Search Nursing Jobs

Molina Healthcare is seeking a Medical Review Nurse (RN) to review documentation for medical necessity and appropriate levels of care, using clinical knowledge and utilization review expertise. This remote US role offers a full-time schedule.

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...

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...

Position Title: Remote Telephonic RN Case Manager Mandatory Requirement: Must hold an Active Compact RN License and/or an Active California (CA) RN License to be considered. Pay Rate: $48.00 – $50.00 per hour...

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...

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...

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...

Amerit Consulting is seeking an experienced Utilization Management Nurse (RN) in California for a remote 6-month contract. The incumbent will support inpatient utilization review, medical necessity determinations, and facility claims compliance,...

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...

Spectraforce Technologies, Inc. is seeking a Clinical Review Nurse - Prior Authorization for a 12-month assignment. The role is remote (PST/CST) with scheduling across multiple shifts, supporting national guidelines and contractual requirements.

Molina Healthcare is hiring a remote RN Care Manager. Preference for candidates in Washington State. This role will be working Pacific Standard Time hours. This role supports Medicare members through telephonic case management and...

Ochsner Health, a leading not-for-profit healthcare provider in the Gulf South, seeks an experienced RN for a remote case management role. You will coordinate care by liaising with patients, caregivers, multidisciplinary teams, and payers to...

Freeman Health System is hiring for a remote/hybrid position in Utilization Review and Case Management. The role focuses on assisting Emergency Department patients with their social and discharge needs. Candidates must be licensed RNs with strong...

Optum is seeking a remote IRR Clinical Claim Review Nurse to perform clinical review of claims against medical records and guidelines. The role requires an active RN license, 2+ years of acute care clinical experience, and 1+ year in claim review...

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...

Program Integrity Clinical Compliance AuditorOptum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers.

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...

Medix is seeking a Remote Utilization Review Registered Nurse (UR RN) to bridge clinical care and hospital operations from a remote setting. Join a team optimizing patient care while safeguarding revenue integrity, with a compressed 4-day week,...

About the job Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark , General Catalyst , Peter Thiel , Adam D'Angelo , Larry Summers , and Jack Dorsey .

Managed Medical Review Organization seeks a licensed RN for a home-office, remote role focused on telephonic customer service and clinical documentation. The position emphasizes quality review, case management, and adherence to policy, with...

Baptist Health in Jacksonville, FL, is seeking a Registered Nurse for its Hospital At Home program. You will educate patients and families, advocate for patient needs, and coordinate care across medical and nursing teams in a home-based setting.

HonorHealth is seeking an experienced Utilization Review RN Specialist for a remote-capable role serving the greater Phoenix area. The position focuses on reviewing medical necessity and coordinating reviews for diverse payers, ensuring...

Ethos Risk Services is seeking a full-time Clinical Recruiter (REMOTE) to lead hiring for the Case Management division. You will own full-cycle recruiting for nurse case managers and other clinical pros, from posting to onboarding, ensuring a...

Sentara Health is hiring a part-time Registered Nurse for a Physician Practice in a remote role. The RN will provide outpatient nursing care, triage, education, and care coordination in a physician practice or ambulatory clinic setting.

Essentia Health Moose Lake Clinic is seeking a licensed registered nurse for the Family Practice team. The role emphasizes primary care, triage, and coordination of care for individuals, families, and communities in outpatient settings.