The Registered Nurse for PreCert and Appeals at ProMedica Health System performs prior authorization/certification of scheduled services with payers and assists with the appeal process when needed. This role involves clinical review and document submission for oncology treatments plans and services, interfacing with payers on plan medical coverage policies, and managing denial reports. The position is remote, ideally within 120 miles of Toledo, OH, and requires a nursing degree, 2 years of clinical experience, and familiarity with ICD10 and CPT codes.

RN / Registered Nurse - PreCert and Appeals - Remote - Per Diem - Days

Registered Nurse - PreCert and Appeals

IntellaTriage is seeking part-time Hospice Triage Registered Nurses to join their team, offering a remote work setting with a focus on end-of-life care. Nurses will provide compassionate care through nurse triage, utilizing high-speed internet and tech-savvy skills. The role involves working a minimum of one evening shift weekly, every other weekend, and may include additional shifts as needed. Training is provided remotely, and nurses will use their own laptop and high-speed internet for work.

Remote Hospice Triage RN- PT 1 shift 6p-12a+ rotating Sat & Sun

Hospice Triage Registered Nurse

AmeriHealth Caritas is seeking a Care Manager II Registered Nurse for their Foster Care Program in South Carolina. This remote position requires a BSN and an unrestricted RN license in South Carolina or a compact state. The role involves engaging directly with members through face-to-face visits in the community, monitoring and updating care plans, and collaborating with healthcare professionals to ensure members receive comprehensive care. The ideal candidate will have experience in pediatric home care or acute care, and preferably in the Foster Care System, Department of Social Services, or Department of Juvenile Justice.

REMOTE | CARE MANAGER II REGISTERED NURSE (BSN) - FOSTER CARE PROGRAM -SC

Care Manager II Registered Nurse

The Payment Integrity RN at Cambia Health Solutions, Inc. is responsible for conducting post-service review of claims in prepayment, post-payment, or audit capacity to ensure appropriate clinical review, reimbursement of claims, and accuracy of coding. This role involves applying internal medical and reimbursement policies, as well as correct coding guidelines based on national standards, all in service of making members' health journeys easier. The position offers the opportunity to work from home within Oregon, Washington, Idaho, or Utah.

Payment Integrity RN

Payment Integrity Registered Nurse

The Licensed Practical Nurse (LPN/LVN) is responsible for providing and documenting skilled nursing care under the supervision of a Registered Nurse, in accordance with the developed care plan and physicians orders for each individual patient. This role involves adhering to confidentiality standards and professional boundaries, delivering and coordinating quality patient care, and educating patients and families on self-care techniques and prevention strategies.

Licensed Practical Nurse (LPN/LVN)

Licensed Practical Nurse

The Registered Nurse for the Minimum Data Set at Ascension Living is responsible for collecting data for use in determining care plans, ensuring the accuracy of patient charts and medical data, and participating in the CMS survey process. This role is part of an interdisciplinary team and requires current knowledge of federal, state, and local standards and regulations for long-term care. The position is remote and offers a variety of benefits, including paid time off, health insurance options, retirement benefits, and more.

RN-Minimum Data Set

Registered Nurse - Minimum Data Set

Two immediate vacancies for dedicated registered nurses in Irving, Texas, working remotely. The role involves using Axxess software for home health care, including start of care, revisits, and discharges. The nurse will collaborate with other healthcare professionals to ensure comprehensive patient care.

Remote Home Health Nurse

Remote Licensed Registered Nurse for Home Care

We are seeking a Registered Nurse Coder to join our team in the healthcare industry. This remote position involves working on a COC/SPD project to build out the coding for our benefit plans. The role offers an opportunity to contribute to the team's objectives while working in a thriving sector.

Registered Nurse Coder

The Clinical Nurse Educator at Amgen is a field-based position responsible for supporting patients prescribed ACTIMMUNE. This role involves providing logistical and educational assistance to patients, caregivers, and office staff, including physicians, nurses, and social workers. The CNE will work closely with patients and families, as well as healthcare professionals, to address barriers to patient medication access and improve adherence. The role requires collaboration with numerous internal teams to offer education and resources on insurance processes and treatment access.

Clinical Nurse Educator (Rare Disease)

Clinical Nurse Educator

The Registered Nurse Case Manager at Guidehealth is responsible for partnering with clinical teams to provide complex case management and strengthen the connection between patients and their primary care physician/medical practice staff. This role involves assisting patients to achieve their highest level of wellness through assessment, planning, implementation, coordination, monitoring, and evaluation of care options. The position is remote with a requirement for travel (10%-15%) to clinical sites in Philadelphia and Harrisburg, PA.

Remote Registered Nurse Case Manager - Reading, PA

Registered Nurse Case Manager

The Registered Nurse - Utilization Review at Ascension St. Vincent's Birmingham is responsible for providing health care services regarding admissions, case management, discharge planning, and utilization review. This role involves reviewing admissions and service requests for medical necessity, providing case management for complex cases, assisting staff with coding, documentation, and reimbursement issues, and overseeing compliance with utilization management rules. The position requires at least 3 years of acute care experience and utilization management experience.

Registered Nurse RN - Utilization Review  PRN

Registered Nurse - Utilization Review

The Utilization Review Nurse is responsible for reviewing Workers Compensation requests submitted by providers, requestors, claimants, or carriers to determine the medical necessity of the treatment. This role involves utilizing clinical expertise and evidence-based treatment guidelines, performing evaluations of medical data, and coordinating information between all parties involved. The position is remote but requires living in the state of Florida.

Utilization Review Nurse (Injured Workers)

Utilization Review Nurse

Oscar Medical Group is seeking a Registered Nurse Lead to join their Primary Care team. This role involves managing a team of clinicians, working with a care team of Physicians, Advanced Practitioners, Social Workers, and Medical Assistants to provide collaborative care. The position is remote, requiring the candidate to reside in specific states, and offers a blended work culture with a focus on personalized healthcare goals.

RN Lead, Oscar Primary Care

Registered Nurse Lead

Adelphi Medical Staffing is seeking an autonomous Psychiatric Nurse Practitioner (PMHNP) to provide virtual psychiatric services to adolescents and children, and conduct primary care screenings at multiple clinics in Petersburg, Virginia. This contract position involves a telehealth shift schedule of one day per week, offering an opportunity to contribute to global health initiatives, embrace lifelong learning, increase earnings, and learn from seasoned professionals.

NURSE PRACTITIONER (NP) - PSYCHIATRY IN PETERSBURG, VA - EXCELLENT BENEFITS 2024-07-14

Psychiatric Nurse Practitioner

Sequence Health is seeking a part-time Triage Nurse to provide nursing and administrative support to a range of practices across the country. The role involves receiving and making calls to patients, providing clinical assessments, responding to messages in patient portals, and offering administrative support for patient and provider needs. The ideal candidate will have strong computer and phone skills, excellent communication abilities, and the ability to work independently.

Triage Nurse (Telehealth) [Part-Time]

Triage Nurse

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