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*NURSING AT CHILDREN'S HOSPITAL LOS ANGELES* As a nurse, you approach care with energy and resolve. When you join us, you'll find the perfect environment to develop your nursing career. We stop at nothing to make sure that every patient we see...

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*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...

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 health care professional, delivering compassionate, high-quality care that truly impacts our patients' well-being and recovery. Every day, you will...

Supports the values of service excellence, teamwork, and integrity while managing patient care.Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers.Qualifications:Requires a current RN license, nursing diploma or...

Humana is seeking a Pre-Authorization Nurse for remote work to review prior authorization requests and determine appropriate care following guidelines. The role involves clinical judgment, data entry in management systems, and collaboration with...

Dialysis experience required Western Regional Float, MULTI-STATE travel required PURPOSE AND SCOPE: The professional...

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University Hospitals is seeking a Registered Nurse to collaborate with the health care team to coordinate admissions, continued stays, and level-of-care decisions. You will communicate with patients and families to ensure timely care and proper...

Saint Joseph Health System is seeking an RN Utilization Review specialist for a part-time, remote PRN role that requires on-site training in Mishawaka, Indiana. The position emphasizes reviewing medical necessity, insurance requirements, and...

Registered Nurse Navigator - Cancer Center Exams - 10 Hour Days Do you have a passion for the highest clinical quality and patient happiness? Would you like to use your expert clinical competencies with an organization known nationally...

*Job Summary and Responsibilities* As our surgical services nurse at Glendale Memorial Medical Center you will prepare patients for surgical procedures and assist in the operating room to ensure they receive excellent nursing when they are at...

Humana is seeking a Pre-Authorization Nurse to review requests for medical necessity and level of care, working remotely from Virginia or a compact-licensed state. You will educate providers, document clinical data, and make independent...

CVS Health Corporation is seeking a RN-qualified professional to lead quality improvement initiatives and performance measurement within POSC, aiming to meet HEDIS and CAHPS goals. The role involves analyzing clinical workflows, implementing...

Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET Medix is supporting a healthcare technology organization that is adding...

Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make...

Responsibilities: How you'll change lives ...

JOB DESCRIPTION - REGISTERED NURSE (A) Job Summary: The Registered Nurse provides patient care on a supplemental basis to our client facilities. With the delivery of safe, quality patient care as...

Case Manager, RN WelbeHealth PACE helps seniors stay in their homes and communities by providing comprehensive medical care and community-based services. We serve the most vulnerable seniors with better quality and compassion in a...

Nurse Navigator - Cancer Center Exams - 10 Hour Days Beverly Hills, CA, United States Job Description Do you have a passion for the highest clinical quality and patient happiness? Would you like to use your expert clinical...

As a Clinical Documentation Review Specialist (RN), you will help medical staff clarify patient records to ensure appropriate reimbursement and reflect care complexity. You will perform concurrent reviews and engage with physicians...

Case Manager Utilization RN, 32 Day Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate...

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...

ExamWorks is seeking a self-driven RN or LPN to join our team as a Clinical Quality Assurance Coordinator. This 100% remote role supports peer review reports, ensuring high quality, evidence-based rationales, and compliance with client...