- Actalent (Salt Lake City, UT)
- …and collaboration with key facility personnel within the healthcare setting. + Use clinical expertise, review clinical information and clinical ... Job Title: PAC NurseJob Description The PAC Nurse is a telephonic position responsible for recommending...status to ensure optimal outcomes. + Act as a clinical resource for unlicensed Post-Acute Care Coordinators, providing … more
- CareFirst (Baltimore, MD)
- …This position will support the government programs line of business. The Clinical Appeals Nurse completes research, basic analysis, and evaluation of ... provider disputes regarding adverse and adverse coverage decisions. The Clinical Appeals Nurse utilizes clinical ...and mandates. + Organizes the appeal case for physician review by compiling clinical , contractual, medical policy… more
- Actalent (Tampa, FL)
- …and collaboration with key facility personnel within the healthcare setting. + Use clinical expertise, review clinical information and clinical ... Actalent is Hiring a Team of Post Acute Utilization Review Nurses - Open to both RNs and LPNs! - Remote ! No Time Off Allowed For the 1st 90 Days and Start Date… more
- Molina Healthcare (Tampa, FL)
- …decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and...specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service… more
- Centene Corporation (Tallahassee, FL)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... and cost effectiveness of medical care. + Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in… more
- Actalent (Dallas, TX)
- …Management NurseJob Description We are seeking a dedicated Utilization Management Nurse to review handwritten and computer-generated documents, ensuring tasks ... are prioritized effectively. The nurse will be responsible for assessing medical necessity for...inpatient stays and coordinating with medical directors for further review if criteria are not met. This role involves… more
- Actalent (San Antonio, TX)
- Job Title: Registered Nurse - Utilization ManagementJob Description We are seeking a dedicated Registered Nurse with a strong background in utilization ... inpatient stays, and managing authorization processes efficiently. Responsibilities + Review handwritten and computer-generated documents while prioritizing tasks effectively.… more
- Actalent (Houston, TX)
- …NurseJob Description We are seeking a dedicated and detail-oriented Utilization Management Nurse to oversee and review both handwritten and computer-generated ... with the Utilization Management department at hospitals. Responsibilities + Review handwritten and computer-generated medical documents. + Prioritize tasks… 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 scheduling priorities. + Help eligible patient's access appropriate clinical trials + Track individual patients' progress along care… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- Summary The Wound Ostomy Clinical Nurse Specialist is an Advanced Practice Nurse (APN) who provides a full range of services emphasizing quality, timeliness, ... advanced clinical practice, consultation, and management. Responsibilities The Wound Ostomy, Clinical Nurse Specialist, is a certified wound ostomy nurse … more