...

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 provider is looking for an RN Coordinator Utilization Management to evaluate authorization requests and ensure proper care procedures. The position requires a current nursing license in Wisconsin and a minimum of four years of...

Pyramid Consulting (Travel) is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Philadelphia, Pennsylvania. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 13 weeks 40...

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be...

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...

Fully Remote: Clinical Documentation Specialist Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical...

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...

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...

A leading healthcare organization is seeking a Utilization Management Registered Nurse 2 to support medical services coordination. This remote position requires a valid RN license, with preference for candidates with 3+ years in skilled nursing...

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that...

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...

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...

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...

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic...

Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The...

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 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.

Job Title: Nurse Case Manager II Location: Remote Field Visit (Cook, Lake, Will, Kane, Winnebago, Rock Island County- IL) Duration: 3 months (possible extension) Schedule: 40hr/ per week and 5 days week. Pay Rate: $39.32 hr. on w2. Job Summary:...

Optum Insight Quality Review Operations Specialist 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...