Medical Review InstituteLos Angeles,CA
Medical Review Institute of America (MRIoA) seeks Board-Certified Dermatologists to perform independent Utilization Reviews. This fully remote independent contractor role requires just 1–2 hours per week with no minimum commitment, working from...
Posted October 20, 2026
Cedars-SinaiBeverly Hills,CA
Job DescriptionJoin Cedars-Sinai Cedars-Sinai has been named to the Honor...
Posted October 26, 2026
Medical Review InstituteLos Angeles,CA
Description Flexible Independent Contractor (1099) Remote Opportunity Required State Medical License in one of the following states: Indiana, Kentucky, Nevada, Oregon, Oklahoma, South Carolina or Texas ABOUT MRIoA Founded in 1983,...
Posted October 20, 2026
Charter GlobalLos Angeles,CA
Job Title: Nurse, Clinical Medical Review Location: Columbia, MD (Primarily remote, but hybrid) Duration: 6 Months Contract PURPOSE: We are seeking a qualified RN or LPN with experience supporting HEDIS reporting and abstraction processes in a...
Posted October 22, 2026
Clinical Management ConsultantsLos Angeles,CA
Bring clinical insight, nursing expertise, and data-driven precision to a Hybrid/Remote Clinical Documentation Improvement Nurse Specialist career that combines meaningful patient impact, supportive leadership, modern healthcare technology,...
Posted October 20, 2026
HCSCLos Angeles,CA
Job Summary This position is responsible for ensuring compliance with Utilization Management (UM) and Quality Review (QR) functions performed by the health plan. The role supports clinical review activities requiring 5+ years of...
Posted October 26, 2026
HonorHealthLos Angeles,CA
HonorHealth is seeking an Utilization Review RN Specialist to review and monitor the utilization of health care services, ensuring medical necessity and appropriate levels of care. You will coordinate reviews for Medicare, AHCCCS, self-pay, and...
Posted October 20, 2026
MercorLos Angeles,CA
About the Role Mercor is hiring experienced Nurse Practitioners to help evaluate and improve cutting-edge AI systems. In this role, you'll evaluate AI-generated clinical content and workflows, leveraging your real-world expertise in...
Posted October 26, 2026
Molina HealthcareLos Angeles,CA
Molina Healthcare is seeking a Care Review Clinician (RN or LPN) for a remote, full-time position operating 8a-5p Pacific Time, Monday through Friday. You will support clinical member services review processes, verify medical necessity, and ensure...
Posted October 20, 2026
Centene CorporationLos Angeles,CA
Centene Corporation is seeking a Licensed Practical Nurse (LPN) or Registered Nurse (RN) for a remote case management role in Pennsylvania. The selected candidate will perform concurrent reviews, determine appropriate care levels, and assist with...
Posted October 20, 2026
START ResearchLos Angeles,CA
START Research's START Center for Cancer Research in Los Angeles is seeking a Clinical Research Coordinator, RN to support early-phase oncology trials. The role involves direct patient interaction, data collection, and ensuring protocol compliance...
Posted October 26, 2026
Ensemble Health PartnersLos Angeles,CA
Ensemble Health Partners is seeking a Virtual Utilization Review Specialist to join our remote team. You will perform medical necessity reviews, manage denials, and coordinate with FCC and care management to optimize patient care while controlling...
Posted October 22, 2026
TEEMALos Angeles,CA
TEEMA is seeking an RN with 3+ years of clinical experience for a remote role in the United States. The position emphasizes medical record review, quality assurance, and collaboration with medical leadership. The role requires strong...
Posted October 20, 2026
TEKsystemsLos Angeles,CA
Job Title: Clinical Quality Assurance Nurse Pay: see below Registered Nurse - $28.50/hr (Non-negotiable) LPN/LVN- $26.50/hr (non-negotiable) Regular Schedule after training: M-F...
Posted October 21, 2026
Sentara HealthLos Angeles,CA
Sentara Health Plans is seeking a Clinical Claims Reviewer/RN for a remote role. This full-time, 40-hour position offers remote work across multiple states and requires RN licensure, BSN, and CPC certification within a year. The role focuses on...
Posted October 20, 2026
Novitas SolutionsLos Angeles,CA
Novitas Solutions, Inc. seeks a Clinical Review Nurse to review and substantiate medical determinations for health claims. You will assess medical necessity, service levels, and appropriateness of care under national and local policies,...
Posted October 20, 2026
4004 Aetna Medicaid AdministratorsLos Angeles,CA
CVS Health is recruiting for an RN Concurrent Review Nurse in a remote capacity, focusing on inpatient clinical expertise to ensure medically necessary care across the continuum. The role requires an active RN license and 5+ years of...
Posted October 17, 2026
HealthHelpLos Angeles,CA
HealthHelp, a WNS company, seeks a Clinical Review Nurse for a fully remote role in the United States. You will perform prospective reviews for medical necessity on prior authorization requests across multiple specialty programs and refer...
Posted October 24, 2026
Virtual VocationsLos Angeles,CA
To support Oregon Medicaid, the full-time Oregon Licensed Utilization Review Clinician will conduct clinical reviews and assessments related to mental health and substance abuse services, ensuring medical appropriateness for both inpatient and...
Posted October 22, 2026
Baptist.orgLos Angeles,CA
Baptist in Meridian, MS seeks a Specialist-Clinical Documentation III RN to evaluate day-to-day documentation practices and advise the clinical team on accurate diagnoses and coding. The role requires five years of acute care experience,...
Posted October 20, 2026
Centene CorporationLos Angeles,CA
Centene is seeking a Clinical Review Nurse - Concurrent Review to perform concurrent reviews, assess medical necessity, and contribute to discharge planning. This role supports Medicaid and Marketplace/Ambetter members in a remote setting.
Posted October 16, 2026
LifePoint HealthLos Angeles,CA
Schedule: Flexible Shifts! You provide your manager with the days and start/end time you are available to complete your hours. All United States time zones are welcome. PRN opportunity to work 20-30hrs per week Job Location Type:...
Posted October 20, 2026
ActalentLos Angeles,CA
Fully Remote: Clinical Documentation SpecialistFacilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical records to...
Posted October 23, 2026
MUSCLos Angeles,CA
The Virtual Nurse, RN at MUSC coordinates and delivers professional clinical, quality, and educational services to patients engaging with MUSC via virtual care. This role reports to leadership within the MUSC Center for Telehealth and aims to...
Posted October 26, 2026
Boston Health Care for the Homeless ProgramLos Angeles,CA
Who We Are: Since 1985, BHCHP's mission has been to provide or assure access to the highest quality health care for all individuals and families experiencing homelessness in greater Boston. We care for over 11,000 homeless individuals each...
Posted October 20, 2026