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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,...

Mass General Brigham Health Plan Holding Company, Inc. is seeking an RN-based Utilization Management Nurse to support network adequacy reviews and authorization decisions for ACO, HMO, and EPO products. The role emphasizes medical necessity...

Elevance Health in Denver, CO seeks a Wellness Nurse Consultant to develop and manage health programs for federal employees under the Federal Employee Program. The role is field-based with travel to client sites and occasional home-office work,...

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...

Leading cross-functional initiatives, the full-time RN Medical Coding Consultant will research and develop clinical services, manage episodic projects, and support the implementation of medical policies and coding practices while working...

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...

Alliance Health in North Carolina is seeking a Telework-enabled Care Management Consultant who will provide secondary care coordination and medication reviews for members with physical health needs. The role requires licensure in NC (RN or OT/PT)...

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...

Responsibilities: How you'll change lives...

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...

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...

RN Navigator Oncology Fairview is looking for an RN Navigator Oncology to join our team! This is a remote position. Schedule: This role is casual and remote. Responsibilities: Provides care navigation, communication...

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 Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure...

Job Summary Uses the electronic medical record and telecommunication technology to provide care remotely in an inpatient setting. Collaborates with patients and other members of the healthcare team to provide admission and discharge...

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...

Registered Nurse Navigator - Cancer Center Exams - 10 Hour Days Do you have a passion for the highest clinical quality and patient happiness? Would you like to use your expert clinical competencies with an organization known nationally...

A quality improvement consulting company is seeking an RN Health Care Facility Surveyor to work remotely with up to 75% travel. Responsibilities include conducting surveys of healthcare facilities to ensure compliance with standards and...

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...

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...

A leading Quality Improvement Consulting Company is seeking an RN Health Care Facility Surveyor to conduct compliance surveys across various healthcare facilities. The role is heavily focused on ensuring quality standards are met, involving...

CVS Health is seeking a Clinical Quality & Compliance RN for a remote role focused on quality, compliance, and operational excellence. You will ensure utilization management processes meet regulatory, accreditation, and quality standards,...

Working as a Nurse Case Manager at Cunningham Childrens Home means youll be part of team that is dedicated to supporting youth in critical need of emotional, psychological, and physical care. Located in Urbana, IL, Cunningham Children's Home is a...

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...

Cadence is looking for a Clinical Navigator (Licensed Practical Nurse) to provide virtual chronic care support for Medicare patients. The role involves conducting patient outreach, documenting interactions in the Cadence platform, and ensuring...