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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...

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...

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...

Get AI-powered advice on this job and more exclusive features. This range is provided by Medix. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $37.00/hr...

Northwell Health in New York is seeking a Registered Nurse to perform age-specific care using the nursing process. You will assess physiologic and psychosocial health, develop and implement care plans, and coordinate with physicians and the health...

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...

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...

RN opportunity with out the bedside burnout + sign on bonus. This Jobot Job is hosted by: Dexter Dionio Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $80,000 -...

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...

Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations. The role involves collaborating with medical leadership, reviewing cases for appropriate treatments,...

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...

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...

Abbott is seeking a per-diem RN trainer in the Durham, NC area to deliver Face-2-Face training for home testing customers. You will guide finger stick collection, explain PT/INR device use, and assist with reporting responsibilities. The...

JOB DESCRIPTION Must reside in Florida Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established...

Overview Detailed review, analysis and extraction of clinical information from patient medical records and drafting of effective narratives for Medicare and Medicaid appeals documentation and briefs in support of denied cases under appeal...

Kaiser Permanente in Washington state offers a remote Registered Nurse position serving a defined patient group, adhering to KFHPW nursing standards and ethics. The RN collaborates with the care team to assess patients, develop and implement care...

Find your calling at Mercy! Overview Provides professional nursing care to patients within the medical practice in support of, and as directed by, the physicians. Assists the physician in the treatment of patients and completes...

Job Title: Remote Prior Authorization Registered NurseJob Description We are seeking experienced Registered Nurses (RNs) to join a remote Prior Authorization team supporting Dual Eligible (Medicare and Medicaid) populations. In...

Providence Home Services Oregon is seeking a Clinical Documentation Specialist, Registered Nurse (RN) for a full-time, day-shift remote role open to multiple states. You will review OASIS admission documents and Plans of Care to ensure CMS...

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...

CVS Health is seeking an ICM Care Manager to assess, plan and coordinate patient care from a home-based setting with 25-50% travel within Passaic County, NJ. The role requires an active NJ RN license and a minimum of 3 years clinical experience,...

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 Summary and Responsibilities* As our Registered Nurse (RN), you will be a pivotal healthcare professional, delivering compassionate, high-quality care that truly impacts our patients' well-being and recovery. Every day, you will...

Sedgwick is seeking an RN Telephonic Case Manager to manage medical recovery and return-to-work coordination for injured workers. This US telecommuter role invites candidates nationwide, with emphasis on strong clinical assessment and advocacy via...

Overview Utilization Management for the assigned inpatient Care Management population. This position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial...