Location: Fully remote (PA RN License or Compact including PA Required), Must Reside in PA, NJ, or DE Employment type: Contract to full-time hire Position Overview: We are seeking a skilled and detail-oriented Utilization Review RN with a valid PA license (or Compact)to join our team. This position is ideal for an RN with prior work in insurance utilization review. Key Responsibilities: Conduct clinical reviews to determine medical necessity and appropriateness of care Apply evidence-based criteria to assess patient treatment plans and services Collaborate with healthcare providers and insurance partners to ensure efficient, quality patient care Document review findings accurately and in a timely manner Maintain compliance with internal and external regulatory standards Required Qualifications: Active and unrestricted PA RN license (or Compact license including PA) 2-5+ years ofprior experience in insurance utilization review Strong clinical judgment and knowledge of hospital workflows Proficient in using clinical review tools and electronic health records Familiarity with InterQual or Milliman criteria. #J-18808-Ljbffr
...Corporate Communications Intern New York, New York, United States Smartly is looking for a Corporate Communications Intern to join our Marketing team for Fall 2026. This role sits at the center of how Smartly shows up, internally and externally, and offers hands...
...Australia and distributing nationally across the US. The Logistics Coordinator supports the Domestic Distribution and Logistics... ...the day-to-day movement of LWX product across the domestic and international supply chain. As part of a small, collaborative logistics team...
Description You have what it takes: a competitive drive coupled with exceptional sales ability. In this role, you will be responsible for implementing the sales plan by delivering proficient sales presentations to a defined list of current and prospective...
...Church with world-class, pastoral leadership formation and consulting services that strengthen their confidence and competence in ministry, enabling them to articulate a vision for their local church, to call forth the gifts of those they lead, and to create more vibrant...
Join Veyo in revolutionizing the logistics of medical transportation. As a Part-Time Driver with Veyo, you will be at the forefront of our... ...improve patient outcomes by ensuring reliable and efficient non-emergency medical transport. Your role involves driving patients to...