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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...

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,...

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...

OU Health is seeking an entry-level RN Care Manager Utilization Review I to collaborate with health care providers and ensure patients receive appropriate care while complying with regulations. This role evaluates medical necessity, negotiates...

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...

CorVel is seeking a Quality Assurance Nurse to oversee case management quality assurance, provide mentorship to operations staff, and calibrate processes to ensure consistent delivery of CorVel's case management services. This remote role...

POSITION SUMMARY Under the supervision of the Vice President of Patient Care Services/ACNO, the lead wound care nurse will serve as a clinical resource to MLKCH staff on issues pertaining to patients with wounds, pressure...

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)...

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...

Job Title : Registered Nurse (Navy Nurse Corps) Category / Component : Officer • Both Overview Navy Nurse Corps officers deliver professional nursing care to service members, families, and global communities in leading edge military medical...

This is a 100% remote role. Must be an RN and reside in California. Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating...

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...

Cross Country Education is seeking a local contract nurse RN School RN for a local contract nursing job in Downey, California. Job Description & Requirements Specialty: School RN Discipline: RN Duration: 41 weeks 36 hours per week Shift: 12 hours...

Overview Position Type: Full time Job Title: Care Review Clinician I Location: 100% Remote (Must reside in one of the following states: NV, AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater-NYC), OH,...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: MIST Registered Nurse (RN) – Position Summary The Multidisciplinary...

Job Title: Clinical Review Nurse (Remote) Position Summary: We are seeking a detail-oriented and clinically skilled Clinical Review Nurse to join our team in a fully remote role. The Clinical Review Nurse is...

Program Integrity Clinical Compliance Auditor Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately...

Job Title : Registered Nurse (Navy Nurse Corps) Category / Component : Officer • Both Overview Navy Nurse Corps officers deliver professional nursing care to service members, families, and global communities in leading edge military medical...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing, and evaluating the care of patients. The staff RN utilizes the nursing process by use of...

St. Joseph Mercy Health System is seeking a Registered Nurse Education Coordinator to join the FirstChoice Iowa Regional program as a remote leader in nursing education. This full-time role supports curriculum design, staff development, and...

Working remotely in a full-time capacity, the Clinical Appeals RN will perform medical necessity reviews, consult with Medical Directors, and collaborate with various departments to ensure appropriate care and compliance with established...

Overview Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Garden Grove Hospital Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand...

A healthcare staffing company is seeking a Remote Registered Nurse (RN) to specialize in triage on a PRN basis. Ideal candidates will have at least 1 year of nursing experience and an active RN license. Responsibilities include conducting patient...