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Care Career is seeking a local contract nurse RN Case Manager, Utilization Review for a local contract nursing job in Torrance, California. Job Description &...

Stability Healthcare is seeking a local contract nurse RN Infusion for a local contract nursing job in Santa Monica, California. Job Description & RequirementsSpecialty:...

Care Career is seeking a travel nurse RN Case Management for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: Case...

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...

AHS Staffing is seeking a local contract nurse RN Clinic Director of Nursing for a local contract nursing job in Northridge, California. Job Description &...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. **This position is remote. Candidates must be local to New England States for consideration** The Clinical...

iMPROve Health seeks an RN Reviewer (Workers' Compensation Utilization Review) to perform independent external medical reviews remotely as an independent contractor (1099). The reviewer applies clinical expertise to evaluate cases, ensuring...

Job Description: The Nurse Clinical Leader provides leadership and clinical expertise during their shift and within their department. They manage unit resources and supervise personnel to ensure appropriate staffing levels based on the unique...

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...

Staffmark Group is recruiting a Registered Nurse for a remote role. Primary duties include reviewing peer review reports, ensuring evidence-based rationales, and ensuring compliance with client, contract, and regulatory standards. The ideal...

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UnitedHealth Group is seeking a Utilization Review Nurse, RN to perform inpatient utilization management in California. The role involves reviewing inpatient criteria, preauthorizations, and ensuring medical necessity while applying evidence-based...

Optum is seeking a Utilization Review Nurse, RN, to lead inpatient utilization management, applying evidence-based guidelines and criteria to determine medical necessity for admissions and authorizations. The role requires 3+ years of...

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...

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: Functions as part of the...

CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full-time position open to MST/PST residents. You will coordinate and document utilization and benefit management activities, ensuring timely,...

Overview TEEMA is partnering with a leading organization supporting a large-scale federal healthcare program to identify a Clinical Quality Reviewer. This role focuses on reviewing clinical cases, identifying potential quality or safety...

Provides direct nursing care including assessment, plan of care, education, and evaluation for assigned patients. Performs patient duties necessary to maintain the...

Humana is seeking a Utilization Management Nurse 2 to apply clinical nursing skills in coordinating, documenting and communicating medical services and benefit determinations. This remote role may require occasional travel to Humana's offices for...

UnitedHealth Group is seeking an experienced Utilization Management Nurse to ensure efficient and effective health services administration. The role involves assessing member needs, interpreting guidelines, and recommending appropriate care levels...

A health care organization is seeking a Clinical Documentation Improvement Specialist (RN) to enhance the accuracy and quality of patient documentation. The ideal candidate will have experience in clinical nursing and a strong ability to work with...

Harris Health is seeking a Nurse Manager to oversee operations and care delivery for one or more clinics or units. You will manage human resources, quality, and financial aspects while aligning with nursing leadership and professional practice...

Illingworth Research Group is seeking a Per Diem Freelance Research Nurse to support patients in clinical studies by coordinating care and liaising with healthcare providers. The role involves guiding participants through study protocols,...

Qualifications Basic Requirements: English Language Proficiency In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English Graduate of a school of...

To support client care authorization processes, the full-time Clinical Letter Writer will gather and review medical records, draft letters of medical necessity, and communicate with team members regarding client authorizations and recertifications...