- Molina Healthcare (Boise, ID)
- **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring ... nursing experience, including at least 1 year of utilization review , medical claims review , long-term...or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must… more
- Idaho Division of Human Resources (Meridian, ID)
- Registered Nurse RN Manager - Idaho State Police ISP Posting Begin Date: 2025/12/01 Posting End Date: 2025/12/14 Category: Nursing Sub Category: Management ... This recruitment is being used to fill a second registered nurse manager position with Idaho State...to health care professionals related to sexual assault forensic medical examinations. The individual selected will also coordinate statewide… more
- Surgery Care Affiliates (Boise, ID)
- …If you join our team, they will. Responsibilities We are actively hiring for an Registered Nurse ( RN ) Inpatient. + Promote the mission, vision, and values ... your health, well-being, and financial future. Our offerings include medical , dental, and vision coverage, 401k plan with company...to care. + Delegate tasks according to the state Nurse Practice Act (if applicable), state board of nursing… more
- Molina Healthcare (Boise, ID)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Boise, ID)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Boise, ID)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Evolent (Boise, ID)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... are performed within the ** RN /LVN/LPN** scope of practice, under the Medical ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate,… more
- HCA Healthcare (Caldwell, ID)
- …professional manner, especially under pressure.** **Qualifications:** + **Current State of Idaho Registered Nurse License.** + **American Red Cross or American ... an exciting opportunity for you to join West Valley Medical Center which is part of the nation's leading...growth, we encourage you to apply for our OR RN PRN opening. We review all applications.… more
- Humana (Boise, ID)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and… more
- HCA Healthcare (Caldwell, ID)
- …and follow-up measures **What qualifications you will need:** + Current State of Idaho Registered Nurse License or Compact RN License + Associate's Degree ... an exciting opportunity for you to join West Valley Medical Center which is part of the nation's leading...you to apply for our PRN Pre Op SDS RN opening. We review all applications. Qualified… more
- Trinity Health (Boise, ID)
- …and support. + **Deliver Patient Care** : Actively perform the essential functions of a Registered Nurse within the assigned unit and assist with patient care as ... Forbes as one of **America's Best Large Employers for 2025** , is looking for a ** Nurse Unit Supervisor** to join our team at our Level II Trauma Center in **Boise,… more
- Humana (Boise, ID)
- …each day between 6AM and 9AM in their home time zone. **Required Qualifications** + Active Registered Nurse ( RN ) license in the state they reside. + Minimum ... independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical ...clinical and coding experience to conduct a clinical validation review of the inpatient medical record to… more
- Cardinal Health (Boise, ID)
- …interactions **_Qualifications_** + 2-4 years of experience, preferred + Current, unrestricted Registered Nurse license, required + Bachelor's degree in related ... to meet the needs of an individual patient. **_Job Summary_** The Nurse , Individualized Care promotes high-quality patient care and treatment through patient… more
- Datavant (Boise, ID)
- …+ 3+ years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS ... you will play a pivotal role in elevating the impact of our medical record documentation. You will conduct daily evaluations and engage in direct communication… more
- Highmark Health (Boise, ID)
- …State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC). + Delaware RN license must be obtained within ... **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria… more
- Veterans Affairs, Veterans Health Administration (Boise, ID)
- …equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion ... intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community… more
- Fresenius Medical Center (Nampa, ID)
- …Report any significant information and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine ... policy. Report any change or unusual findings to the registered nurse or supervisor. + Perform and...+ Monitors patients performing self-care under the supervision of RN . **Staff Related** + Assists in training of applicable… more
- Trinity Health (Boise, ID)
- … review , and updating families. **Ideal candidate** : + Graduate from a Nurse Practitioner Program with current RN and APRN licensure; current national board ... Tail) + Health/Dental/Vision + Retirement (403b) **Practice Highlights:** Saint Alphonsus Medical Group (SAMG) is a physician led 650+ provider multispecialty group… more
- Highmark Health (Boise, ID)
- …Preferred + Associate's or Bachelor's Degree in Nursing + 1 year performing medical record review and data abstraction for cardiovascular registries + Proficient ... **Job Description :** **GENERAL OVERVIEW:** This job performs clinical review and data abstraction of patient records to support...Minimum + High School/GED + Current State of PA RN licensure OR Current multi-state licensure through the enhanced… more
- CenterWell (Boise, ID)
- …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part...to make an impact** **Required Qualifications** + Active unrestricted RN license with the ability to obtain Compact Nursing… more