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Responsibilities: How you'll change lives...

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...

Nursing Assistant PositionUnder the direction of a Registered or Licensed Vocational Nurse, provides basic nursing care and implements selected aspects of the patients nursing plan of care.This position requires providing care/service to an...

Responsibilities: How you'll change lives...

Santa Barbara Cottage Hospital is seeking a licensed practical nurse to join BHPS Utilization Management as a remote reviewer of medical necessity and benefit determinations. You will assess cases using clinical guidelines and coordinate with...

Are you a person who believes in providing great care? Do you believe in having a positive impact on other people's lives? Are you a team-player, quick-thinker, and ready to be a part of an organization that supports your...

Nexus Health Systems is seeking a seasoned Utilization Review Registered Nurse (UR RN) for a fully remote role in the US. The ideal candidate will have experience in utilization review, case management, or behavioral health, and will ensure...

CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full-time position open to MST/PST residents. You will coordinate and document utilization and benefit management activities, ensuring timely,...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing, and evaluating the care of patients. The staff RN utilizes the nursing process by use of...

Centene is seeking a licensed Practical Nurse or Registered Nurse for a remote utilization management role based in Oklahoma. You will review prior authorization requests for medical necessity and coordinate with medical teams to ensure...

Job description California Post Acute is a premier healthcare facility dedicated to providing exceptional care to our residents and patients. Our commitment to excellence, compassionate care, and innovative practices sets us apart as a...

We are so glad you are interested in joining Sutter Health! Position Overview: Aids patients in obtaining the correct level of care with the appropriate provider at the right time. Provides advance clinical telephone...

Job Description Part and Full-time roles are eligible for a $30,000 sign-on bonus — apply today to learn more! Varied scheduling options are available, including 8-hour, 10-hour, and 12-hour shifts, as...

Registered Nurse - Primary Care Location: Long Beach, CA Schedule: Monday-Friday, 8:00 AM-5:00 PM Setting: Onsite Position Summary We are seeking an...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse. The Utilization Review Nurse is...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: The Virtual Mental Health Intake RN is a Registered Nurse who provides competent and...

Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant...

St. Louis Children's Hospital is seeking an RN for after-hours triage and nursing support via the Answer Line. The role involves assessing patient needs, guiding care plans, and educating families within established guidelines. Part-time...

Description The Nurse Navigator is a professional Registered Nurse who assumes responsibility and accountability for a group of patients for a designated time frame and provides care to these patients using the nursing...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This is a hybrid remote position with occasional float in-person at our Mount Auburn Primary Care offices in...

A national healthcare recruiting firm is seeking remote workers fluent in Spanish for a role supporting HEDIS project management. Responsibilities include coordinating the collection and abstraction of medical records, participating in vendor...

Healthy Brain Clinic in Long Beach is part of the Irvine Clinical Research site network, the largest of its kind on the West Coast. With 5 research centers in California, we are leaders in the search for new treatments in neurology, psychiatry,...

Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information...

California residency required. Job Summary Leads and supervises a multidisciplinary team of healthcare services professionals in some or all of the following functions: care management,...

Job Title: Clinical Review Nurse (Remote) Position Summary: We are seeking a detail-oriented and clinically skilled Clinical Review Nurse to join our team in a fully remote role. The Clinical Review Nurse is responsible for conducting...