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CVS Health Corporation is seeking a RN-qualified professional to lead quality improvement initiatives and performance measurement within POSC, aiming to meet HEDIS and CAHPS goals. The role involves analyzing clinical workflows, implementing...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...

To support an upcoming clinical project, experienced Registered Nurses (RNs) will find a fully remote contract opportunity as a Remote RN Clinical Consultant, focusing on conducting comprehensive medical record and clinical chart reviews while...

Washington State Department of Social and Health Services is seeking a registered nurse with long-term care experience to join our Nursing Consultant team. This role focuses on inspections, investigations, and applying state nursing requirements...

Santa Barbara Cottage Hospital is seeking a QIC Part A Nurse Consultant for a remote six-month assignment. The role focuses on reviewing determinations and rendering medical necessity decisions for Medicare State East cases, while resolving...

Job Title: Clinical Chart Reviewer Job Description This role involves reviewing clinical charts for medical necessity in inpatient admissions, ensuring compliance with healthcare standards, and making appropriate referrals based on...

Get AI-powered advice on this job and more exclusive features. This range is provided by The Judge Group. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range...

Job Title: Remote Prior Authorization Registered NurseJob Description We are seeking experienced Registered Nurses (RNs) to join a remote Prior Authorization team supporting Dual Eligible (Medicare and Medicaid) populations. In...

Leveraging clinical expertise, the fully remote Multi Benefit Services RN Consultant in Wisconsin will review Medicaid prior authorization requests, determine medical necessity, and support providers while ensuring compliance with state policy...

Centene is seeking a Nursing professional to perform concurrent reviews from a home-based setting, ensuring appropriate care levels and discharge planning. Requires an Iowa license (or compact) and nursing degree with 2–4 years of related...

Actalent is seeking an LVN Nurse Consultant for a fully remote telephonic nursing position. You will contact patients or caregivers to ensure adherence to prescribed therapies and address issues they may encounter, including nursing home...

Clinical Nurse Consultant At Bristol Myers Squibb, our employees often ask, "Who are you working for?"—a question that fuels collaboration, accountability, and urgency in our work. Our purpose-driven culture inspires us to discover,...

CVS Health is seeking an experienced Utilization Management Nurse Consultant for a fully remote role across EST or CST zones. You will coordinate and document UM activities, ensuring safe, appropriate care and adherence to timelines while working...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...

The Veterans Health Administration is seeking a Registered Nurse (Case Manager/Care Coordinator) at the Charleston VA Medical Center in the Nursing, Specialty department. The role focuses on complex patient management, discharge planning, and...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...

Optum Infusion Pharmacy is seeking a Clinical Administrative Consultant RN (CAC, Clinical Coordinator) to act as a clinical liaison and coordinate home or AIS infusion therapy for patients across the U.S. The role supports initial intake,...

WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of...

Teleperformance is seeking a Healthcare Customer Service Representative to handle inquiries via phone, email, chat, and social media. The role focuses on de-escalation, issue resolution, and proactive payment processing while maintaining quality...

Registered Nurse (RN) - Utilization Management 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...

Clinical Reimbursement Consultant Unique remote opportunity for an experienced MDS Nurse to work in a professional atmosphere alongside experienced MDS consultants in the role of a Clinical Reimbursement Consultant. The successful...

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...

Get AI-powered advice on this job and more exclusive features. This range is provided by Medix. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $37.00/hr...

Titanium Healthcare is seeking an RN Clinical Consultant to lead clinical oversight within the Enhanced Care Management (ECM) program for Medi-Cal members in California. You will collaborate with Lead Care Managers and the interdisciplinary team...

Are you an experienced MDS nurse who enjoys solving problems, supporting teams, and making an impact across different skilled nursing environments? Health Dimensions Group (HDG)—a nationally respected leader in senior care consulting and...