Assists in identifying opportunities for alternative care options based on member needs and assessments. Documents all encounters with providers, members, and vendors in the appropriate system in accordance with internal and established documentation procedures; follows up as needed; and updates car...
Professional Growth - internal and external learning and development opportunities. The RN Care Manager (RN CM), as part of an interdisciplinary team (IDT) with a Care Manager, serves Lakeland Care's (LCI) members, the frail elderly, adults with physical disabilities, and adults with intellectual/de...
Dane Street is seeking highly motivated candidates to join our team as a Lead Clinical (RN) QA Specialist, specializing in Long Term Disability (LTD). As a Lead Clinical (RN) QA - Long Term Disability Specialist, you will leverage your expertise in long-term disability claims to review and ensure to...
Strategic Staffing Solutions is currently looking for an RN Case Manager for a contract opportunity with one of our largest healthcare clients!. The Care Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health pl...
RN - Registered Nurse - State Licensure and/or Compact State Licensure required. ...
Ability to work independently and effectively communicate to internal and external customers in a telephonic environment. Active unrestricted Registered Nurse (RN) license in state or territory of the United States. Ability to learn new processes and systems quickly. Strong personal computer skills,...
RN or MD degree with strong clinical knowledge - Active unrestricted clinical license in at least one state within the United States. ...
Works with senior management on escalated and complex care cases, and provides guidance to junior team members to address member concerns. RN - Registered Nurse - State Licensure and/or Compact State Licensure required. ...
The Good Samaritan Society is seeking to hire a compassionate and adaptable Registered Nurse to join our team as a Travel RN This opportunity allows a RN to travel locally by working in various GSS locations within a -mile radius from home address providing care with competitive pay, mileage reimbur...
HEDIS RN/abstraction, Legal RN, Utilization Review/Utilization Management experience (Preferred). The RN Reviewer position is a crucial role in our organization in this role you are responsible for performing a full range of activities that will positively impact the organization and contribute to ...
Bachelor's degree in Nursing, or obtained within five (5) years from the initial date of hire; RN with 15+ years of service may be considered in lieu of education agreement. Advanced Degree in Nursing (MSN, PhD, DNP, ARNP) preferred. Washington state's largest community-based, locally governed healt...
RN Clinical Quality Analyst - Case Management | Remote. For the past 20 years, EXL has worked as a strategic partner and won awards in its approach to helping its clients solve business challenges such as digital transformation, improving customer experience, streamlining business operations, taking...
Active RN Compact State license. RN experience (any environment as long as they have a solid work history). ...
RN, LPN, remote, hybrid, wfh, primary care, clinic. ...
We are seeking dedicated and qualified RNs to join our team as Remote Contingent Hurricane Response Inbound Phone Agents. As a Remote RN Contingent Hurricane Response Agent, you will play a critical role in assisting individuals who have been impacted by hurricanes and are seeking insurance claim as...
CANDIDATE MUST HAVE EITHER RN OR CPC**. CANDIDATE THAT HAS RN AND CPC STRONGLY PREFERRED***. Presents draft document at the Health Net, Inc Medical Director Forum and the Health Net of California Medical Policy Committee. Must have and maintain current, valid and unrestricted RN or CPC license. ...
Dane Street is seeking highly motivated candidates to join our team as a Lead Clinical (RN) QA Specialist, specializing in Long Term Disability (LTD). As a Lead Clinical (RN) QA - Long Term Disability Specialist, you will leverage your expertise in long-term disability claims to review and ensure to...
By providing clinical advice and triaging clinical concerns when members call Devoted, you can help members achieve better health outcomes. A compact RN license and willingness to obtain additional licenses as needed (for non-compact states). A minimum of 4 years of RN patient care experience. Eager...
This position includes responsibility for conducting research and analysis of published medical literature in order to respond to internal and external inquiries and the development of Cigna Medical Coverage Policies. Presents proposals to the TMC committee for consideration; once a project is recom...
CPT, HCPCS, ICD-10, CMS,), 3+ years Certified Professional Coder (AAPC or AHIMA), 3+ years Active unrestricted RN license. ...
Mental and Behavioral Health RN / VA Reviewer - Remote. Mental and Behavioral Health RN / VA Reviewer. Mental and Behavioral Health RN / VA Reviewer. Mental and Behavioral Health RN / VA Reviewer. ...
Ability to work independently and effectively communicate to internal and external customers in a telephonic environment. Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained. RN and c...
This position offers a unique opportunity to be the first steppingstone in their career journey, overseeing their onboarding, training curriculum, and professional development as they progress over time. Provide constructive feedback via review calls, individual case notes, and internal team trackin...
Dane Street is seeking highly motivated candidates to join our team as a Lead Clinical (RN) QA Specialist, specializing in Long Term Disability (LTD). As a Lead Clinical (RN) QA - Long Term Disability Specialist, you will leverage your expertise in long-term disability claims to review and ensure to...
This includes meeting scheduling best practices and turnaround time requirements. Supply and support their own internet services. Maintaining an uninterrupted internet connection is a requirement of all work from home position. ...