• Director - Nursing Services

    Avera (Aberdeen, SD)
    …cause undue hardship to the employer. **Required Education, License/Certification, or Work Experience:** + Registered Nurse ( RN ) - Board of Nursing An active ... and relocation allowance!** We are seeking a compassionate, experienced long term care nurse leader. Apply today, or reach out by email to ###@avera.org with any… more
    Avera (01/09/26)
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  • Clinical Review Nurse - Prior Authorization

    Centene Corporation (New York, NY)
    …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure preferred Pay Range: ... determine medical necessity of service preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred.… more
    Centene Corporation (01/09/26)
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  • Clinical Documentation Integrity Lead - Service…

    Stanford Health Care (Palo Alto, CA)
    …. + CCDS - Cert Clinical Document Spec . + CCDS-O or CDIP . + Nursing\ RN - Registered Nurse - State Licensure And/Or Compact State Licensure preferred ... Abilities** + Expertise in coding and CDI practices., maintaining expertise in Medicare/ Medicaid rules and regulations, as well as current trends and developments. +… more
    Stanford Health Care (01/08/26)
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  • Case Manager - 40 Hours - Days

    Henry Ford Health System (Detroit, MI)
    …ability to successfully advocate for patients and their families. CERTIFICATIONS/LICENSURES REQUIRED: + Registered Nurse ( RN ) + Licensed Social Worker (LMSW) ... service guidelines, clinical practice guidelines, behavior change theory, Medicare and Medicaid regulations and case management principles. + Knowledge of medical… more
    Henry Ford Health System (01/08/26)
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  • Nurse Appeals

    Elevance Health (Indianapolis, IN)
    …or BS in Nursing preferred. + 3 years of clinical experience as a Registered Nurse is strongly preferred. + Experience reviewing medical records, investigation, ... ** Nurse Appeals** **Location: Indiana** **Virtual:** This role enables...would provide an equivalent background. + Current active unrestricted RN license to practice as a health professional within… more
    Elevance Health (01/07/26)
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  • Medical Review & Appeals Director (Hybrid)

    CareFirst (Baltimore, MD)
    …in addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + RN - Registered Nurse - State Licensure And/or Compact ... Qualifications:** + Significant experience with Government programs including Maryland Medicaid , Medicare Advantage and DSNP. **Knowledge, Skills and Abilities… more
    CareFirst (01/06/26)
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  • Director of Nursing (DON)

    Accura Healthcare (West Des Moines, IA)
    …of training, education, and effective clinical practices. QUALIFICATIONS: + Hold current Registered Nurse ( RN ) license with applicable state, without ... experience in Long Term Care (LTC). + Knowledge of Medicare and Medicaid rules and regulations. + Strong skills in the following areas: business… more
    Accura Healthcare (01/05/26)
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  • Director of Nursing (DON)

    Accura Healthcare (Franklin, NE)
    …of training, education, and effective clinical practices. QUALIFICATIONS: + Hold current Registered Nurse ( RN ) license with applicable state, without ... experience in Long Term Care (LTC). + Knowledge of Medicare and Medicaid rules and regulations. + Strong skills in the following areas: business… more
    Accura Healthcare (01/05/26)
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  • LPN - Licensed Practical Nurse

    Elderwood (North Creek, NY)
    …Practical Nurse ): + Credentials as a Licensed Practical Nurse (LPN) or Registered Nurse ( RN ) with a current state license required. + LPN Training ... more! Are you a compassionate and skilled Licensed Practical Nurse (LPN) looking for a fulfilling career? Elderwood at...a 4-star rating from the Centers for Medicare and Medicaid Services (CMS)-exceeding both the New York state average… more
    Elderwood (01/05/26)
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  • Director of Nursing (DON)

    Accura Healthcare (Eagle Grove, IA)
    …of training, education, and effective clinical practices. QUALIFICATIONS: + Hold current Registered Nurse ( RN ) license with applicable state, without ... experience in Long Term Care (LTC). + Knowledge of Medicare and Medicaid rules and regulations. + Strong skills in the following areas: business… more
    Accura Healthcare (01/02/26)
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