Appeals and Grievance Registered Nurse II - TLRA Clinical Appeals
Houston, Texas
Description Summary: Responsible for the management and communication of denials/appeals received from third party payers, managed care companies, and/or government entities/auditors related to medical necessity and/or level of care. This a...
8d
| Job Type | Full Time |
Care Manager II, Case Management - Full time
Beaumont, Texas
Description Summary: The Care Manager (CM) II works in collaboration with the patient/family, physicians and multidisciplinary team members to ensure patient progression through the continuum of care and to develop a plan of care for each a...
8d
| Job Type | Full Time |
Clinical Nurse Specialist (RN) - Geriatrics
Portland, Maine
Description Maine Medical Center Nursing Req #: 35179 This is a Bargaining Unit Position Job Posting Date: 07/01/2025 Full Time/Days For a limited time MaineHealth is offering up to $20,000 for experienced Registered Nurses with greater tha...
8d
| Job Type | Full Time |
Clinical Nurse Specialist (RN) - Adult Medicine
Portland, Maine
Description Maine Medical Center Nursing Req #: 35320 This is a Bargaining Unit Position Job Posting Date: 07/01/2025 Full Time/Days For a limited time MaineHealth is offering up to $20,000 for experienced Registered Nurses with greater tha...
8d
| Job Type | Full Time |
Shaker Heights, Ohio
About Us One Medical is a primary care solution challenging the industry status quo by making quality care more affordable, accessible and enjoyable. But this isn't your average doctor's office. We're on a mission to transform healthcare, w...
8d
| Job Type | Full Time |
Behavioral Health Utilization Management Clinician, Consultant (Lead)
Long Beach, California
Your Role The Behavioral Health (BH) Utilization Management (UM) team performs prospective, concurrent, retrospective utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, and nationa...
8d
| Job Type | Full Time |
Behavioral Health Utilization Management Clinician, Consultant (Lead)
Rancho Cordova, California
Your Role The Behavioral Health (BH) Utilization Management (UM) team performs prospective, concurrent, retrospective utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, and nationa...
8d
| Job Type | Full Time |
Behavioral Health Utilization Management Clinician, Consultant (Lead)
Lodi, California
Your Role The Behavioral Health (BH) Utilization Management (UM) team performs prospective, concurrent, retrospective utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, and nationa...
8d
| Job Type | Full Time |
Behavioral Health Utilization Management Clinician, Consultant (Lead)
Oakland, California
Your Role The Behavioral Health (BH) Utilization Management (UM) team performs prospective, concurrent, retrospective utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, and nationa...
8d
| Job Type | Full Time |
Behavioral Health Utilization Management Clinician, Consultant (Lead)
San Diego, California
Your Role The Behavioral Health (BH) Utilization Management (UM) team performs prospective, concurrent, retrospective utilization reviews and first level determinations for members using BSC evidenced based guidelines, policies, and nationa...
8d
| Job Type | Full Time |