Clinical Review Nurse - UM & Post-Appeals (RN)
Molina Healthcare of Illinois
Molina Healthcare in Charleston, SC seeks an experienced clinical professional to perform thorough reviews of medical documentation. The role requires strong analytical skills, attention to detail, and the ability to navigate state and federal guidelines effectively. Responsibilities include facilitating medical reviews, validating claims, and training peers. A minimum of 2 years nursing experience is essential, alongside an active RN license. Competitive benefits and compensation are offered. #J-18808-Ljbffr
$29.05 - $67.97 per hour
...Summary Utilizing clinical knowledge and experience... ..., responsible for review of documentation... ...review of appeals for denied prior authorizations... ...2 years clinical nursing experience,... ...Registered Nurse (RN). License must be... ...compensation may vary from posting based on...SuggestedHourly payWork experience placementWork at office$29.05 - $67.97 per hour
...Summary Utilizing clinical knowledge and... ..., responsible for review of documentation to... ...concurrent review of appeals for denied prior authorizations... ...2 years clinical nursing experience,... ...Registered Nurse (RN). License must be... ...may vary from posting based on geographic...SuggestedHourly payWork experience placementWork at office- ...million patient interactions every year, nurses at HCA Healthcare Trident Hospital... ...real impact. As a Behavioral Health Clinical Nurse Coordinator RN you can be a part of change. Benefits... ...! Our Talent Acquisition team is reviewing applications for our Behavioral Health...SuggestedHourly payFull timeTemporary workPart timeRelocation packageFlexible hoursShift work
- ...in their positions. Join our Team as a(an) Neuro Med Surg Clinical Nurse Coordinator RN and access programs to assist with every stage of your career... ...Nurse Coordinator RN opening. Our team will promptly review your application. Highly qualified candidates will be contacted...SuggestedHourly payFull timeTemporary workPart timeFlexible hoursShift work
- ...The Head and Neck Surgical Nurse Coordinator (CNC) ensures exceptional... ...policies. Serving as a clinical resource, the CNC embodies the... ...roles, including circulating RN, surgical technologist, and resource... .... Our team will promptly review your application. Highly qualified...SuggestedTemporary workRelocation packageFlexible hours
- ...SIGN ON BONUS As an Emergency Room Clinical Nurse Coordinator RN, your voice to influence patient care is valued and empowered at every turn... ...Emergency Room Clinical Nurse Coordinator RN opening. We review all applications. Qualified candidates will be contacted by...Hourly payTemporary workRelocation packageFlexible hoursShift work
- ...that reduces opioid prescriptions and post-surgical readmissions. As a national... ...care delivery, advancing clinical outcomes, and empowering our nursing teams in a collaborative effort to give... ...Associate Degree in Nursing or RN Diploma Bachelor's Degree in Nursing...Hourly payTemporary workRelocation packageFlexible hoursShift work
- ...Introduction Do you want to be appreciated daily? Our nurses are celebrated for being on the front line, empathetic for... ...healthcare provider. We are seeking a(an) Medical Surgical Clinical Nurse Coordinator RN to join our healthcare family. Benefits HCA Healthcare...Hourly payFull timeTemporary workPart timeRelocation packageFlexible hoursShift work
$1,909 - $2,194 per week
...Registered Nurse (RN) | Cardiac Catheterization Lab Location: Charleston... ...the support of a dedicated clinical team. Required... ...interventions, and monitors immediate post-procedure recovery. Working... ...to procedures, including reviewing medical history and performing...Full timeContract workTemporary workImmediate startShift work$2,069 per week
...Registered Nurse (RN) | Cardiac Catheterization Lab Location: Charleston, SC Agency: Atlas MedStaff Pay: $2,069 per week... ...Great Recruiters. Both of those recognitions are fueled by real reviews by real travel nurses and allied healthcare professionals that...Hourly payFull timeContract workWork at officeRemote workShift workWeekend work$1,909 - $2,194 per week
...Registered Nurse (RN) | Cardiac Catheterization Lab Location: Charleston... ...the support of a dedicated clinical team. Required... ...interventions, and monitors immediate post-procedure recovery. Working... ...to procedures, including reviewing medical history and performing...Full timeContract workTemporary workImmediate startShift work$2,032 - $2,185 per week
...Registered Nurse (RN) | Cardiac Catheterization Lab Location: Charleston, SC Agency... ...Satisfaction by MIT Sloan Management Review. No matter if you want to explore the... ...matching after 6 months · 24/7 support · Clinical support throughout your assignment 299...Full timeContract workLocal areaImmediate startShift work$1,984 - $2,137 per week
...Registered Nurse (RN) | Cardiac Catheterization Lab Location: Charleston, SC Agency... ...Satisfaction by MIT Sloan Management Review. No matter if you want to explore the... ...matching after 6 months · 24/7 support · Clinical support throughout your assignment 279...Full timeLocal areaImmediate start$43.69 - $67.72 per hour
...offered is determined by a candidate's expertise and years of experience, among other factors. Position Highlights Position: RN Clinical Nurse Practice Specialist supporting OB services (Labor & Delivery, Postpartum, Antepartum) Location: Elmhurst Hospital, Elmhurst, IL...Hourly payFull timeMonday to FridayShift work$1,698 per week
