- US Tech Solutions, Inc. (Columbia, SC)
- …decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. May provide any ... Job Title: Licensed Practical Nurse Location: Columbia SC 29229 Duration: 3+ Months...of the following in support of medical claims review and utilization … more
- Saint Francis Health System (Tulsa, OK)
- …- 7aVirtual Nurse works from an on-site office location (not a remote position)Will perform admit, discharge chart review and other patient care duties ... Saint Francis Health System is seeking a Registered Nurse (RN) Virtual Care for a nursing job...adverse physiological trends, assurance of appropriate prophylactic strategies, and medical chart review . Virtually evaluates patients, educates… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …members as needed to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure patients are ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia...needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team to… more
- Spectraforce Technologies (Columbia, SC)
- …decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. Responsibilities: 80% ... Columbia, SC , 29229 (1 week Onsite training then remote ) Duration: 4 months assignment with possible extension Shift:...May provide any of the following in support of medical claims review and utilization review… more
- TalentBurst, Inc (Irving, TX)
- TalentBurst, Inc is seeking a travel Medical Lab Scientist for a travel job in Irving, Texas.Job Description & RequirementsSpecialty: Medical Lab ... weeks40 hours per weekShift: 8 hoursEmployment Type: TravelTitle: Technical Lab - Medical Laboratory Scientist Location: Irving, TX Duration: 03 Months Is Covid… more
- Merck & Co. (Phoenix, AZ)
- …may include:- Health care providers such as physicians, physician assistants, nurse practitioners, nurses, pharmacists as well as quality directors and office ... at product workshops and conferences, as well as consistent and ongoing review of Company promotional materials.Providing Company management with updates on customer… more
- Merck & Co. (St. Paul, MN)
- …drug distribution (Oncology group purchasing organizations, wholesalers, and specialty pharmacies). Review and evaluate patterns for products purchased and prescribed ... in-scope customer team: Customer Team Leader, Key Account Manager, Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, and… more
- Northeast Georgia Health System, Inc (Braselton, GA)
- …certifications: Current Georgia LPN license.Preferred Educational Requirements: Licensed Practical Nurse with an active Georgia license preferred or Associates ... all referrals on the same day received as evidenced by documentation in the medical record.Performs all tasks in a timely manner and assists in monitoring length of… more
- University of Miami (Miami, FL)
- …please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Nurse Navigator - Site Disease Group - Remote ... Group has an exciting opportunity for a Per Diem Nurse Navigator. The Nurse Navigator is the...and assures timely scheduling of initial appointments. Reviews outside medical records for appropriate scheduling. Assess barriers to care… more
- Sedgwick Government Solutions (Orlando, FL)
- Job Details Nurse Case Manager ( Remote ) 2024-1342 Orlando, FL, USA Medical Case Management Full Time Description Nurse Case Manager (Home Based) - ... + 3 years related clinical experience in discharge planning, oncology, utilization review /management to determine the necessity of medical services, behavioral… more
- Bozeman Health (Bozeman, MT)
- Remote is only possible if your live in one of...of care + Works with non-licensed staff to gather necessary medical records for review . + Works with other ... the 14 approved states. Approved Remote States 1. Arizona 2. Florida 3. Georgia 4....North Dakota 13. Wisconsin 14. Tennessee Position Summary: The Nurse Navigator collaborates with providers and/or clinical areas to… more
- ProgenyHealth (Elk Grove Village, IL)
- …coordinate overall member care, from pre-admission, continued stay (concurrent review ) and any outpatient services utilizing a pro-active, evidence-based ... attaining quality outcomes for the members. The clinical care nurse serves as a nurse reviewer for...and referring potential quality of care issues to the Medical Director, client and/or appropriate staff. Job Responsibilities: +… more
- Fairview Health Services (St. Paul, MN)
- **Overview** M Health Fairview is hiring for Remote Triage Nurse Advisor Supervisor! This position will be providing daily supervision of department ... team in collaboration with their leaders. This role will review efficiency reports and lead staff to assure they...for benefits? We offer benefits for this role, including medical , dental, and vision coverage along with a 403b… 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
- aptihealth (Clifton Park, NY)
- …and coordinate patient care as required/requested by member's prescriber + Perform patient medical review and gather additional medical history information ... aptihealth is a digital technology platform with an affiliated medical group that makes it easier for people to...freedom in your work habits Your Role The Registered Nurse Case Manager team at AptiHealth is pivotal to… more
- CVS Health (Hartford, CT)
- …The Appeals Nurse Consultant position is responsible for processing the medical necessity of Medicare Part C appeals from both members and providers. This ... are Monday-Friday 8a-5p in time zone of residence. Position OverviewAdministers review and resolution of clinical complaints and appeals. Interprets data obtained… more
- Commonwealth Care Alliance (Boston, MA)
- …for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has ... Reviewer is responsible for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Utilization Management… more
- Insight Global (Menlo Park, CA)
- …virtual wellness visits directly to patients in the comfort of their homes. As a Nurse Practitioner, you'll leverage your medical expertise to offer a wide range ... Job Description A client of Insight Global is seeking a dynamic Nurse Practitioner who is ready to revolutionize healthcare delivery by conducting… more
- Insight Global (New York, NY)
- Job Description Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health insurance clients. ... to day this individual will be assessing patient care requests for medical services (such as surgeries, procedures, hospital admissions, etc.) and collaborating with… more
- CVS Health (Hartford, CT)
- …The Appeals Nurse Consultant position is responsible for processing the medical necessity of Medicare Part C appeals from both members and providers. This ... a production role and remains as part of the Nurse Appeal Consultant job code. Primary duties may include,...appeals submitted by patients or healthcare providers for MD review + C ollaborate with internal business partners and… more
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