Cherokee Federal
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Travis Afb,CA
Shall read, understand, speak, and write English fluently. - Shall have knowledge, skills, and computer literacy to interpret and apply medical care criteria, such as, but not limited to, Inter. Qual or Milliman Ambulatory Care Guidelines. - Shall...
RYZ Labs
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Fairfield,CA
A healthcare company is seeking a Registered Nurse to provide home care services to patients. In this role, you will assess and evaluate patient needs, implement care plans, and monitor patient progress. Candidates must hold a valid RN license and...
Catholic Hospice
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Fairfield,CA
Per-Diem Hours: Sundays 12am to 8am Summary & Objective The Triage Registered Nurse is responsible for identifying and coordinating patient/family needs and for providing preventive and supportive care...
BlueCross BlueShield of South Carolina
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Fairfield,CA
Summary We are currently hiring for a Quality Nurse Navigator to join BlueCross BlueShield of South Carolina. In this role as a Quality nurse Navigator, you will monitor/implement quality improvement/management activities,...
Highmark Health
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Fairfield,CA
Company : Highmark Inc. Job Description : JOB SUMMARY This job implements effective utilization management strategies including: review of appropriateness of health care...
Network Health Plan (Wisconsin)
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Fairfield,CA
A leading health organization is seeking a RN Coordinator for Utilization Management in Wisconsin. This full-time position involves reviewing authorization requests for medical necessity and collaborating with various departments. Applicants...
Optum
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Fairfield,CA
A healthcare organization is seeking a Registered Nurse in Massachusetts to conduct medical record audits and support patient care. The role involves collaborating with peers, communicating findings and requires an RN license and MDS...
Grossman Roth Yaffa Cohen
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Fairfield,CA
A leading nursing advocacy organization seeks a committed Nursing Practice and Policy Specialist to drive nursing practice, collective advocacy, and healthcare policy initiatives. The role demands a passion for patient care, strong analytical...
North Dakota Staffing
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Fairfield,CA
Job Opportunity at Highmark Inc. This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization,...
Houston Methodist Hospital
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Fairfield,CA
At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical necessity and level of care using nationally...
Blue Cross Blue Shield of Arizona
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Fairfield,CA
Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families,...
John Muir Health
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Concord,CA
Job Description:Based on John Muir Health Nursing's Vision of being the innovative leader for the professional role of the registered nurse. Through evidence-based practices and relevant patient care models, the nursing culture...
Stanford Health Care
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Fairfield,CA
If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Day - 08 Hour (United States of America) This...
BlueCross BlueShield of Tennessee
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Fairfield,CA
Join our team as a Clinical Review Manager! We are seeking a quick learner who is self-motivated and capable of working independently. The ideal candidate will be able to efficiently navigate and disseminate clinical information in a...
Council of State and Territorial Epidemiologists
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Fairfield,CA
A leading cancer research organization in Seattle is seeking a Clinical Informatics Specialist III to drive IT integration to enhance clinician and patient experiences. This full-time role allows for remote work and involves leading clinical...
John Muir Health
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Concord,CA
Job Description:Job Profile Summary The RN - Manager - Cardiovascular Services shares 24-hour responsibility and accountability for the management and operation of the Cath Lab, Cardiac Nurse Navigators, and the STEMI/ Chest...
UnitedHealth Group
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Fairfield,CA
Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care. Utilize both company and community-based resources to establish a safe and effective case...
Berkley
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Fairfield,CA
Company Details Berkley Medical Management Solutions (BMMS) provides a different kind of managed-care service for W.R. Berkley Corporation. We believe focusing on an injured worker's successful and speedy return to work is...
Qlarant
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Fairfield,CA
Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health,...
Pyramid Healthcare
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Fairfield,CA
Pyramid Healthcare is dedicated to offering the highest quality of care to those we serve. A focus on client-focused care establishes our family of brands as respected leaders in addiction treatment, mental health recovery and eating disorder...
Impact Recruiting Solutions
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Fairfield,CA
A quality improvement consulting company is seeking an RN Health Care Facility Surveyor to join their team. This full-time remote position requires up to 75% travel. Responsibilities include conducting and leading surveys to assess compliance in...
CareSource
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Fairfield,CA
Job Summary: The Clinical Appeals Nurse is responsible for processing clinical appeals and attending state hearings within compliance and regulatory standards, clinical guidelines, and contractual obligations. Essential...
Sioux Empire Society for Human Resource Management
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Fairfield,CA
A healthcare provider is seeking a full-time Clinical Informatics System Analyst, RN, to improve clinical information systems. This role involves optimizing EMR applications, providing user support, and collaborating with clinical staff.