...Registered Nurse (RN) | Operating Room Location: Charleston, SC Agency: Magnet Medical... ...care plans. Verify surgical consent, review medications, and prepare patients physically... ...and Monitoring: Transfer patients to post-anesthesia care units (PACUs) or recovery...Full timeContract workFlexible hoursShift work$2,380 per week
...Registered Nurse (RN) | Cardiovascular Operating Room Location: Charleston, SC Agency... ...Assess patients prior to surgery by reviewing medical histories, allergies, and current... ...the patient for signs of complications post-surgery, such as bleeding, infection, or...Full timeContract workImmediate startShift work- ...behavioral health utilization reviews, applying evidence-... ...physicians to ensure clinically appropriate, cost-... ...CMS). Participates in UM quality audits, internal... ...Psychiatric-Mental Health Nursing from an accredited program... ...may vary from posting based on geographic location...Hourly payWork experience placement
- ...application for the opportunity below: Clinical Nurse Coordinator for the Preop/PACU at Trident... ...within 30 days of employment start date ~(RN) Registered Nurse ~ Registered Nurse... ...- Preop PACU opening. We promptly review all applications. Highly qualified candidates...Hourly payTemporary workFlexible hoursShift work
- ...their consumer rights. Qualifications Bachelor of Nursing degree preferred with minimum of one year of experience. RN staff hired on or after July 1, 2013 with an... ...One year of case management and/or utilization review work experience preferred. Case Management certification...Work experience placement
- ...Registered Nurse (RN) Care Manager Role Summary Seeking a compassionate and experienced Registered... ...to coordinate and deliver care across clinical, home, and community settings. Duties •... ...improvement initiatives, utilization reviews, and interdisciplinary communication. •...Flexible hours
$1,515 - $1,749 per week
...Registered Nurse (RN) | Orthopedics Location: Charleston, SC Agency: National Staffing Solutions Pay: $1,515 to $1,749 per week Shift Information: Days - 5 days x 8 hours Contract Duration: 13 Weeks Start Date: 6/15/2026 About the Position...Full timeContract workTemporary workShift work$1,515 - $1,749 per week
...Registered Nurse (RN) | Orthopedics Location: Charleston, SC Agency: National Staffing Solutions Pay: $1,515 to $1,749 per week Shift Information: Days - 5 days x 8 hours Contract Duration: 13 Weeks Start Date: 6/15/2026 About the Position...Full timeContract workTemporary workShift work- ...million patient interactions every year, nurses at HCA Healthcare Trident Hospital... ...real impact. As a Behavioral Health Clinical Nurse Coordinator RN you can be a part of change. BenefitsHCA... ...! Our Talent Acquisition team is reviewing applications for our Behavioral Health...Hourly payFull timeTemporary workPart timeFlexible hoursShift work
- ...that reduces opioid prescriptions and post-surgical readmissions. As a national... ...care delivery, advancing clinical outcomes, and empowering our nursing teams in a collaborative effort to give... ...Associate Degree in Nursing or RN Diploma Bachelor's Degree in Nursing...Hourly payTemporary workRelocation packageFlexible hoursShift work
- ...program reduces opioid prescriptions and post‑surgical readmissions. As a national... ...care delivery, advancing clinical outcomes, and empowering our nursing teams to give people a healthier tomorrow... ...Qualifications Associate Degree in Nursing or RN Diploma Bachelor’s Degree in Nursing...Hourly payTemporary workRelocation packageFlexible hoursShift work
$90k
...Requisition Number: ASSIS003297 Posted : May 11, 2026 Full-... .../Assisted Living Nurse Manager: The RCD establishes... ...care environments. RN license in good... ...Ensures that significant clinical developments of residents... ...further information, please review the Know Your Rights...Full timeWork at officeLocal areaShift workNight shiftWeekend work$2,332 per week
...Travel Nurses, Inc. is seeking a travel nurse RN CVOR for a travel nursing job in Charleston, South Carolina.... ...South Carolina? Travel Nurses, Inc. posted this Travel Nursing Job that offers... ...CVOR Salary information and unbiased reviews from leading Travel Nurse Agencies...Weekly payShift work$2,426 per week
...Health Advocates Network - Nursing is seeking a travel nurse RN CVOR for a travel nursing job in Charleston,... ...Health Advocates Network - Nursing posted this Travel Nursing Job that offers... ...CVOR Salary information and unbiased reviews from leading Travel Nurse Agencies...Daily paidLong term contractTemporary workLocal areaImmediate startFlexible hoursShift work- HCA Healthcare is seeking a James Island ER Clinical Nurse Coordinator RN to join our Healthcare & Medical Services team and support high-quality,... ...quality improvement projects, participating in performance reviews and incident follow-up, and ensuring compliance with...
- ...Gifted Healthcare is an award-winning travel nursing agency that offers nursing contracts at... ...survivorship to end-of-life care. Oncology RNs review health history and keep track of... ...pathology, and imaging studies. Oncology RN job responsibilities include, but are not...Hourly payWeekly payTemporary workReliefLocal areaShift work
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