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Stanford Health Care in Palo Alto is seeking an Oncology Nurse Navigator to coordinate care from diagnosis through survivorship. As a licensed RN with oncology experience, you will partner with physicians, social workers, nutritionists, and...

Qlarant, a nonprofit organization, seeks a Nurse Specialist II to perform medical record and claims review for Medicare, Medicaid, and other data. This remote role in the United States involves ensuring adherence to guidelines while assessing for...

Parenteral Services Clinical RN Specialist The Parenteral Services Clinical RN Specialist provides clinical support to the Parenteral Services team through advanced nursing expertise, education, care coordination, and operational...

Join Cedars-Sinai Cedars-Sinai has been named to the Honor Roll for the ninth consecutive year and tied for #1 in California and Los Angeles in U.S. News & World Report's "Best Hospitals 2024-25" rankings, as well as placed among the very...

The Ohio State University is seeking a Staff Nurse (RN) for Oncology Continuing Care Triage. This remote phone triage role handles oncology patient calls, performs initial assessments, and uses triage algorithms to guide care. The nurse documents...

Responsibilities SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

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...

Exceptional care starts with exceptional people. For us, this is more than a job– it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you...

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...

SCHOOL NURSE Published Date: Jul 7, 2026 Location: US Company: Los Angeles Unified School District SALARY DETAILS All Salary Tables located at School Nurse Salary Table - N Table APPLICATION FILING DATES...

Clinical Documentation Improvement Specialist-RN- Remote The Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) assists with the identification of diagnoses, conditions, and procedures that are representative of the...

Job DescriptionJob Summary Provides support for clinical facility site reviews. Under the supervision of leadership, uses clinical judgement within appropriate scope to independently conduct reviews and other monitoring activities...

Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's benefit coverage. Provides...

The Health Specialist role is to provide advanced and accurate clinical inquiry responses to health related, disease control and prevention issues, including questions related to bioterrorism, first responders and national emergency situations...

Physicians East seeks a QEC Pre Procedure Screening Nurse for a part-time remote role based in Greenville, NC. The nurse will review patient charts, screen for procedural eligibility, and coordinate with physicians to ensure proper evaluation and...

HonorHealth in Arizona is seeking a Clinical Data Abstractor II to abstract and audit complex clinical records for registries, ensuring compliance with care standards and accreditation requirements. This remote position requires Arizona residency.

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...

Trinity Health is seeking a Night Shift RN Utilization Review in Grand Rapids, MI, offering full-time work with remote options. You will review assigned cases against criteria and payor guidelines to ensure proper reimbursement and medical...

Virtua Health is seeking a remote RN to support the application of medical necessity tools, ensuring compliance and achieving positive patient outcomes. You will collaborate with Physician Advisors, manage denials, and document review activities...

Immunization RN- Vaccination Our client, a retail pharmacy company, is looking for an Immunization RN- Vaccination for their remote location. Responsibilities Lead with heart – display empathy and compassion for...

Job Summary and Responsibilities As our Utilization Review RN, you will meticulously review medical records to confirm appropriate admission status and continued hospitalization, utilizing established criteria and critical...

Registered Nurses Mon-Fri Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think...

Mass General Brigham Health Plan Holding Company, Inc. seeks a Nurse for utilization review to assess medical necessity and benefit coverage for ACO/HMO/EPO members. Remote with occasional on-site team meetings in Somerville, MA. Strong...

Humana is seeking a skilled Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations for post-acute care such as SNF, Home Health, and DME. You will report to the Manager of Utilization...

AmeriPharma is seeking a Parenteral Services Clinical RN Specialist to provide advanced nursing expertise, care coordination, education, and operational collaboration. The role supports nurses, pharmacists, dietitians, and care coordinators to...