Search Nursing Jobs

American Traveler is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Glendale, California. Job Description & RequirementsSpecialty:...

Talent4Health is seeking a travel nurse RN Case Management for a travel nursing job in Santa Monica, California. Job Description & RequirementsSpecialty: Case...

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...

Optum is recruiting a remote Behavioral Health Utilization Review Specialist to support case management for behavioral health and substance use. You will review cases, determine levels of care, and coordinate transitions between inpatient and...

Humana Inc. is seeking a Pre-Authorization Nurse to review prior authorization requests, determine medical necessity, and educate providers on utilization management processes. The role requires clinical judgment, independent decision...

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...

Actalent is seeking a Case Management Nurse to deliver client-centered case management across the continuum of care. The role blends direct patient contact with care coordination, education, advocacy and resource navigation to improve outcomes.

JOB DESCRIPTION Job Summary Work Location: California - Ability to work remote, but selected candidate must reside in the state of California. This position requires California RN Licensure. Candidates must...

Responsible for the retrospective review of medical records and compiling data to validate quality of...

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...

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...

A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and...

Be part of a soul-hearted approach to healing Alsana is a national leader in eating disorder treatment, offering a holistic, soul-hearted approach to recovery for adults and adolescents of all genders. We exist to be a source of hope...

Nurse Case ManagerPosition Type: Full-Time Contract RoleLocation: Work from homeWork Type: Remote Est. Pay Range: $35.00/hour – $38.46/Hour on W2 (USD) (all inclusive)Schedule: Mon-Fri 8am-5pm ESTRegistered Nurse with active state license in...

Humana is seeking a Utilization Management Nurse to support coordination, documentation, and communication of medical services and benefit determinations. This role suits experienced nurses who can work independently and make critical patient-care...

Cunningham Children's Home in Urbana, IL is seeking a Nurse Case Manager to join our team supporting youth in emotional, psychological, and physical care. This role involves medical case management, screening, education, counseling, and...

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 levels of care when the patient does not meet the medical...

Elevance Health is seeking a Utilization Management Representative I to coordinate precertification and prior authorization reviews. This full-time role supports calls, post services work, and data entry into the UM system with accuracy and...

CVS Health Corporation seeks an experienced Registered Nurse (RN) to support 24/7 Utilization Management operations. You will review cases, assess medical necessity, coordinate care, and ensure members receive appropriate, high-quality healthcare...

Job Requirements General Summary Under general supervision, conducts internal audits of hospital bills working with external auditors to ensure that uncompensated patient revenues resulting from...

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 experienced RNs to its clinical...

Full-time Company Description WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable,...

Cunningham Children0s Home in Urbana, IL seeks a Nurse Case Manager to support residential programs with medical case management, screening, education, counseling, and medication management, while networking with community health providers. The...

Medlivo is seeking a travel nurse RN Utilization Review for a travel nursing job in Downey, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment...

Trillium Health Resources is seeking a Compliance Nurse to perform clinical compliance reviews and evaluate claims to ensure adherence to regulatory and coverage requirements. The role applies clinical judgment to assess documentation, determine...