Clinical Investigator Oscar HealthClinical InvestigatorNew York, NYRemote$75,348–$98,894 / yearBachelor of Science in Nursing (BSN), Associate Degree in Nursing (ADN) with a Bachelor of Science in Health Administration, Clinical Informatics, or a related Medical Science field, or Associate Degree in Nursing (ADN) with 5+ years of specialized clinical audit experience. Work Location: This is a remote position, open to candidates who reside in: Arizona, Florida, Georgia, Illinois, Iowa, Kansas, Michigan, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and Virginia.
Complex Oncology Nurse Navigator (11:30AM - 8:00PM EST) Thyme Care IncComplex Oncology Nurse Navigator (11:30AM - 8:00PM EST)NYRemoteToday, Thyme Care is a market-leading value-based oncology care enabler, partnering with national and regional health plans, providers, and employers to deliver better outcomes and lower costs for thousands of people across the country. In it, you will conduct clinical assessments, monitor for changes in health, coordinate care, including transitions, and educate members and caregivers about their diagnosis and treatment over the phone to support our higher-acuity members as they move through the oncology care continuum.
Remote Registered Nurse (RN) Case Manager ValerisRemote Registered Nurse (RN) Case ManagerDanbury, ConnecticutRemoteBacked by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. calling and working with the patient’s insurance payer to determine coverage benefits, anticipated out-of-pocket costs associated with their therapy and resources for financial assistance, where applicable based upon needs communicated by the patient.
Oncology Transitions of Care Nurse (11:30AM - 8:00PM EST) Thyme Care IncOncology Transitions of Care Nurse (11:30AM - 8:00PM EST)NYRemoteToday, Thyme Care is a market-leading value-based oncology care enabler, partnering with national and regional health plans, providers, and employers to deliver better outcomes and lower costs for thousands of people across the country. In it, you will conduct clinical assessments, monitor for changes in health, coordinate care, including transitions, and educate members and caregivers about their diagnosis and treatment over the phone to support our members as they move through the oncology care continuum.
Registered Nurse Patient Care Manager American Oncology Network IncRegistered Nurse Patient Care ManagerNYRemote$52,395.20–$92,164.80 / yearProvides disease specific management, a working knowledge of oncology principles, the ability to manage chemotherapy and the side effects, and can monitor and address symptoms. Ensure patient has all information to make informed decisions regarding treatment, understands the role of Care Management, and how to access services appropriately.
Registered Nurse - Fully Remote MercorRegistered Nurse - Fully RemoteNew York, New YorkRemote$55–$65 / hourExperience reviewing charts for quality improvement, utilization review, CDI, or clinical informatics. For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome.
NewRN 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 an 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.
Senior Manager, Patient Access Advocate, West Revolution Medicines IncSenior Manager, Patient Access Advocate, WestNYRemote$187,200–$208,000 / yearBy acting as a single point of contact, the RNCM will proactively manage and work individual patient cases to ensure access and financial barriers are compliantly overcome -including benefit verifications, Prior Authorization (PA) delays, denials, appeals hurdles, specialty pharmacy (SP) and non-commercial pharmacy routing issues, affordability barriers, complex Center for Medicare and Medicaid cases (CMS), community resources and more. RNCMs will work directly with patients, healthcare providers, insurers, field reimbursement team, and other key stakeholders to help patients understand their coverage, access the company's patient support programs, and connect with external resources that help overcome access barriers.
Senior Manager, Patient Access Advocate, East Revolution Medicines IncSenior Manager, Patient Access Advocate, EastNYRemote$187,200–$208,000 / yearBy acting as a single point of contact, the RNCM will proactively manage and work individual patient cases to ensure access and financial barriers are compliantly overcome -including benefit verifications, Prior Authorization (PA) delays, denials, appeals hurdles, specialty pharmacy (SP) and non-commercial pharmacy routing issues, affordability barriers, complex Center for Medicare and Medicaid cases (CMS), community resources and more. RNCMs will work directly with patients, healthcare providers, insurers, field reimbursement team, and other key stakeholders to help patients understand their coverage, access the company's patient support programs, and connect with external resources that help overcome access barriers.
NewRN Infusion - Transition Associate (Travel) American Oncology Network IncRN Infusion - Transition Associate (Travel)NYRemote$29.52–$42.39 / hourAbility to build an engaging culture of quality, performance effectiveness and operational excellence through best practices, strong business and political acumen, collaboration and partnerships, as well as a positive employee, physician and community relations. Telephone triage: Includes prioritizing incoming calls and messages from patients, family members, hospitals, nursing facilities, pharmacies and physician offices from emergent to non-urgent.
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.
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.
NewDirector Of Sales & Business Development Harris Computer SystemsDirector Of Sales & Business DevelopmentFlorida, PRRemote$80,000–$110,000 / yearYou'll work alongside experienced professionals, including a professional services team comprised of Registered Nurses and former perioperative staff, who bring deep clinical expertise and a customer-centric perspective to every challenge. About Picis: Join Picis, a global leader in perioperative and critical-care information systems, where you'll be part of a team that is genuinely pleased with their colleagues and thrives in a positive, comfortably fast-paced environment.
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.
NewDental Network Content Manager Government Employees Health AssociationDental Network Content ManagerSummit, New JerseyRemoteCollaborate with the dental network team and cross-functional GEHA teams to produce all CDN marketing and administrative collateral required for provider acquisition and ongoing provider administration. While this is a remote opportunity, at this time G.E.H.A does not hire employees from U.S. territories or the following states: Alaska, Hawaii, California, Washington, Oregon, Colorado, Wyoming, Montana, New York, Connecticut, Vermont, Pennsylvania, Maine.
NewComplex Discharge Planner Centene Corporation GroupComplex Discharge PlannerNJRemote$27.02–$48.55 / hourAssists with the facilitation of a smooth transition from the acute care setting to the next level of care and educates members and their families/caregivers on discharge plan to ensure appropriate high-quality transitional care. Assists with providing education to members and their families on discharge plan and utilization processes to ensure high quality appropriate care to members, as applicable.
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.
Pediatric Triage RN - Overnight 9pm - 9am ET Pomelo Care IncPediatric Triage RN - Overnight 9pm - 9am ETNYRemote$78,000–$83,000 / yearWith the increase of remote work and digital hiring, phishing and job scams are on the rise with malicious actors impersonating real employees and sending fake job offers in an effort to collect personal or financial information. Reporting to a Nurse Lead, your key responsibilities will include: Assessment of urgent pediatric concerns and proactively triaging patients to support appropriate utilization of Pomelo Care and/or emergency services.
Remote Care Manager, LTSS (RN) NEW YORK Molina Healthcare IncRemote Care Manager, LTSS (RN) NEW YORKLong Island, NYRemoteAt least 2 years of experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
RN Care Manager – Cardiac SeamlessassistRN Care Manager – CardiacFlorida, FloridaRemoteThis is a full-time, remote, hourly contract position focused on delivering advanced clinical support through clinical triage, care plan development, and high-risk care management, including Transitional Care Management (TCM), Principal Care Management (PCM), Complex Care Management (CCM), Remote Patient Monitoring (RPM), and other applicable clinical programs. CCA is seeking experienced Registered Nurse (RN) Care Managers to support a high-acuity population of patients with complex cardiac conditions, including congestive heart failure (CHF) and other comorbidities.