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The Utilization Review Specialist will be part of our Physician Advisory Team providing first level initial admission and continued stay case reviews. The Utilization Review Specialist will determine

The Utilization Review Specialist will be part of our Physician Advisory Team providing first level initial admission and continued stay case reviews. The Utilization Review Specialist will determine

Utilization Review RN - Remote Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focus

DescriptionUtilization Review RN - Remote. The RN Care Coord‑Qual Med Mgmt will provide administration of medical management programs that include prior authorization, concurrent hospital and skilled

Company Description Rangam is a global, innovative Total Talent management firm dedicated to accelerating meaningful employment for everyone. As a minority-, woman-, and disability-owned firm, Rangam

3 days ago Be among the first 25 applicantsThis is full-time remote, but candidates must reside in IL or TXContract: 12/22/2025 to 03/31/2026RN working in theinsuranceormanaged careindustry using medi

Description Providence Health Plan caregivers are not simply valued – they’re invaluable. Join our team and thrive in our culture of patient‑focused, whole‑person care built on understanding, commitme

Overview Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. We are currently seeking Board-Certified Orthopedic Surgeons with an

REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties RN working in the insurance or managed care industry using medically ac

JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinica

Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. We are currently seeking a Board-Certified Physical Medicine and Rehabilitati

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinic

Description We are hiring for Care Manager RN positions at Providence Alaska Medical Center in Anchorage, AK! Join us as a Care Manager to play a vital, hands‑on role during a transformational t

Part-Time | Remote (U.S. Based)Medical Review Institute of America (MRIoA) is a nationally recognized leader in utilization management and clinical review services, delivering evidence-based solutions

Description We are hiring for Care Manager RN positions at Providence Alaska Medical Center in Anchorage, AK! Join us as a Care Manager to play a vital, hands‑on role during a transformational t

Overview Works with physicians and multidisciplinary team members to develop a plan of care for assigned patients. Ensures patient is progressing towards desired outcomes by monitoring care through as

Utilization Review Nurse RN - Grace Medical Center Baltimore, MD GRACE MEDICAL CENTER Part-time - Weekends - Day shift - 8:00am-4:30pm RN OTHER 96385 $40.12-$62.19 Experience based Posted:

Complexity of Work: Essential Competencies and Skills: Excellent customer service and interpersonal skills. Able to effectively present information, both formal and informal. Strong written and verbal

Responsibilities The Valley Health System has expanded into an integrated health network that serves more than two million people in Southern Nevada. Starting with Valley Hospital Medical Center in 1

Description We are hiring for Care Manager RN positions at Providence Alaska Medical Center in Anchorage, AK! Join us as a Care Manager to play a vital, hands‑on role during a transformational t

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.Full Time Social Services Albemarle, NC, US

Requisition number:2358175Job category:NursingOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connectin

Molina Healthcare is hiring for a Pharmacist in our UM/Prior Authorization department. Candidates must be licensed to practice in the state of Florida or be able to obtain Florida licensure within 90

Must reside in FloridaJob Summary Provides lead level clinical support to healthcare services team supporting one or more of the following functions: care management, utilization management, care tran