3 days ago Be among the first 25 applicants This is full-time remote, but candidates must reside in IL or TX Contract: 12/22/2025 to 03/31/2026 RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan . This position is responsible for performing accurate and timely medical review of claims suspended for medical necessity, contract interpretation, pricing; and to initiate and/or respond to correspondence from providers or members concerning medical determinations. Qualifications: Knowledge of accreditation , i.e. URAC , NCQA standards and health insurance legislation . Awareness of claims processes and claims processing systems. PC proficiency to include Microsoft Word and Excel and health insurance databases . Verbal and written communication skills with ability to communicate to physicians, members and providers and compose and explain document findings. Organizational skills and prioritization skills. Registered Nurse (RN) with unrestricted license in state . 3 years clinical experience . #J-18808-Ljbffr
Driven Media Group is actively searching for a quality individual to join their digital media team in a full-time position, and further build out the companys search engine marketing capabilities, strategies, and processes within this department. Below are the key requirements...
...We are hiring immediately for a District Manager position. Location : Bayarea, CA. Schedule : Monday - Friday Pay Range: $145,000.00 - $155,000.00 annually Bonus Eligible We Make Applying Easy! Want to apply to this job via text messaging? Text...
...miles from this facility. Scrub Color: Dark Grey or Navy EMR - EPIC --- mandatory to attend EPIC training ILLINOIS STATE AGENCY LICENSE MUST BE UPLOADED WITH EACH PROFILE This is not the Traveler Nursys - this is a license in YOUR AGENCY NAME from the State...
...Serve with compassion. Be the difference. Job Summary Provides and coordinates nursing care in a non-acute ambulatory, medical office, or urgent care setting in accordance with the State Board of Nursing, Nurse Practice Act, professional standards of care, state...
...Requirements: ~3+ years experience in a Talent Acquisition function, ideally within a global Life Science/STEM recruitment or staffing agency ~ Experience working in highly targeted fast-paced environments, ideally within a fast growth staffing and or start-up...