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Job Description
Remote Roles of Local MI Nurses
Job Description:
* Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including appeal requests initiated by providers, facilities and members.
* May establish care plans and...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of...

A collective energy and ambition. A place where you can make a real difference.
We’re a company that genuinely cares about our people, our products, our consumers and the environment.
Our unique, informal culture champions courage, determination and collaboration. Knowing we have an open and supportive team means each of us has the freedom to take responsibility and ownership. We have a share...

Job Description
Remote Jobs for Candiate located in Michigan
Job Description:
* Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including appeal requests initiated by providers, facilities and members.
* May establish c...

Job Description:
* Participates in the development and ongoing implementation of QM Work Plan activities.
* Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet QM objectives
Responsibilities:
* Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit det...

Sidecar Health is redefining health insurance. Our mission is to make excellent healthcare affordable and attainable for everyone. We know that to accomplish this lofty mission, we need driven people who will make things happen.
The passionate people who make up Sidecar Health’s team come from all over, with backgrounds as tech leaders, policy makers, healthcare professionals, and beyond. And...

Job Description:
· Participates in the development and ongoing implementation of QM Work Plan activities.
· Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet QM objectives
Responsibilities:
· Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations.
...

Number of Job Openings Available:
1
Date Posted:
March 03, 2025
Department:
78008776 Care Navigation
Shift:
Permanent Nights (United States of America)
Shift Length:
8 hour shift
Hours Per Week:
32
Union Contract:
Non-Union-NCT
Weekend Rotation:
Every Other
Job Summary:
Allina Health is a not-for-profit health system that cares for individuals, families and communities throughout Minne...

Discover. Achieve. Succeed. #BeHere
Location: US:WI:MENOMONEE FALLS at our WOODLAND PRIME 400 facility.
This job is REMOTE.
FTE: 0.900000
Shift: Shift 1
Job Summary:
The Nurse Triage Registered Nurse is a practitioner who is responsible for assessing, planning, implementing, and evaluating care for an identified group of patients within the Froedtert and MCW Patient Engagement Center...

Overview
AccentCare Home Health
Position: Triage Nurse
RN Registered Nurse License for Texas required
Office Location: Remote
Territory: Texas
Hours:
Sat 7a-7p
Sun 7a-7p
With the possibility of another weeknight 5:30-10 (which day can be discussed on interview)
Hourly Rate Range: $33 to $38
Type: Remote
Find Your Passion and Purpose as a Home Health Triage Registered Nurse
Reimagine ...