- Molina Healthcare (Everett, WA)
- …DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate ... more
- Actalent (Tampa, FL)
- … Remote PAC Nurses!Job Description Actalent is looking for PAC Utilization Review Nurses that will work remote ! Qualified candidates must have experience ... more
- University of Miami (Miami, FL)
- …please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Nurse Navigator - Site Disease Group - Remote ... more
- Monroe One Boces (Fairport, NY)
- …2. Work with a team to include- Athletic Directors, Coaches, and the Boces Nurse Practitioner to review student requalification status. 3. Consult with staff ... more
- CareFirst (Baltimore, MD)
- …mental health, psychiatric setting. **Preferred Qualifications:** + 2 years' experience in Medical Review , Utilization Management or Case Management at CareFirst ... more
- Cedars-Sinai (Los Angeles, CA)
- …a condition of continued employment. **Req ID** : 8897 **Working Title** : Registered Nurse - Heart Transplant Coordinator - Remote ON CALL **Department** : ... more
- Molina Healthcare (Albany, NY)
- …contained in the delegation agreement. **KNOWLEDGE/SKILLS/ABILITIES** The Delegation Oversight Nurse is responsible for ensuring that Molina Healthcare's UM ... more
- University of Miami (Miami, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Location: ... more
- 315 health (Warner Robins, GA)
- …confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and ... more
- CVS Health (Montgomery, AL)
- …DSNP into new markets across the country. **Fundamental Components** + Nurse Care Manager is responsible for assessing, planning, implementing, and coordinating ... more
- Bon Secours Mercy Health (Cincinnati, OH)
- …Health Partners Mission and Values. Works closely through collaboration with clinical, medical staff and leadership teams to identify, trend, and report barriers to ... more
- Actalent (San Antonio, TX)
- Job Title: Review Nurse Job Description The Review Nurse will be responsible for reviewing approximately 20 cases a day to assess medical necessity ... more
- Equitable (Charlotte, NC)
- Clinical Review Nurse , Disability Claims ( 25000067 ) **Primary Location** : UNITED STATES-NC-Charlotte **Other Locations** : UNITED STATES- Remote , UNITED ... more
- Bon Secours Mercy Health (Cincinnati, OH)
- …if applicable. + Participates in process improvement, professionaldevelopment and peer review + Responsible for other tasks and analysis as requested /directed. ... more
- McLaren Health Care (Indianapolis, IN)
- …This includes but is not limited to the following: participates in the medical management of members in assigned product lines, including case specific and disease ... more
- Centene Corporation (Salem, OR)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... more
- Centene Corporation (Getzville, NY)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... more
- Highmark Health (Carson City, NV)
- …to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and ... more
- BJC HealthCare (St. Louis, MO)
- … experience performing care for hospitalized patients. + 2 years of utilization review (UR) experience reviewing hospital admissions for medical necessity + Must ... more
- Community Health Systems (Sarasota, FL)
- (Full-Time, Remote ) The Clinical Review Analyst is a professionally licensed nurse /LPN who is responsible for effectively managing the denial/appeal process ... more
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