NewCompliance UM Nurse (Wed - Sun) Humana IncCompliance UM Nurse (Wed - Sun)NJRemote$71,100–$97,800 / yearWork at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.
Telehealth Triage Registered Nurse New York + Compact State RN License Required Ophelia Health IncTelehealth Triage Registered Nurse New York + Compact State RN License RequiredNYRemoteTriage RNs have experience working with patients with substance use and are comfortable conducting ongoing medication management, performing check-in calls and urine drug screens, assessing bridge prescription requests, and identifying escalation events requiring clinical oversight. Support medication management by communicating with patients regarding medication dosing, interactions, and taking meds as prescribed; discussing comfort medications during the induction phase, and educating patients on proper dosing method of buprenorphine.
Remote Nurse Practitioner, Palliative Care at Home - Mount Sinai Home Health - Full Time - Day Mount Sinai Health SystemRemote Nurse Practitioner, Palliative Care at Home - Mount Sinai Home Health - Full Time - DayNew York, NYRemote$123,576–$197,400 / yearWe are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. The team works in collaboration with patients' healthcare teams to provide high quality evidence based complex palliative care and chronic care management and is designed to improve symptoms and QOL, reduce caregiver burden, reduce unnecessary inpatient utilization, and facilitate hospice when appropriate.
(RN) Registered Nurse Coding Auditor - HCS-D, COS-C - Full Time Northwell Health Inc(RN) Registered Nurse Coding Auditor - HCS-D, COS-C - Full TimeGarden City, NYRemoteWhen determining a team members base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity). Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record.
Clinical Review & Correspondence RN Cohere Health Technologies LLCClinical Review & Correspondence RNNYRemote$31–$35 / hourBy unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately. Opportunity Overview: The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical determinations, and ensuring accurate member and provider communications.
Remote | Nursing Clinical Review Expert — $65–$95/hour 24-MagRemote | Nursing Clinical Review Expert — $65–$95/hourNew York, New YorkRemote$65–$95 / hourThis role supports current and upcoming remote consulting opportunities focused on nursing-related clinical review, patient care workflow evaluation, documentation assessment, medication administration scenarios, clinical data review, and high-quality project execution. We are sharing a specialised part-time consulting opportunity for nursing professionals experienced in patient care, clinical monitoring, medication administration, clinical documentation, care coordination, and structured healthcare workflow review.
RN Health Care Facility Surveyor Impact Recruiting SolutionsRN Health Care Facility SurveyorNew York, New YorkRemote$75,000–$90,000The Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide.
Behavioral Health RN Greenlife Healthcare StaffingBehavioral Health RNJericho, New YorkRemote$55In this 1099 contract role, you'll serve as a Behavioral Health Subject Matter Expert, providing clinical expertise in developing resources and identifying best practices around evidence-based guidelines to identify and treat tobacco use disorder (TUD). Provide subject matter expertise in developing resources and identifying best practices around the use of evidence-based guidelines to identify and treat tobacco use disorder.
Clinical Clearance Specialist RN Charlie Health IncClinical Clearance Specialist RNNYRemote$48–$52 / hourThis RN serves as the dedicated clinical reviewer for escalated admissions cases involving eating disorder (ED) and substance use disorder (SUD) presentations - cases that require nursing-level clinical expertise beyond the independent decision-making scope of the CAT team, but that do not require physician review. You will own the clearance review queue, interpret labs, vitals, and EKGs, issue timely admission determinations, and serve as the primary clinical bridge between the admissions team and medical leadership.
Urgent Care Nurse Practitioner (Full Time, Weekend Only) Teladoc Health IncUrgent Care Nurse Practitioner (Full Time, Weekend Only)New York City, NYRemoteJoin Teladoc Health, a pioneer in virtual healthcare, as a full-time, General Medicine Nurse Practitioner (NP), where youll be on the front lines of accessible, patient-first care. Explore candidate resources with tips and tricks from Teladoc Health recruiters and learn more about our company culture by exploring #TeamTeladocHealth on LinkedIn.
Urgent Care Nurse Practitioner (Full Time) Teladoc Health IncUrgent Care Nurse Practitioner (Full Time)NYRemoteJoin Teladoc Health, a pioneer in virtual healthcare, as a full-time, General Medicine Nurse Practitioner (NP), where youll be on the front lines of accessible, patient-first care. Explore candidate resources with tips and tricks from Teladoc Health recruiters and learn more about our company culture by exploring #TeamTeladocHealth on LinkedIn.
