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JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Responsibilities: Essential Duties and Responsibilities include the following. Other duties and tasks may be assigned. ...

*Job Summary and Responsibilities* As our surgical services nurse at Glendale Memorial Medical Center you will prepare patients for surgical procedures and assist in the operating room to ensure they receive excellent nursing when they are at...

Remote LPN/LVN – Chronic Care Management (Full‑Time, Work From Home) CARDIOVASCULAR INSTITUTE OF EXCELLENCE PLLC is a dedicated medical practice company headquartered in Wagoner, Oklahoma. With a focus on delivering high‑quality...

Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.00 - $34.00 / hour Department: HS -...

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The Gardens at Cedarwood is seeking an experienced MDS LPN for a full-time remote position based in Franklin, MA. The role offers a remote, fully remote work setting with a salary of $8,200 per month. Responsibilities include completing...

A healthcare solutions provider is seeking a Registered Nurse for Claims & Appeals Review. This remote role supports compliance and quality assurance in appeal reviews. Candidates should have a Bachelor's degree in healthcare and valid RN license...

Remote position, however, candidates must reside in the State of TX or State of IL. This position is a contract for about 9 months. Pay: $41/hour Job Responsibilities: RN working in the insurance or managed...

Part C Grievance & Appeals Nurse Become a part of our caring community The Part C Grievance & Appeals (G&A) Nurse (Utilization Management Nurse 2) utilizes clinical nursing skills to support the coordination, documentation and...

BrightSpring Health Services seeks a part-time Tele-Triage Licensed Practical Nurse (LPN) to provide remote triage and care planning for populations in the assigned locations. Must hold an LPN compact license and have experience in home health or...

Job Summary: The Clinical Nurse Specialist role at Kaiser Permanente Southern California Region is a clinical manager who partners with the operational manager to ensure that nursing staff delivers safe and effective care. The role is built...

ComplexCare Solutions, Inc. is seeking a Clinical Quality Assurance Analyst (RN-BSN required) for a temporary remote role lasting up to one year. The position focuses on auditing and training to support clinical data standards across the...

Mist Registered Nurse (Rn) – Position Summary The Multidisciplinary Inbasket Support Team (MIST) Registered Nurse is a highly skilled ambulatory care nurse who provides comprehensive, remote clinical support to primary care patients and...

Randstad USA is hiring a Licensed Practical Nurse/Licensed Vocational Nurse to support the Commercial Prior Authorization team. This 100% remote, non-patient-facing role processes and communicates prior authorization requests and determinations...

Greenlife Healthcare Staffing is looking for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical studies. With a...

MaziCTools is seeking a Freelance Utilization Management Nurse Consultant to work remotely in the United States. This full-time role requires an active RN licensure and 3+ years of clinical experience. Responsibilities include assessing healthcare...

Job Profile Summary Job Profile Summary This role focuses on providing professional and nonprofessional nursing care services in accordance with physician orders. In addition, this role focuses on performing the following duties:...

Optum is seeking an Inpatient Care Management Nurse to assess and interpret member needs, guiding utilization of health services to improve outcomes. You will collaborate with clinicians, perform case reviews, and support discharge planning from...

Qualifications VA Health Professional Trainees (HPT) pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. A HPT is an individual...

General Information Press space or enter keys to toggle section visibility Work Location: Los Angeles, CA, USA Onsite or Remote Fully On-Site Work...

Overview It's inspiring to work with a company where people truly BELIEVE in what they're doing! When you become part of the Chapters Health Team, you'll realize it's more than a job. It's a mission. We're committed to providing...

Home Infusion Nurse Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the...

Care Coordinator/LPNEmpassion is one of the most impactful and exciting start ups in health care. We are focused on improving the experience and lowering costs for seniors at end of life. Specifically, we provide palliative and hospice care for...

After Hours Service Answer Line Rn The Answer Line After Hours Service provides after-hours exchange and nurse triage services for over 300 subscribing community pediatricians in the St. Louis and surrounding areas. Answer Line RNs...