- Molina Healthcare (Boise, ID)
- … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Provides support for … more
- Idaho Division of Human Resources (Meridian, ID)
- Registered Nurse RN Manager - Idaho State Police ISP Posting Begin Date: 2025/11/07 Posting End Date: 2025/11/21 Category: Nursing Sub Category: Management ... This recruitment is being used to fill a second registered nurse manager position with Idaho State...to health care professionals related to sexual assault forensic medical examinations. The individual selected will also coordinate statewide… more
- Cognizant (Boise, ID)
- …expectations. **What you need to have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...the medical necessity determinations to the Health Plan/ Medical Director based on the review of… more
- Surgery Care Affiliates (Boise, ID)
- …If you join our team, they will. Responsibilities We are actively hiring for an Registered Nurse ( RN ) Inpatient. + Promote the mission, vision, and values ... your health, well-being, and financial future. Our offerings include medical , dental, and vision coverage, 401k plan with company...to care. + Delegate tasks according to the state Nurse Practice Act (if applicable), state board of nursing… more
- Molina Healthcare (Meridian, ID)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...specific programs supported by the plan such as utilization review , medical claims review , long-term… more
- BioLife Plasma Services (Boise, ID)
- …requirements Currently licensed or certified in the state where responsibilities will be assigned: Registered Nurse ( RN ), Nurse Practitioner (NP) or ... the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to...eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of… more
- Humana (Boise, ID)
- …concerns.** **Use your skills to make an impact** **Required Qualifications** + **Active Registered Nurse ( RN ) Multi-state/Compact State license with no ... needs at the discretion of department leadership. The Telephonic Nurse provides medical guidance, assists with access...degree in nursing (BSN) + Previous case management, utilization review , or triage experience + Previous experience in a… more
- Molina Healthcare (Meridian, ID)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Meridian, ID)
- For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review for ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
- Molina Healthcare (Meridian, ID)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support...care unit, or in a telemetry type setting. UM medical review experience highly preferred. Work Hours:… more
- Molina Healthcare (Meridian, ID)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The Care Review Clinician ( RN ) provides support for...requests within required timelines. * Refers appropriate cases to medical directors (MDs) and presents them in a consistent… more
- Molina Healthcare (Meridian, ID)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- Molina Healthcare (Meridian, ID)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (Meridian, ID)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Humana (Boise, ID)
- …Typical work hours are Monday-Friday, 8 hours/day, 5 days/week. **Required Qualifications** + Registered Nurse ( RN ), holding an active and unrestricted ... resources, schedules and goals. The Manager, Fraud and Waste Investigator: Nurse Audit/ Review validates and interprets medical documentation to ensure… more
- Veterans Affairs, Veterans Health Administration (Boise, ID)
- …patient information. Completed work should need only a general review by a registered nurse ( RN ) or physician (MD/DO) for appropriateness and conformity ... VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities This position is...condition and range levels not in range and notifies RN and/or provider for assessment. The nurse … more
- Humana (Boise, ID)
- …an impact** **Use your skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the (appropriate state) with no ... caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and… more
- Trinity Health (Boise, ID)
- …and support. + **Deliver Patient Care** : Actively perform the essential functions of a Registered Nurse within the assigned unit and assist with patient care as ... Forbes as one of **America's Best Large Employers for 2025** , is looking for a ** Nurse Unit Supervisor** to join our team at our Level II Trauma Center in **Boise,… more
- IQVIA (Boise, ID)
- Our **MedTech Registered Nurse Liaison** experiences a unique opportunity and leverage your clinical expertise in a dynamic role that goes beyond bedside care. ... with healthcare professionals and advocate for the well-being of patients through medical device technology. You will be responsible for assisting the service team… more
- Humana (Boise, ID)
- …MRM, SRO **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the (appropriate state) with no disciplinary ... Nurse who will assist in preparation of cases prior to review by the Humana G&A Medicare Medical Directors. The Nurse reviews the medical … more