Molina Healthcare
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San Diego,CA
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 clinical guidelines, insurance policies, and...
FRESENIUS
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San Diego,CA
PURPOSE AND SCOPE: The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable...
University of Utah
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San Diego,CA
Overview As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of...
Care Career
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San Diego,CA
Care Career is seeking a travel nurse Correctional for a travel nursing job in San Diego, California. Job Description & RequirementsSpecialty:...
UNIVERSITY OF VIRGINIA
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San Diego,CA
The Clinical Documentation Specialist is responsible for the evaluation of physician documentation utilizing their clinical expertise to ensure the patients' severity of illness is accurately portrayed in the medical record for specificity of...
Premier Health
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San Diego,CA
Position: Virtual Nurse-RN Department: Virtual Nursing Facility: Premier System Support Shift: Full-time 7:00am-7:30pm/ 72 Hours Per Pay *This is...
Virtual Vocations
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San Diego,CA
Providing clinical review support on an as-needed basis, the part-time PRN Clinical Review Specialist will review medical records for medical necessity, level of care, and authorization compliance while ensuring timely appeal submissions and...
St Vincent Hospital
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San Diego,CA
Utilization Management Position Provide health care services regarding admissions, case management, discharge planning and utilization review. Review admissions and service requests within assigned unit for prospective, concurrent...
Molina Healthcare
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San Diego,CA
JOB DESCRIPTION Job Summary Leads and manages multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term...
UnitedHealth Group
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San Diego,CA
Ssbv Clinical Claims Review Rn 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 connecting...
Sentara Healthcare
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San Diego,CA
City/State Virginia Beach, VA Work Shift Second (Evenings) Overview: Sentara is hiring Registered Nurses for the Innovative Inpatient Care Model in the Brand-New Centralized Virtual Acute...
GovernmentJobs.com
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Coronado,CA
Job Summary The ideal candidate: Licensed public health nurse with strong clinical assessment and health education skills. Experienced in providing preventive and community-based nursing services across diverse settings. Skilled in health...
Hireops Staffing Llc
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San Diego,CA
Job Title This position is fully remote, however, you must reside in the State of Texas The position is a contract for about 6 months. RN working in the insurance or managed care industry using medically accepted criteria to...
BlueCross BlueShield of South Carolina
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San Diego,CA
Summary Performs medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated protocol sets or...
Americare
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San Diego,CA
Job Description: The Intake Coordinator is a Registered Professional Nurse who takes referrals and processes appropriate home care services. To maintain open lines of communication with referral sources and within Americare...
TotalMed Staffing
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San Diego,CA
Registered Nurse-Utilization Review Job ID #2038951 | Share About this Role As a Utilization Review Registered Nurse (RN) supporting a health plan or insurance organization, you will use your...
Children's Health System of Texas
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San Diego,CA
Prospective Review RN Department: Utilization Management Location: Children's Health- Trinity Towers Shift: Full-time, Monday through Friday Job Type: Remote, with some occasional onsite attendance required Why...
Beth Israel Lahey Health
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San Diego,CA
Clinical Documentation Improvement Specialist II When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This position is remote. Candidates must be local to New England...
North Carolina
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San Diego,CA
Nurse Consultant I (NS) The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health,...
Virtual Vocations
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San Diego,CA
Focused on auditing outpatient and specialty claims, the full-time Clinical Auditor RN will utilize coding and clinical chart validation expertise to ensure accuracy, medical necessity, and appropriateness of services delivered, while working in a...
Umpqua Health
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San Diego,CA
UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health...
