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Prime Staffing is seeking a travel nurse RN Research / Clinical Research for a travel nursing job in Fullerton, California. Job Description & RequirementsSpecialty:...

Trustaff is seeking a travel nurse RN Clinic for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: ClinicDiscipline:...

Resp & Qualifications We are looking for an experienced professional to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for...

Army Public Health Nurse Job Overview As an Army Public Health Nurse, you'll assess health risks and implement programs to monitor the spread of disease. You'll promote wellness for Soldiers and their families while also informing policy and...

Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in accordance with established standards of care, policies, and procedures. Demonstrates performance consistent...

Nurse Appeals Location: Nashville Tennessee (This role is open only to residents of Tennessee). Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum...

Ensemble Health Partners is seeking an experienced RN for Utilization Review to assess medical necessity and optimize hospital and patient care. This remote role involves coordinating with the FCC, care management, and interdisciplinary teams to...

Clinical Review Nurse - Prior Authorization Various, NV Clinical Review Nurse - Prior Authorization Various, NV All On-site Location: Fully Remote – Prefer Candidates reside in NV, but can reside elsewhere if they...

Bestica is seeking a travel nurse RN Research / Clinical Research for a travel nursing job in Fullerton, California. Job Description & RequirementsSpecialty: Research /...

Inland Empire Health Plan in California seeks an LVN-validated Claims Review Nurse to audit medical necessity across inpatient and outpatient claims and support the UM/Claims interface. You will analyze records, determine authorization needs, and...

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...

HealthHelp, a WNS company, seeks a Clinical Review Nurse for a fully remote role in the United States. You will perform prospective reviews for medical necessity on prior authorization requests across multiple specialty programs and refer...

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 in...

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...

Job Title: Clinical Quality Assurance Nurse Pay: see below Registered Nurse - $28.50/hr (Non-negotiable) LPN/LVN- $26.50/hr (non-negotiable) Regular Schedule after training: M-F...

Schedule: Flexible Shifts! You provide your manager with the days and start/end time you are available to complete your hours. All United States time zones are welcome. PRN opportunity to work 20-30hrs per week Job Location Type:...

Army Public Health Nurse Job Overview As an Army Public Health Nurse, you'll assess health risks and implement programs to monitor the spread of disease. You'll promote wellness for Soldiers and their families while also informing policy and...

TalentBurst, Inc is seeking a travel nurse RN Research / Clinical Research for a travel nursing job in Fullerton, California. Job Description & RequirementsSpecialty:...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

HonorHealth is seeking an Utilization Review RN Specialist to review and monitor the utilization of health care services, ensuring medical necessity and appropriate levels of care. You will coordinate reviews for Medicare, AHCCCS, self-pay, 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...

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...

Location United States of America-USAUS Job Description Are you interested in joining a team of experienced healthcare experts and have the ability to shape and transform the healthcare delivery system? At our family of...

Netsmart is seeking a registered nurse to perform utilization review for emergency department admissions and ongoing stay reviews. You will evaluate EMRs, apply InterQual/MCG criteria, and collaborate with ED physicians to determine admission...

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...