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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...

MaziCTools is seeking a Freelance Utilization Management Nurse Consultant to work remotely in the United States. This full-time role requires an active RN licensure and 3+ years of clinical experience. Responsibilities include assessing healthcare...

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,...

Santa Barbara Cottage Hospital is seeking an experienced Utilization Management Nurse Consultant for a remote role with the Spine Team. You will review spine-related authorizations, apply criteria, and collaborate with providers and Medical...

To ensure the highest quality and integrity of peer review case reports, the full-time Remote RN Clinical QA Coordinator will perform quality assurance reviews, verify compliance with client specifications and regulatory standards, and support the...

Back Medical Claim Review Nurse | Remote | Washington | Contract Business & Care Management Long Beach , California Contract Aug 11, 2026 Medical Claim Review Nurse | Remote (Washington) | Contract Walker Healthforce is seeking a...

Molina Healthcare is recruiting a qualified RN for a fully remote Utilization Management role requiring an active Illinois license. The position operates Monday–Friday, 8:30 AM–5:30 PM CST, with emphasis on clinical determinations using MCG...

iMPROve Health seeks an RN Reviewer (Workers' Compensation Utilization Review) to perform independent external medical reviews remotely as an independent contractor (1099). The reviewer applies clinical expertise to evaluate cases, ensuring...

A healthcare technology company seeks an experienced Registered Nurse for a remote role providing clinical technology services. This position is for independent contractors, focusing on chart reviews and clinical data analysis. Candidates should...

Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical Nurse - Work from Home! Get AI-powered advice on this job and more exclusive features.Direct message the job poster from BroadPathGlobal Talent Attraction...

UnitedHealth Group seeks an Inpatient Care Management Nurse to ensure proper utilization of health services for members. You will assess needs, plan care, and collaborate with physicians to expedite appropriate levels of care. The role...

A healthcare solutions provider is looking for a qualified RN to perform medical reviews and coordinate care for members. This role involves assessing service needs, engaging in patient education, and ensuring compliance with healthcare...

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...

Broadway Ventures, a veteran-owned SDVOSB headquartered in Mississippi, seeks an experienced Registered Nurse to perform medical review of complex claims, pre-authorization requests, appeals, and fraud referrals. You will apply clinical expertise...

Remote Nurse Triage RN PT (5p-11p weekdays, 8a-4p/2p-10p weekends) IntellaTriage continues to GROW! Shift Schedule3 shifts per 2‑week pay period, Mon‑Fri, rotating 5p‑11p CST.2 of every 3 weekend...

WPS Health Solutions in Columbus, OH, is seeking an Appeals Nurse to review medical records and Medicare claims for first-level appeals to determine medical necessity and coverage alignment. The role collaborates with Appeals Examiners to...

A healthcare organization in Connecticut is seeking an HCC Documentation Lead (RN) to coordinate and oversee documentation specialists. The ideal candidate must have a valid RN license, relevant coding credentials, and a minimum of three years'...

Description We are looking for a full-time LPN passionate about all aspects of women's health to provide direct patient care as part of an interdisciplinary care team and to serve as the first line of communication with patients in...

Cadence in Dallas, TX is seeking an RN Supervisor to lead a remote team of Registered Nurses in a high-volume triage environment. This role demands strong clinical judgment, operational management, and performance coaching to maintain quality...

firsthand Health is seeking a Remote Triage Nurse to support clients and staff by phone and electronic triage. This day-shift role (8:30-4:30 PST) focuses on care coordination, training, and administrative tasks while delivering compassionate,...

UnitedHealthcare is seeking a field-based Care Coordinator (RN) to coordinate care for medically complex members primarily within Medicare/Medicaid. You will apply clinical knowledge to identify needs, educate members, and ensure access to...

Turing is looking for candidates who have solid experience in nursing care, patient assessment, and clinical documentation, particularly at the level expected for licensed registered nurses working in hospital or outpatient care...

Inland Empire Health Plan (IEHP) seeks a Quality Program Nurse to implement and monitor quality management policies under the DHCS framework. Responsibilities include site reviews, medical record surveys, CAP oversight, and HEDIS data abstraction.

DaMar Staffing is seeking a Registered Nurse (RN) to review and evaluate medical necessity, appropriateness, quality, and compliance of services rendered by providers. The role covers claims analysis, provider audits, fraud detection, and...

A leading health care provider is seeking a Massachusetts Telehealth Nurse to assist patients in accessing care through phone consultations. Candidates must have a valid RN license in Massachusetts and 3+ years of clinical experience. The ideal...