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A technology and business consulting firm is seeking a Clinical Medical Review Nurse to analyze health data and provide insights for internal stakeholders. The ideal candidate has a Registered Nurse license, along with four years of clinical...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. **This position is remote. Candidates must be local to New England States for consideration** The Clinical...

Actalent is seeking a remote Utilization Review Registered Nurse to perform concurrent reviews, validate medical necessity, and ensure appropriate care settings. You will partner with providers and internal teams to support decisions and discharge...

Fully Remote : Clinical Documentation Specialist Job Description Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers.

Nurse Consultant I (NS) The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health,...

CVS Health is seeking an Appeals Nurse Consultant to join our remote team. You will review and resolve clinical appeals, applying clinical judgment and regulatory knowledge to ensure fair outcomes for members and providers. This full-time...

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...

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...

Absolute Elder Care is seeking a Remote Nurse Consultant to provide compassionate and expert guidance to seniors and their families. This full-time, remote position includes conducting health care assessments, creating individualized care plans,...

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...

Title: QIC Part A Nurse Consultant Location: Remote Duration: 6 months Shift time: Hours; 8:30 am - 5:00 pm EST (Monday - Friday) Pay rate: 30.00/hr Job Description Essential Duties and...

Centene Corporation is seeking a remote Mississippi-based Registered Nurse to develop and manage complex care plans for members, coordinating with providers and families to ensure timely, person-centered care. The role emphasizes ongoing...

Guidehealth is seeking a remote-based Care Manager (RN) to guide patients and families through complex health journeys. You will blend clinical expertise with holistic care, addressing medical, behavioral, and social needs while coordinating...

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...

The VITAS Telecare RN is a member of the interdisciplinary team who is the pivotal person responsible for identifying the physical, psychological, social, and spiritual needs of those patients and families needing assistance after normal business...

Employment Type: Part time Shift: Description: Hours/Schedule: Saturday & Sunday 2:00 p.m. 12:30 a.m. EST Home Care & Hospice Virtual Care Center Coordinator Registered Nurse...

Humana is seeking a Telephonic Registered Nurse Care Manager to support patients transitioning into and out of Humana's home-based services. This remote role reports to the Manager, Care Management and focuses on post-acute levels of care,...

Job ID: Posted: Location: Eden Prairie, Minnesota, United StatesSalary: $91,700 - $163,700/yearJob Area: Medical & Clinical OperationsCompany: UnitedHealth GroupOptum is a global organization that delivers care, aided by technology to help...

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry‑leading solutions to build an integrated care model that holistically addresses an individual's...

Guidehealth in the United States seeks an experienced RN Case Manager to work remotely with Illinois licensure. You will oversee member management, promote wellness, and support cost-effective care within a value-based care framework.

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...

Employment Type: Full time Shift: Night Shift Description: Position Summary: Reviews assigned cases applying specific criteria and payor guidelines and communicates this review to...

Illingworth Research Group is seeking a Per Diem Freelance Research Nurse to support patients in clinical studies by coordinating care and liaising with healthcare providers. The role involves guiding participants through study protocols,...

EK Health is hiring a full-time Telephonic Nurse Case Manager (RN) for our Case Management Team. The role includes assessing, planning, coordinating, and evaluating service options to ensure injured workers receive timely, cost-effective care and...

RN - Quality & Safety Improvement Consultant V, Patient SafetyOnsite in Downey, CA. Travel: Yes, 10% of the time.Patient Safety Officer RN in acute care hospital setting. You will attend national safety goal monitoring committees, sit on nursing...