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...
26d
| 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...
26d
| 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...
26d
| 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...
26d
| 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...
26d
| 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...
26d
| 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...
26d
| 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...
26d
| Job Type | Full Time |
Behavioral Health Utilization Management Clinician, Consultant (Lead)
Woodland Hills, 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...
26d
| Job Type | Full Time |
Clinical Resource RN - Emergency Department
Boston, Massachusetts
Tufts Medical Center is a world-renowned academic medical center that has been caring for patients across New England for more than 200 years. As the principal teaching hospital of Tufts University School of Medicine and a nationally respec...
26d
| Job Type | Full Time |