Molina Healthcare
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San Diego,CA
JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...
Family Health Centers of San Diego
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San Diego,CA
For more than55 years, Family Health Centers of San Diego's (FHCSD) mission has been to provide caring, affordable, high-quality health care and supportive services to everyone, with a special commitment to uninsured, low-income and...
Molina Healthcare
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San Diego,CA
JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations...
Scene Health
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San Diego,CA
About Scene Health Scene is reimagining medication adherence with our 360° model of care, bringing the gold standard of Directly Observed Therapy into the digital age. Through personalized video coaching, engaging...
UW Health
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San Diego,CA
Job Description Description: Work Schedule: Day/evening, you will work five10-hour shifts per pay period including every other weekend. Holiday rotation required. Hours are based...
Providence Service
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San Diego,CA
Description 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...
National Coalition of Healthcare Recruiters
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San Diego,CA
20 miles from Boston - surrounding areas (Only QUALIFIED Healthcare Professionals accepted) Case Manager - Are you ready to make a real difference in people's lives while enjoying a schedule that suits your lifestyle? We're on the lookout...
US Navy
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Coronado,CA
Job Title : Registered Nurse (Navy Nurse Corps) Category / Component : Officer • Both Overview Navy Nurse Corps officers deliver professional nursing care to service members, families, and global communities in leading edge military medical...
Inland Empire Health Plan
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San Diego,CA
Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic...
CareFirst BlueCross BlueShield
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San Diego,CA
Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The...
UC San Diego Health
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San Diego,CA
Are you a new graduate nurse looking to apply to UC San Diego Health?Please join us for our New Graduate Nurse Applicant Webinar on Wednesday April 8, 2026 from 11:00am-12:30pm.Learn More About: Our organization's nursing mission, vision...
Parkview Health
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San Diego,CA
Summary Independently plans and provides excellent professional nursing care for patients in accordance with physician orders, established hospital and departmental policies and procedures, American Nurses Association Standards of...
CVS Health
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San Diego,CA
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...
UnitedHealth Group
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San Diego,CA
Explore Opportunities With [Agency Name] A part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their...
American Recruiting and Consulting Group
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San Diego,CA
CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to...
Hireops Staffing Llc
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San Diego,CA
$40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical...
US Navy
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San Diego,CA
Job Title : Registered Nurse (Navy Nurse Corps) Category / Component : Officer • Both Overview Navy Nurse Corps officers deliver professional nursing care to service members, families, and global communities in leading edge military medical...
CareSource
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San Diego,CA
Job Summary: The Intake Nurse - RN is responsible for assessing potential new members for eligibility for the program and for explaining the program to them and their families. Responsible for knowing required outreach activities...
UC San Diego Health
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San Diego,CA
UCSD Layoff from Career Appointment: Apply by 1-26-26 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor. Reassignment Applicants: Eligible Reassignment clients should contact their Disability...
Ingenesis
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San Diego,CA
RN / Medical Reviewer / Remote Job Details Professional Discipline : Registered Nurse Specialty : Utilization Review Employment Type : Full Time City :...
The CKHobbie Group
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San Diego,CA
Job Description Are you a registered nurse ready to take your career in an exciting new direction-one where your expertise truly makes a difference? Join Pennsylvania's premier Quality Improvement Organization and step into a...
Hendrick Health
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San Diego,CA
JOB SUMMARY The Utilization Review (UR) Nurse is a registered nurse who provides clinical review against nationally recognized medical necessity criteria for the purpose of evaluating medical necessity or hospitalization...
Actalent
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San Diego,CA
Fully Remote : Clinical Documentation Specialist Job Description Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers.
