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Confidential
A company is looking for a Medical Review Nurse (RN) to support medical claim and internal appeals review activities remotely. Key Responsibilities Facilitates clinical reviews of medical claims and appeals to ensure medical necessity and...
Confidential
A company is looking for a Nurse Case Manager. Key Responsibilities Conduct early medical management assessments and interventions on claims requiring treatment Evaluate claims using evidence-based guidelines to create proactive action plans...
Confidential
A company is looking for a Care Manager (RN) to develop and facilitate complex care management activities for members with physical needs. Key Responsibilities Evaluate member needs and recommend plans for optimal care outcomes Develop and...
Confidential
A company is looking for an RN Clinical Case Manager. Key Responsibilities Conduct clinical assessments and develop individualized ECM care plans Provide clinical oversight and guidance to ECM Lead Care Managers Ensure compliance with...
Confidential
A company is looking for a Credentialing and Licensing Manager. Key Responsibilities Manage and improve credentialing and licensing workflows Onboard new providers and oversee the completion of credentialing tasks Ensure compliance with...
Confidential
A company is looking for an RN - Care Manager (Bilingual). Key Responsibilities Manage care planning, coordination, and health assessments for patients Monitor the quality and effectiveness of services and track progress towards individual...
Confidential
A company is looking for a Safety Writer - Contract. Key Responsibilities Author comprehensive safety assessment reports for BLA submissions, ensuring scientific accuracy and regulatory alignment Prepare and draft responses to FDA Information...
Confidential
A company is looking for a Field RN II. Key Responsibilities Follow professional practice standards, mentor peers, and support patient safety initiatives Recognize healthcare systems affecting patient experiences and anticipate patient needs...
