- Sedgwick Government Solutions (Orlando, FL)
- Job Details Nurse Case Manager ( Remote - Strong Internal) 2024-1374 Orlando, FL, USA Medical Case Management Full Time Description Nurse Case Manager (Home ... you like to be part of a highly skilled team of home-based ** Nurse Case Manager (NCM)s** providing telephonic case management, focused on supporting individuals in… more
- AmeriHealth Caritas (Florence, SC)
- ** REMOTE | Care Manager II Registered Nurse (BSN) - Foster Care Program -SC** Location: Florence, SC Primary Job Function: Medical Management ID**: 34390 **Job ... Counties preferred are York, Florence, Darlington, Williamsburg and Horry. RN required. ** Remote to qualified candidates living in South Carolina with a preference… 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 ... management of their health through continuous care programs like Remote Patient Monitoring and Chronic Care Management. Our team works fervently to anticipate the… more
- SUNY Upstate Medical University (Syracuse, NY)
- Job Summary: Registered Nurse (RN) provides professional nursing care to patients within the practice, located in the Hill building of Upstate University Hospital. ... care while overseeing the work of the licensed practical nurse , and ancillary staff in the Practice. Triage ...to the patient's satisfaction and undstanding. This position is remote , requires internet service and private working space Minimum… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Quality Review Nurse (RN) is to evaluate clinical quality and procedures within the Clinical Appeals & ... Management, Case Management, Claims, Quality Management and Compliance. The Nurse , Quality Review position develops procedures and reinforce quality standards… more
- CareFirst (Baltimore, MD)
- **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 Clinical Appeals Nurse utilizes clinical skills and knowledge of all applicable State and Federal rules and regulations… more
- CareFirst (Cumberland, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider appeals that ... excellent verbal and written communication skills. **Licenses/Certifications** : RN - Registered Nurse - State Licensure And/or Compact State Licensure RN-VA, DC and… more
- Actalent (Austin, TX)
- Actalent is currently hiring for Remote HEDIS Nurses (RN/LPN)! Job Description: + Lead data collection and abstraction for company quality measures, including HEDIS, ... CMS, CHIPRA and/or any other custom measurements. + Assess vendor-delegated abstraction activities and compare results to HEDIS standards and/or custom or other measure set standards + Review medical records and abstract data for HEDIS and other measure sets… more
- Actalent (Atlanta, GA)
- Actalent is currently hiring for Remote Utilization Review RNs! Job Description: + Reviewing authorization requests + Utilizing evidence-based criteria and making a ... medically necessary determination. + Outreach calls to providers to request additional details if applicable. Qualifications: + Active RN License + Prior Utilization management/Concurrent review experience + Experience with MCG Why Actalent? + Work with a… more
- Actalent (Austin, TX)
- …* Current RN or LPN license Work Environment This position will be fully remote . Candidate must have strong internet connection. Hours are Monday through Friday from ... 8:00am - 5:00pm, 7:00am - 4:00pm, or 9:00am - 6pm CST Dress code is business casual. All work equipment will be provided. About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance… more
- Actalent (Tampa, FL)
- Exciting REMOTE Triage Nurse Opp for February 2025! The schedule will be a Monday, Tuesday, Thursday, Friday, and Saturday (Off Sunday and Wednesday) Job ... + Work closely with the Post-Acute Care patient home health agency nurse and physicians to facilitate education and adherence to established healthcare goals… more
- SteadyMD (Thousand Oaks, CA)
- SteadyMD is excited to invite Nurse Practitioners with licensure and residency in at least one of the following states (AZ, CA, FL, GA, IL, MA, MI, NY, OH, PA, TX) ... Just to name a few! Position Overview: + Role: Nurse Practitioner for Virtual Patient Care + Location: Fully... Practitioner for Virtual Patient Care + Location: Fully Remote + Schedule: Available 10 hours a week, scheduling… more
- SteadyMD (Thousand Oaks, CA)
- SteadyMD is excited to invite Nurse Practitioners with licenses in at least 5 states (3 of which must be in AZ, WA, PA, MN, CA, TX, or NY) to join our diverse and ... welcoming environment for clinicians from all backgrounds. Position Overview: + Role: Nurse Practitioner for Urgent Care Telehealth Program + Location: Fully … more
- Penn Medicine (Plainsboro, NJ)
- …established standards.Other duties and projects as assigned. **Credentials:** + Licensed Practical Nurse (Required) + Active Practical Nurse License in the state ... of New Jersey **Education or Equivalent Experience:** + HS Diploma/GED (Required) + High School Diploma or GED required.Graduate of a nursing program as an LPN.Previous experience in treatment of the program's patient population. We believe that the best care… more
- Fairview Health Services (St. Paul, MN)
- …full time or needing to face the physical demands of a hospital or clinic nurse role? On the Telephone Triage Nurse Line Advisor with Fairview Health Services, ... that's what we do! Join other nursing professionals in an encouraging environment where we support each other. We are adding new positions due to growth. The schedule for this opening is **0.6 FTE (48 hours per two weeks) of a day/evening mix (** **weekday… more
- CVS Health (Hartford, CT)
- …verbal and written **Required Qualifications** + 3+ years of experience as a Registered Nurse + Must have active current and unrestricted RN licensure in state of ... residence + Must possess 1+ year(s) of clinical experience in acute or post acute setting **Preferred Qualifications** + Managed Care experience preferred **Education** + Associates Degree required + BSN preferred **Pay Range** The typical pay range for this… more
- Medical Mutual of Ohio (OH)
- …workplace and perform pre-employment substance abuse and nicotine testing._ \#LI- REMOTE **Title:** _Medicare Nurse Reviewer_ **Location:** _Ohio_ **Requisition ... Supplement, and individual plans. Under limited supervision, the Medicare Nurse Reviewer applies medical necessity guidelines in making authorization determinations… more
- Medical Mutual of Ohio (OH)
- …drug-free workplace and perform pre-employment substance abuse and nicotine testing._ \#LI- REMOTE **Title:** _Registered Nurse Clinical Appeal & Claim_ ... degree preferred + 3 years' experience as a Registered Nurse in acute care, critical care, emergency medical or...keyboard, mouse and headset. + Whether you are working remote or in the office, employees have access to… more
- CVS Health (Tallahassee, FL)
- …more personal, convenient and affordable. **Position Summary** This is a full-time remote Quality Management Nurse Consultant opportunity. Working schedule is ... as needed. This position reports to the Potential Quality of Care (PQOC) nurse investigator team manager. This position is responsible for the review and evaluation… more
- CVS Health (Tallahassee, FL)
- …include weekends and holidays and evening rotations. This is a full-time remote Utilization Management Nurse Consultant opportunity. As a Utilization Management ... RN licensure in state of residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical experience in acute or post-acute setting + Candidates must… more
Related Job Searches:
Infusion Referral Nurse Remote,
Nurse,
Nurse Case Manager Remote,
Nurse Liaison Remote,
Nurse Practitioner Remote,
Remote,
Remote Medical Review Nurse,
Remote Nurse Auditor,
Remote Registered Nurse,
Utilization Management Nurse Remote