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We believe everyone should have confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care...

A leading healthcare company is seeking a Utilization Management Nurse 2 to provide care coordination and clinical oversight. The ideal candidate will have a Registered Nurse license and 3-5 years of relevant experience in critical care or...

Job Description Critical Care Virtual Registered Nurse - located in Big Flats, NY! This position is per diem night shift. Position Details: The Virtual Critical Care Registered Nurse works from the...

Remote Clinical Review Nurse - Prior Authorization Location: Must be located in Central or Eastern time zones Employment Type: Full-Time About the Role We are seeking an experienced Registered Nurse to join our team within...

A leading health organization is seeking a Utilization Review Nurse to manage inpatient care efficiently. In this role, you will be responsible for reviewing admission criteria and ensuring high-quality patient care. The position offers...

JOB DESCRIPTION Job Summary Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically...

About the job RN - Hybrid Critical Care SUMMARY: As a registered nurse, you are expected to consistently deliver the best in care and customer service and demonstrate respect, dignity, kindness and empathy in each...

A healthcare company is hiring a Utilization Review Nurse, RN, in California. This role involves managing inpatient utilization efficiently by reviewing admissions, applying medical necessity criteria, and collaborating with healthcare teams.

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to...

Job Summary: The Clinical Nurse Specialist is an advanced practice nurse who functions in the role of expert clinician, educator, leader, consultant and researcher. In collaboration with the healthcare team, the CNS...

Description As an RN Care Manager, you will function as a clinician, advocate, and educator to achieve optimal clinical and quality outcomes by effectively managing care and resources to reduce unnecessary utilization. The RN Care Manager...

Site: Mass General Brigham Home Care, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The...

A healthcare organization is seeking skilled nursing professionals to provide remote consultative and supportive care to Intensive Care Units (ICU) utilizing advanced technology. This role requires collaboration with ICU teams to monitor patient...

A health insurance company is seeking a Prior Authorization RN to review requests for health services and ensure compliance with Medicare and Medicaid guidelines. This remote role involves clinical decision-making and documentation for...

Facility: CoxHealth South: 3801 S National Ave, Springfield, Missouri, United States of America, 65807 Department: 1651 Virtual Care Command Center Scheduled Weekly Hours: 24 Hours:...

Registered Nurses are encouraged to consider a part-time remote Nurse Reviewer position with Liberty Healthcare Corporation. Liberty Healthcare operates a statewide program in Idaho which assesses children and adults who are living with...

The Ohio State University Wexner Medical Center's mission is to improve health in Ohio and across the world through innovation in research, education, and patient care. The team provides patient care and supportive services directed towards...

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic...

$40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical...

American Traveler is seeking a travel nurse RN ICU - Intensive Care Unit Med Surg for a travel nursing job in Columbus, Ohio. Job Description & RequirementsSpecialty: ICU -...

Description RN Utilization Review at Irvine, CA. This position is Part- time and will work Remote 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our...

A healthcare organization in Washington, DC, is seeking a qualified nurse for clinical review and care coordination. This role requires evaluating medical services and ensuring effective patient care while maintaining communication with various...

A leading pharmacy company is seeking a Clinical Outcomes Quality Assurance Nurse to ensure the quality of documentation and implement clinical best practices. Responsibilities include managing outcomes forms and communicating with patients and...