• Graduate Nurse Critical Care Float Pool…

    Catholic Health (Buffalo, NY)
    …residency program, residents will transition to a full-time, permanent job as a Registered Nurse in the float pool. Competency assessments Competency assessments ... have an emphasis on the development of clinical and leadership skills for the novice/beginner nurse to be successful as a competent RN . Components of the program… more
    Catholic Health (11/19/25)
    - Related Jobs

  • Clinical Review Nurse - Prior…

    Centene Corporation (Salem, OR)
    …home anywhere in the United States. This position does require an Oregon RN or LPN license. **Position Purpose:** Analyzes all prior authorization requests to ... criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care +… more
    Centene Corporation (12/24/25)
    - Related Jobs

  • Advanced Practice Nurse Practitioner

    Molina Healthcare (Madison, WI)
    …or equivalent combination of relevant education and experience. * Advanced Practice Registered Nurse (APRN) license. License must be active and unrestricted ... the chief medical officer. * Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review and manages the… more
    Molina Healthcare (12/20/25)
    - Related Jobs

  • Clinical Business Consultant

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …and administrative staff at all levels of the organization. Education and Experience: + Registered nurse with BSN and 3-5 years in a managed care health ... plan setting. + Strong understanding of Utilization Review , Care Management and Medical Polices. + Knowledge of APR DRG, HCPCS, CPT, ICD-10 diagnosis and… more
    Blue Cross Blue Shield of Massachusetts (12/19/25)
    - Related Jobs

  • Medical Operations Coordinator ( Nurse V)…

    State of Colorado (Golden, CO)
    …diagnostic equipment, medication formulary, quality assurance program, and hospitalization utilization review . This position works collaboratively with Agency ... include staffing patterns and assignments, training and quality assurance review in collaboration with the DYS Quality Coordinator for...from an accredited institution Current, valid licensure as a Registered Nurse from the Colorado Board of… more
    State of Colorado (12/13/25)
    - Related Jobs

  • Care Review Clinician (BH Licensed)

    Molina Healthcare (Louisville, KY)
    …state of KY or RN who must be licensed in KY or have a compact RN license. The Care Review Clinician Inpatient Review BH will provide prior authorization ... JOB DESCRIPTION Job Summary Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services… more
    Molina Healthcare (11/09/25)
    - Related Jobs

  • Nurse Practitioner APN Fellow

    Hackensack Meridian Health (Hackensack, NJ)
    …terms of collaborative agreement. Licenses and Certifications Required: 1. NJ State Professional Registered Nurse License. 2. AHA Basic Health Care Life Support ... **The post-graduate internal medicine fellowship for Nurse Practitioners is designed to provide Advanced Practice...practice. 5. Participates in APRN interviewing, credentialing, and peer review process as requested. 6. Participates in a minimum… more
    Hackensack Meridian Health (12/22/25)
    - Related Jobs

  • Supv Clinical Documentation / HIM Clinical…

    Hartford HealthCare (Farmington, CT)
    …others as needed. **Education** . Bachelor degree or equivalent experience **Experience** . Minimum: Registered Nurse ( RN ) with 3-5 years CDS experience . ... matter expert guidance to CDS team, coding, physician leadership, quality management, utilization management, all providers, and others as required. . Assists in… more
    Hartford HealthCare (12/17/25)
    - Related Jobs

  • Director Critical Care

    HCA Healthcare (Salem, VA)
    …BSN from a school of nursing or within 1 year of employment. Valid VA RN Licensure, OR Registered Nurse with "multi-state privilege" granted to them ... annual strategic plans, Professional Practice Model, Shared Governance bylaws, Nurse Residency Program, educational programs, clinical ladder, and essential Nursing… more
    HCA Healthcare (11/10/25)
    - Related Jobs

  • Clinical Appeals and Disputes Nurse

    University of Washington (Seattle, WA)
    …changes impacting revenue cycle **REQUIREMENTS** + Active licensure to practice as a Registered Nurse in Washington State + Bachelor's degree in Nursing + ... one of the following: certified healthcare chart auditor, certified professional in utilization review (or utilization management or healthcare management),… more
    University of Washington (12/19/25)
    - Related Jobs