Psychiatric Nurse Practitioner (Full-Time W2) Reklame HealthPsychiatric Nurse Practitioner (Full-Time W2)New York, New YorkRemoteWe are a clinician-led, tech-enabled provider group that exists to provide culturally competent behavioral health care addiction care, medication management, crisis intervention, and care coordination for people working towards taking back control of their lives, while expanding access to care. Psychiatric Evaluations and Medication Management : Deliver compassionate and high-quality psychiatric care, addiction care, and medication management through a convenient telehealth platform, ensuring members receive accessible and effective care.
RN Clinical Reviewer / IDR Greenlife Healthcare StaffingRN Clinical Reviewer / IDRJericho, NYRemoteGreenlife Healthcare Staffing is seeking an experienced Registered Nurse Clinical Reviewer (IDR) to join a remote position at a Non-profit organization located in New York. Soft Skills: Excellent written/verbal communication; ability to work independently; flexible and innovative; meets deadlines in sensitive environments; strong collaborative and problem-solving skills.
Remote 24-MAGRemoteNew York, New YorkRemote$65–$95 / hourThis role supports current and upcoming remote consulting opportunities focused on nursing-related clinical review, patient care workflow evaluation, documentation assessment, medication administration scenarios, clinical data review, and high-quality project execution. We are sharing a specialised part-time consulting opportunity for nursing professionals experienced in patient care, clinical monitoring, medication administration, clinical documentation, care coordination, and structured healthcare workflow review.
NewClinical Reviewer-PRN (RN) Acentra HealthClinical Reviewer-PRN (RN)NYRemote$28.37–$39.19 / hourIn fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. For non-clinical roles, or when not required by the contract specifically, the Company acknowledges that practical, hands-on experience can provide skills and competencies equivalent to formal education.
RN Health Care Facility Surveyor Greenlife Healthcare StaffingRN Health Care Facility SurveyorAvenel, NJRemote$75,000–$90,000 / yearThe Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide.
Vice President, Government and Commercial Programs Allied UniversalVice President, Government and Commercial ProgramsNYRemote$130,000–$160,000 / yearThe Vice President, Government and Commercial Programs is responsible for all government and commercial healthcare operations in addition to managing interactions with government entities while concurrently developing and executing strategies to drive commercial growth and Profit & Loss (P&L) responsibility across both public and private sectors. Responsible for the day-to-day oversight of the operational efficiency and effectiveness of the clinical auditing, compliance and special investigations unit organization, to include special programs such as Physician, Managed Care, Pharmacy, PACE, and Special Needs.
Clinical Clearance Specialist (RN) Charlie HealthClinical Clearance Specialist (RN)New York, NYRemote$48–$52 / hourThis RN serves as the dedicated clinical reviewer for escalated admissions cases involving eating disorder (ED) and substance use disorder (SUD) presentations — cases that require nursing-level clinical expertise beyond the independent decision-making scope of the CAT team, but that do not require physician review. You will own the clearance review queue, interpret labs, vitals, and EKGs, issue timely admission determinations, and serve as the primary clinical bridge between the admissions team and medical leadership.
CDI Specialist- Remote Med-Metrix, LLCCDI Specialist- RemoteNJRemoteThe Clinical Documentation Integrity Specialist performs concurrent chart reviews to validate that the clinical documentation in the medical record appropriately describes the patient's severity of illness, complexity of care, and risk of mortality to facilitate appropriate coding. Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
Clinical Case Manager Blue Cross and Blue Shield AssociationClinical Case ManagerNYRemote$75,000–$85,000 / yearSupport members at all stages of their health care journey and across multiple settings and specialty areas, connecting with multiple providers and community-based organizations; guide members in accessing services to support their health and wellness goals in accordance with their benefits, partnering effectively with the Plan's customer service, providers relations, and/or utilization management teams. Clinical Case Manager Qualifications: Graduate of an approved program in professional nursing: RN, VT licensure and ability to apply for Compact License or active multi-state licensure required, BSN desired; OR Licensed Clinical Social Worker (LICSW) in the State of Vermont or comparable degree and licensure in an allied mental health profession.