About this job Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and ...
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...
Opportunities with AbleTo, part of the Optum family of businesses, are focused on improving millions of lives through technology-enabled behavioral health care. Start a rewarding career where your work will bridge the gap between need and treatment. Join us in making care more accessible and afforda...
DaVita is looking for a Full-Time Nurse Practitioner (NP) Manager to join our Integrated Care team. The Nurse Practitioner Manager leads and manages our Integrated Kidney Care Nurse Practitioners remotely. Must live in Richmond, VA area. *MUST LIVE LOCALLY. Work from home and regional trave...
Description POSITION SUMMARY: Responsibilities include but are not limited to: Concurrent and retroactive chart review, performed for medical necessity as well as for effectiveness and appropriateness of admission, length of stay, and utilization of hospital resources. Knowledge of state an...
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ** ...
Description Are you a registered nurse with a background in utilization management? Are you interested in the opportunity to work from home? UPMC Health Plan is looking for you! We are hiring temporary full-time Utilization Management Care Managers to support the Utilization Management Clinic...
.**Major Job Responsibilities**+ Responsible for leveraging clinical and/or coding experience and perform facility and provider medical record reviews in support the development of a dispute decision as it relates to Payment Integrity Program Claim disputes (i.e. Claims XTEN, Prepay Vendors, etc.).+...
Hi, we're Oscar. We’re hiring a Utilization/Clinical Review Nurse to join our Clinical team. Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 and headquartered in New York City. Our goal is to make health insurance simple, transparent, and human. We need you...
Hi, we're Oscar. We’re hiring a Utilization/Clinical Review Nurse to join our Clinical team. Oscar is a technology-driven, consumer-focused health insurance startup founded in 2012 and headquartered in New York City. Our goal is to make health insurance simple, transparent, and human. We need you...
Description The Chief Medical Officer, Group Medicare relies on the medical background to create and oversee clinical strategy for the Group Medicare business. The CMO Group Medicare, requires and in-depth understanding of how organization capabilities interrelate across segments and/or enterprise-w...
5595 Alameda AveSuite B, El Paso, Texas, 79905, United States of AmericaDaVita Integrated Kidney Care (IKC) is looking for a Full-Time RN Case Manager (RN) to join us in the El Paso, TX region. * Must live locally*As a DaVita Integrated Kidney Care Registered Nurse (RN) Case Manager you will support...
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.Positi...
The Utilization Review Nurse is responsible for the development, implementation, coordination, and follow-up of projects related to Mercy Care Management. This includes the validation, assimilation, and integration of information derived from projects, focus studies, in network and out of network pr...
**Description****Senior Coder - Remote. Most States Eligible.**Applies ICD-10/CM/PCS and CPT-4 codes to medical records based on documentation provided by physicians. Adheres to strict federal coding rules and guidelines in selecting codes that appropriately reflect the condition, which the patient ...
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ** ...
About Lyra Lyra is transforming mental health care through technology with a human touch to help people feel emotionally healthy at work and at home. We work with industry leaders, such as Morgan Stanley, Uber, Amgen, and other Fortune 500 companies, to improve access to effective, high-quality ment...
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...
Meridian Consultants is a small and growing environmental planning firm that handles large and unique projects usually available only to larger firms - they tackle master planning, infill, all varieties of transit/transportation, infrastructure, education, large-scale development and many others. Th...
Responsibilities I. JOB SUMMARY/RESPONSIBILITIES:• Provides clinical consultation as a Registered Nurse (RN) to patients upon discharge through the Transitional Case Management Program (TCMP).• Key responsibilities include, but are not limited to, assessment and development of transitional care plan...
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...
About Lyra Lyra is transforming mental health care through technology with a human touch to help people feel emotionally healthy at work and at home. We work with industry leaders, such as Morgan Stanley, Uber, Amgen, and other Fortune 500 companies, to improve access to effective, high-quality ment...
Meridian Consultants is a small and growing environmental planning firm that handles large and unique projects usually available only to larger firms - they tackle master planning, infill, all varieties of transit/transportation, infrastructure, education, large-scale development and many others. Th...
As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable...
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ...
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. As a Licensed Autism Care Advocate, you will work directly with pro...
Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm) The Nurse Case Manager II (NCM) is responsible for patient case management for longi...
