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About the role We are looking for a dedicated Registered Nurse to join our Emergency Care Center in Neches, Texas. In this fast‑paced environment you will deliver compassionate, high‑quality care to p...

Neches
Patient assessment

Backend Software Engineer

Necessary Ventures

About the role EnsoData is looking for an experienced Backend Software Engineer to own and evolve the core backend infrastructure that powers our AI‑driven healthcare platform. You will work on the AP...

Madison 130,000 - 140,000 USD/year
Python Go Java
2 months ago Apply

About the role The Utilization Review RN provides remote medical necessity reviews for patients admitted to inpatient or observation status, ensuring accurate documentation and appropriate reimburseme...

Kingman
Milliman or InterQual criteria New Remote
3 days ago Apply

About the role The Medical Management Nurse will evaluate complex clinical cases to determine medical necessity, using advanced nursing judgment and critical thinking. This fully remote position serve...

Miami
2 months ago Apply

Utilization Review Nurse

LanceSoft, Inc.

About the role The Utilization Review Nurse ensures that post‑acute care services are medically necessary, appropriately placed, and of suitable duration. Working within a health‑plan environment, the...

Michigan
InterQual

About the role The Part‑Time Physician Reviewer will perform utilization reviews to assess medical necessity across multiple lines of business, including post‑acute care, home health, DME, home infusi...

Permanent
Utilization Management

About the role The Utilization Management Registered Nurse applies clinical nursing expertise to interpret, coordinate, document, and communicate medical service and benefit determinations. You will j...

Floride
Milliman Care Guidelines Interqual Utilization Management Remote
4 months ago Apply

About the role We are seeking a Remote Utilization Management Registered Nurse to join AdventHealth’s interdisciplinary team. In this full‑time position you will evaluate admissions and ongoing stays...

Orlando 68,133 - 119,520 USD/year
Utilization Management Case Management Remote
1 month ago Apply

About the role The Utilization Management RN works within National Medicaid Clinical Operations to review prior‑authorization requests for inpatient services. The nurse ensures each request meets medi...

Virginie
Microsoft Word Electronic Medical Records (EMR) systems
2 months ago Apply

About the role Humana is seeking a Registered Nurse to join its Wisconsin Medicaid (iCare) Prior Authorization team. Working remotely from home, you will evaluate outpatient prior‑authorization reques...

Virginie
Milliman (MCG) TruCare Remote
3 months ago Apply

About the role Humana is seeking a Prior Authorization Registered Nurse to join its Wisconsin Medicaid Market (iCare) team. Working remotely from home, you will evaluate the clinical appropriateness o...

Floride
Milliman (MCG) TruCare Remote
3 months ago Apply

About the role The Utilization Management Nurse reviews inpatient stays, applies national care level guidelines, and ensures appropriate discharge planning. Reporting to the Utilization Management Nur...

Rancho Cordova 44 - 46 USD/hour
4 months ago Apply

Prior Authorization/Clinical Review RN (Specialty Pharmacy)

Orsini - Rare Disease Pharmacy Solutions

About the role The Prior Authorization/Clinical Review Nurse (RN) ensures patients receive timely access to specialty and rare disease therapies by reviewing clinical documentation, confirming medical...

Elk Grove Village 80,000 USD/year

About the role The Utilization Review Nurse will work remotely to collaborate with healthcare providers, members, and business partners. The focus is on evaluating medical necessity, optimizing member...

Richardson Contract
CPT HCPCS ICD-10 Remote

About the role The Case Management Manager serves as a patient advocate and care coordinator for hospital clients, ensuring high‑quality, cost‑effective patient management and continuity of care. This...

FL
InterQual EQ Health JCAHO standards

About the role The Inventory Controller gathers necessary information, generates purchase orders and supports the expedited processing of urgent orders. The role addresses routine discrepancies betwee...

Reedsville 25 - 40 USD/hour
Excel SAP
1 week ago Apply

À propos du poste Vous assurerez les ressources et la logistique nécessaires pour réaliser les activités de service et de maintenance sur les sites ou propriétés des clients. Vous contribuerez à entre...

Sud-Kivu 78,800 - 131,200 USD/year
usinage sur site essais non destructifs soudures critiques New Remote
20 hours ago Apply

About the role The Patient Access Representative 2 registers patients for clinical services, obtains necessary demographic and insurance information, verifies coverage, and collects payments. This on‑...

North Miami
2 weeks ago Apply

About the role The Insurance Verification Specialist II supports UAMS Health in Benton/Bryant by confirming patient insurance coverage and obtaining necessary authorizations. This position is part of...

Benton
1 month ago Apply

About the role This remote position focuses on reviewing members' medical information to confirm appropriate care levels and compliance with medical necessity guidelines. The nurse translates clinical...

New York
Remote
3 months ago Apply