- Cedars-Sinai (CA)
- …a condition of continued employment. **Req ID** : 11005 **Working Title** : Registered Nurse - Lung Transplant Coordinator - Remote ON CALL **Department** : Lung ... happy to hear from you. With expert surgical and medical proficiency in lung, heart, liver, kidney, and pancreas...hope for a longer, healthier life. **This is a remote on-call position with a 24-hour shift schedule (7:00am… more
- CVS Health (Phoenix, AZ)
- …plan administered by Aetna, a CVS Health company, is seeking a Quality Management Nurse Consultant to help ensure the highest standards of care for our diverse ... member population. In this remote role, you'll be part of a collaborative, experienced,...role for you! **Key Responsibilities** + Responsible for the review and evaluation of clinical information and documentation related… 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
- Molina Healthcare (Oakland, CA)
- …Preservice and outpatient experience. **KNOWLEDGE/SKILLS/ABILITIES** The Delegation Oversight Nurse is responsible for ensuring that Molina Healthcare's UM ... as well as Molina Healthcare business needs. In addition, the Delegation Oversight Nurse will assist the Delegation Oversight Manager with additional duties of the… more
- Insight Global (Boston, MA)
- Job Description Insight Global is looking for a Remote Nurse Care Manager to support a virtual care and healthcare navigation company. This individual will act ... packages for this role will start on the 31st day of employment and include medical , dental, and vision insurance, as well as HSA, FSA, and DCFSA account options,… more
- CVS Health (Phoenix, AZ)
- …relationships, coordinating care, and improving health outcomes through integrated medical and behavioral health services. You will collaborate closely with ... health teams, direct care staff, primary care providers, specialists, and Durable Medical Equipment (DME) vendors to address care gaps and support members with… more
- CVS Health (Albany, NY)
- …advocates for members who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current case management and ... to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and… more
- Centene Corporation (Little Rock, AR)
- …perspective on workplace flexibility. Clinical Review Nurse - Concurrent Review & Outpatient Services - Remote - Arkansas **Position Purpose:** Performs ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
- Actalent (Sunrise, FL)
- …staff to direct utilization and capture data effectively. Responsibilities + Review prior authorization requests for medical necessity and appropriateness, ... Utilization Management Nurse !Job Description The Utilization Management Nurse ...standardized Review Criteria. + Coordinate with the Medical Director/Physicians for requests outside standard Review … more
- Baylor Scott & White Health (Bismarck, ND)
- …plan and the provider's care coordination departments. Your expertise is needed to review medical necessity. Working with the team, you'll verify medical ... experience. **Essential Functions of the Role** + You will review medical services. Use guidelines to assess...is required. + You must hold a valid Registered Nurse License (RN). As a health care system committed… more
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