Molina Healthcare
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Bonita,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...
Blue Cross Blue Shield of Wyoming
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San Diego,CA
Deep Roots. Solid Growth. Caring People. Rooted in Wyoming! We are Blue Cross Blue Shield Wyoming: a not-for-profit health insurer with offices throughout the state. Ever since a small group of caring,...
Valeris
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San Diego,CA
Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris™ revolutionizes the path from life...
Humana
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San Diego,CA
Become a part of our caring community and help us put health first Humana Healthy Horizons in Indiana is seeking a Care Coordinator 2 (Field Care Manager 2) who assesses and evaluates member's needs and requirements to...
St. Paul's Senior Services
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San Diego,CA
San Diego's St. Paul's PACE program (Program of All-Inclusive Care for the Elderly). This innovative program is for individuals 55 years or older, who are living with chronic illness, or disabilities and need coordinated medical care to continue...
Pyramid Consulting
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San Diego,CA
Immediate need for a talented Registered Nurse Utilization Review - Onsite-Santa Clara, CA.This is a 03+ months contract opportunity with long-term potential and is located in U.S(Remote). Please...
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...
NuWest Travel Nursing
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Imperial Beach,CA
NuWest Travel Nursing is seeking a local contract nurse RN School RN for a local contract nursing job in Imperial Beach, California. Job Description & RequirementsSpecialty:...
Mercy Health
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San Diego,CA
Find your calling at Mercy! Must live within the Mercy footprint Missouri, Arkansas, Oklahoma and/or Kansas. Delivers and coordinates the standardized new hire Nursing orientation program for licensed and...
UC San Diego
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San Diego,CA
East Campus Medical Center (Alvarado Road) 6655 Alvarado Road, San Diego, CA 92120, United States #137979 (RN) Registered Nurse - East Campus Pre-Op Filing Deadline: Tue 4/7/2026 Apply Now ...
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...
Blue Shield of CA
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San Diego,CA
Your Role The Utilization Management team manages accurate and timely prior authorization and inpatient stays reviews for our members and correctly applies the guidelines for nationally recognized levels of care for our...
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...
UC San Diego Health
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San Diego,CA
Current UC San Diego Health CNA (NX) represented RN/NP applicants will be considered after the first 7 days of job posting. All additional applicants will be considered after 14 days of job posting, pending the status of the initial internal CNA...
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...
Actalent
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San Diego,CA
Immediate Hiring for "Remote Clinical Review Nurses" Job Description: Review approximately 20 cases a day for medical necessity. Advocate for and protect members from unnecessary hospital...
BayCare
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San Diego,CA
At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With...
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...
Umpqua Health
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San Diego,CA
About Umpqua Health At Umpqua Health, we're more than just a healthcare organization; we're a community-driven Coordinated Care Organization (CCO) committed to improving the health and well-being of individuals and families throughout our...
UCHealth
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San Diego,CA
Description Location: UCHealth Anschutz Inpt Pavilion, CO,Aurora Department: UCHA Care Management Work Schedule: PRN, 0.00 hours per pay period (2 weeks) Shift: Days Pay: $38.91 - $60.31 / hour. Pay is dependent on applicant's relevant experience...
Centene Corporation
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San Diego,CA
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a...
Molina Healthcare
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San Diego,CA
Job Description Job Description Job Summary Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal...
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...
UnitedHealth Group
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San Diego,CA
Review the work of others. Develop innovative approaches. Work collaboratively in a matrix environment. Sought out as expert. Anticipate customer needs and proactively develops solutions to meet them. Serve as a key resource on complex and/or...
