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 Triage Nurse (RN) at CenterWell is responsible for assessing patients' health problems and needs, developing and executing nursing care plans, and assisting in maintenance of patient medical records. This role involves varied work assignments that require interpretation and independent determination of appropriate courses of action. The position is remote and telephonic, focusing on evaluation of patients with ambulatory diagnoses as well as possible acute conditions and medication refills, in partnership with the center's mid-levels and PCPs.

Triage Nurse - CenterWell - Eastside

Triage Nurse

We are seeking a Registered Nurse Coder to join our team in the healthcare industry, working remotely with EST hours. This role involves working on a COC/SPD project to build out the coding for our benefit plans, utilizing clinical knowledge and coding skills to support project deliverables. The position offers an opportunity to work in a thriving sector and contribute to the team's objectives.

Registered Nurse Coder

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

UC Health is seeking a Registered Nurse (RN) for Denials/Charge Audits in the Perioperative department. This remote position involves supporting data analysis, data mining, and quality monitoring to improve quality of care, service levels, revenue realization, and cost effectiveness. The role offers a work-from-home schedule and a culture that values success and growth.

Registered Nurse (RN), Denials/Charge Audits, Perioperative, First Shift

Registered Nurse, Denials/Charge Audits

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 inbound calls from patients, providing clinical assessments and triage based on established protocols, and offering administrative support for patients' and providers' 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]

The Regional Family Nurse Practitioner at Paragon Healthcare, a proud member of the Elevance Health family, is responsible for patient care within their scope of practice in the clinical setting. This role involves administering ordered therapies, completing patient assessments, documenting patient data, and ensuring medication orders are accurate. The position requires extensive travel up to 75% of the time across multiple states, including GA, TN, AL, FL, and OH.

Regional Family Nurse Practitioner (FNP) -Paragon Healthcare

Regional Family Nurse Practitioner

A large healthcare insurance company local to the Philadelphia area is seeking a fully remote Case Management RN to join their Care management team. The role involves telephonic or onsite review of hospital admissions, determining alternative settings when appropriate, promoting efficient and high-quality use of the healthcare delivery system, and facilitating timely and dynamic discharge planning. The RN will collaborate with the hospital utilization review department, attending physicians, and members/families as appropriate.

Utilization Management RN - REMOTE (PA, NJ, DE)

Utilization Management Registered Nurse

315 Health is seeking a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention, and management of their health through continuous care programs like Remote Patient Monitoring and Chronic Care Management. The role involves educating patients on in-home monitoring devices, creating personalized care plans, identifying barriers to success, providing specific education and coaching on chronic conditions, and serving as the patient's first contact for non-emergent needs. The position requires an active and unrestricted Georgia RN License, at least three years of experience in adult health, and proficiency in electronic medical records.

Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management)

Registered Nurse

CDR Health Care Inc. is seeking Registered Nurses in the Naples-Collier County, FL area to conduct Health Assessments, lab work, and immunizations for clients within our facility. This role involves recording patients' medical information accurately, taking and recording measurements such as blood pressure, temperature, and heart rate, and providing back-up relief for all staff positions as needed.

Registered Nurse -Naples-Collier County

The RN Care Coordinator at Crouse Medical Practice is responsible for coordinating all systems/services required for an organized, multidisciplinary, patient-centered care team approach. This role ensures quality, cost-effective care for the identified patient population by managing the course of treatment in collaboration with physicians, nurses, other staff, and community health care providers. The position involves directing LPN Care Coordinators and participating in Patient Centered Medical Home activities.

Registered Nurse Care Coordinator

The Infusion Referral Nurse is responsible for performing referral services to support independent physician offices in maintaining member drug infusions in office or to help offices locate a lower cost alternative treatment site. This role involves discussing financial and clinical considerations with members, researching financial programs to decrease out-of-pocket expenses, and coordinating lower cost sites of service for drug administration if necessary. The position requires critical thinking to optimize treatment outcomes and maintain member satisfaction.

Infusion Referral Nurse- REMOTE

Infusion Referral Nurse

The Nurse Utilization/Medical Management I at Elevance Health is responsible for collaborating with healthcare providers and members to promote quality member outcomes, optimize member benefits, and promote effective use of resources. This role involves ensuring medically appropriate, high-quality, cost-effective care through assessing the medical necessity of various services, interpreting benefits accurately, and steering members to appropriate providers or resources. The position is virtual, requiring candidates to reside within 50 miles or a 1-hour commute of an Elevance Health location in the East or Central time zones.

Nurse Utilization / Medical Management l - Medicaid

Nurse Utilization/Medical Management I

Nurse Advice Line staff nurses at Children's Mercy provide telephone triage, illness management, and health promotion for patients and families. They utilize the nursing process, knowledge of scientific principles, and triage protocols to offer safe, high-quality, comprehensive, and age-appropriate nursing care via the telephone. This role is part of a 24/7 team and involves patient and family education, as well as advocating for their needs.

Staff Nurse - Nurse Advice Line - 24/7 Team

Staff Nurse - Nurse Advice Line

SteadyMD is seeking Nurse Practitioners with licensure and residency in at least one of the states (TX, CA, WA, AZ, UT, CO), and 5 years of primary care experience for a potential role in providing virtual patient care. This fully remote position offers a flexible schedule, with an opportunity to work on various programs such as weight loss, urgent care, primary care, and functional medicine. The role involves conducting initial intake evaluations, managing prescription refills, and providing evidence-based care to a diverse patient population.

Nurse Practitioner (Primary Care, Remote)

Nurse Practitioner

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