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Appeals Nurse Consultant (Remote), CVS Health

AI Summary: CVS Aetna seeks a remote Appeals Nurse Consultant to review and resolve clinical appeals, ensuring compliance with regulatory standards. Candidates must possess an active RN license and 3+ years of clinical experience, with preferred qualifications including appeals or utilization review experience.

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Compliance UM Nurse (Wed – Sun), Humana

AI Summary: The Compliance Nurse 2 at Humana will ensure utilization management activities meet policies and detect fraud. A licensed RN with 3+ years in UM or related fields is required, and the role offers a four-day workweek with a focus on compliance analysis and independent decision-making.

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Appeals Nurse, IMCS Group

AI Summary: IMCS Group is looking for a remote Appeals Nurse to manage Medicaid member appeals, ensuring adherence to clinical guidelines. Candidates should have an LPN or RN license and at least 2 years of nursing experience, with a focus on case reviews and communication.

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Urgently Hiring: Remote Nursing Coordinator, remote click jobs

AI Summary: Join a leading company as a Remote Nursing Coordinator, managing patient care needs and coordinating with healthcare providers. Applicants require an RN license and a minimum of 2 years in nursing, with strong organizational skills needed for this full-time role.

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Remote Overnight Nurse: Chronic Disease Care & Triage, Cadence

AI Summary: Cadence is hiring a Registered Nurse for overnight monitoring and triage of patients with chronic diseases. Candidates should have expertise in CHF, hypertension, and diabetes care, with responsibilities including documenting care and managing treatment plans in a remote role.

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