- Geisinger (Pittston, PA)
- Job Title: RN - Registered Nurse - Hospital at HomeLocation: Pittston, PennsylvaniaJob Category: RN - Registered Nurse , Nursing and Nursing SupportSchedule: ... team huddles.Coordinates patient care schedules, diagnostics, and delivery of durable medical equipment.Triages and manages acute patient needs and barriers by… more
- Tenethealth (Frisco, TX)
- …and plans ensuring alignment with national goals and yearly evaluations Improve Medical CMI throughout Conifer. Responsible for the supervision and coordination of ... annual basis (IPPS and OPPS, ICD-9-CM and CPT updates) for inpatient. Quarterly review of AHA Coding Clinic. Attends Quarterly Coding Updates and all coding… more
- Lucile Packard Children's Hospital (Palo Alto, CA)
- …Palo Alto, CA Req: P138659-1121 Employee Group: CRONA Benefits Eligible: Yes Remote Eligible: No Department: Bass Center Scheduled Weekly Hours: 36 At Lucile ... nature, level and purpose of the job. The Clinical Nurse II is an RN that practices as a...efficient, effective, and equitable. - Participates in the design, review , and evaluation of QI data and initiatives at… more
- SR International, Inc. (Phoenix, AZ)
- …to obtain their own laptop SOAZ - Posting ID # 5297 - Medical Review Nurse (Local Only/Mostly Remote /Onsite Trainings) Skills Required: * Medical ... review ; CCI, lnterQual, HCPCS and CPT Coding; managed care medical review experience. Certification in CPT Coding is a plus. Active Fingerprint Clearance… more
- PharmaCord (Jeffersonville, IN)
- …by communicating clearly, focusing on the accuracy of the details of their medical records and your mastery of the program requirements, and ensuring their ... months (or sooner once proficiency in role is demonstrated). Review our Benefits & Perks below to learn more!...to follow up on proper submission and/or outcome Coordinates nurse teach with field-based nurse educators, as… more
- Medalogix (Nashville, TN)
- …mission; specifically, home health and hospice intake and post admission quality review process flow and management of business process and organizational planning. ... Must be able to coordinate and communicate effectively with colleagues, managers, and medical staff, and be able to teach and develop others with an ability… more
- Translational Research in Oncology (Los Angeles, CA)
- …join our Monitoring Resources team in the USA. This position will be remote , but will require travel. Responsibilities: Monitor activities at assigned clinical study ... request any new or updated site-related essential documents and review them for content, consistency with other documents, and...in the field; or very strong experience as Research Nurse or Study Coordinator in oncology Bachelor's Degree in… more
- Actalent (Porterville, CA)
- Remote Concurrent Review Nurse Job...projects within utilization management as part of the clinical review team + Partners and works with Medical ... Description We are seeking a dedicated Concurrent Review Nurse to perform concurrent reviews, assess...perform concurrent reviews, assess members' overall health, evaluate the medical necessity of care, and contribute to discharge planning… more
- Actalent (Tigard, OR)
- Job Title: Clinical Review Nurse - Concurrent Review Work Environment + This is a 100% remote position + The schedule is Tuesday to Saturday, 10 AM to 7 ... and concurrent review . Job Description The Clinical Review Nurse will perform concurrent reviews to...evaluate the type of care being delivered, and determine medical necessity. This role also involves contributing to discharge… more
- Actalent (Bakersfield, CA)
- Position Highlights: + Location: Remote (California-based candidates or CA RN license required) + Schedule: Monday-Friday, 8:00 AM-5:00 PM PST + Start Date: October ... time off during ramp-up) Key Responsibilities: + Conduct concurrent reviews to assess medical necessity and appropriate level of care + Collaborate with providers, … more
- Zurich NA (Schaumburg, IL)
- Medical Bill Review Senior Nurse 127127 Zurich Insurance is currently looking for a ** Medical Bill Review Senior Nurse ** to work from our ... quickly and completely, provide status updates to ensure customer satisfaction. + Review assigned medical bills, apply technical insights, applying discretion… more
- Medical Mutual of Ohio (OH)
- …pre-employment substance abuse and nicotine testing._ **Title:** _Clinical Appeal & Claim Review Nurse II_ **Location:** _Ohio_ **Requisition ID:** _2500127_ ... stay and level of care. + Extrapolates and summarizes medical information for physician review or other...degree preferred. + 3 years experience as a Registered Nurse in acute care, critical care, emergency medical… more
- CVS Health (Lansing, MI)
- …EST Hours; Shift times may vary based on business needs) **Location** : 100% Remote (US only) **Position Summary** American Health Holding, Inc. (AHH), a division of ... Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible,...members. We are seeking a dedicated Utilization Management (UM) Nurse Consultant - Oncology and Transplant to join our… more
- CVS Health (Salt Lake City, UT)
- …do it all with heart, each and every day. **Position Summary** **This is a remote work from home role anywhere in the US with virtual training.** **Shift schedule is ... of residence.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS...**Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in… 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...in being diverse and inclusive The Role The Registered Nurse Case Manager team at AptiHealth is pivotal to… more
- CVS Health (Salt Lake City, UT)
- …skills in a collaborative process to implement, coordinate, monitor and evaluate medical review cases. + Applies the appropriate clinical criteria/guideline and ... Occasional Overtime may be required. This position will be remote working from home anywhere in the US. **Position...Years of clinical experience. + 1+ Year of Utilization Review Management and/or Medical Management experience. +… more
- ManpowerGroup (Austin, TX)
- …partnership team supporting Medicaid services in Texas. This is a non-clinical, ** remote ** - review role focused on **prior authorization** and **utilization ... about improving patient outcomes through smart, resource-conscious care decisions. **Location:** Remote , but near Austin, TX **Schedule:** Full-time | Must be… more
- 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
- Prime Therapeutics (Atlanta, GA)
- …passion and drives every decision we make. **Job Posting Title** Infusion Referral Nurse Sr- REMOTE **Job Description** Under supervision, is responsible for ... Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt...in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. + At minimum must… 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
