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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...

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...

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...

To support a growing clinical operations team, the full-time Nurse Consultant II will provide professional nursing care remotely, focusing on member assessment, planning, evaluation, and evidence-based practice to enhance member experiences 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...

Guidehealth, a data-powered healthcare company, is seeking a remote Care Manager (RN) to guide patients through complex health journeys. You will blend clinical expertise with holistic care, educate patients, and coordinate across providers to...

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...

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...

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...

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...

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...

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 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,...

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...

Army Public Health Nurse Job Overview As an Army Public Health Nurse, you'll assess health risks and implement programs to monitor the spread of disease. You'll promote wellness for Soldiers and their families while also informing policy and...

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,...

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...

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...

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...

Utilization Management Nurse Consultant (RN) Remote | Concurrent Review | Utilization Management Are you an experienced RN with utilization management or prior authorization experience looking to make an impact beyond bedside care?

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...

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...

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...