Job Description Job Description Salary: $22 to $28/ hr plus bonusKlos Consulting, Inc. provides IT consulting to businesses throughout Dade, Broward and Palm Beach Counties. We have been in business for over 20 years but we have the energy and enthusiasm of a startup. We are lean, our engineers are ...
Currently seeking a qualified RN to staff a remote position for Utilization Review in Indianapolis.Must be Indiana Resident.It is a 3 month position, hours being Monday-Friday 8A-5P EST.High speed internet connection is required, along with the ability to connect to a router.Pay is $35/hour.Benefits...
Are you an experienced Registered Nurse with a passion for shaping the future of healthcare? As a Nurse Liaison you will be an expert in resource management, a master of utilization review and a compassionate partner for patients and their support network. You will be responsible for an assigned cas...
We are currently seeking an Acquisition Specialist supporting the Naval Health Research Center (NHRC) San Diego. NHRC optimizes the operational readiness and health of our armed forces by conducting research, development, testing, and evaluation to inform Department of Defense (DoD) policy.Duties in...
Essential Functions: Leads the coordination of patient care with other disciplines within the care team, monitoring the appropriateness and timeliness of care. Ensures the interdisciplinary care plan is consistent with the patient's clinical course, continuing care needs and covered services...
Job Summary Serves a case management role, responsible for an assigned group of patients, typically geographically related and accountable for the oversight and overall management of the post-acute services in the home setting. Provides direct patient care and supervision of LPNs and HHAs in accorda...
Job Summary Serves a case management role, responsible for an assigned group of patients, typically geographically related and accountable for the oversight and overall management of the post-acute services in the home setting. Provides direct patient care and supervision of LPNs and HHAs in accorda...
Job Description Job Description eSentio Technologies is a leading provider of technology consulting and implementation services to law firms and corporate legal departments. Our clients include some of the largest and most technically advanced law firms in the country. Our teams of consultants are i...
Medical Director - Southeast Region - Work from Home at Humana in Boise, Idaho, United States Job Description Become a part of our caring community and help us put health first The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve ...
Description About Us: ImageTrend, Inc. is dedicated to connecting life s most important data in the healthcare and emergency response community. We deliver software solutions, data analytics and services for EMS, hospitals, community paramedicine (CP), critical care, fire, and preparedness to enable...
The position is primarily accountable for performing initial clinical appropriateness review of requests for services that require prior authorization or retrospective review. The review process is performed in accordance with established Client (health plan) protocols/guidelines, benefits, and c...
The position is primarily accountable for performing initial clinical appropriateness review of requests for services that require prior authorization or retrospective review. The review process is performed in accordance with established Client (health plan) protocols/guidelines, benefits, and c...
The position is primarily accountable for performing initial clinical appropriateness review of requests for services that require prior authorization or retrospective review. The review process is performed in accordance with established Client (health plan) protocols/guidelines, benefits, and c...
The position is primarily accountable for performing initial clinical appropriateness review of requests for services that require prior authorization or retrospective review. The review process is performed in accordance with established Client (health plan) protocols/guidelines, benefits, and c...
Job Description Job Summary The Nurse Practitioner Psychiatric-Mental Health (PMHNP) will work primarily in non-clinical settings and provide medical care to all levels of patients. Some programs may focus on specific populations (e.g., adult and geriatric, pediatric, and women’s health). ...
Job Description: Major Job Functions/Components: In addition to the Senior Business Analyst responsibilities, the Enterprise Business Analyst performs the following: Facilitate and influence construction of specific complex solutions through scoping documents, risk assessments, and corresponding fin...
**Facility:** System Services**City** San Diego**Department****Job Status**Per Diem**Shift**Day**FTE**0**Shift Start Time****Shift End Time****Hours** **:****Shift Start Time:**10:30 AM**Shift End Time:**7 PM**AWS Hours Requirement:**8/40 - 8 Hour Shift**Additional Shift Information:****Weekend Requ...
This position is eligible for a hiring incentive of $2,500. Certain payout conditions may apply.Career Ladder Opportunity/Spanish Highly Preferred.Who We ArePacific Clinics is California's largest community-based nonprofit provider of behavioral and mental health services and support. Our team of mo...