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Become a part of our caring community Humana Healthy Horizons in Kentucky is looking for a Utilization Management Behavioral Health Professional 2 who uses behavioral health knowledge and skills to support the coordination, documentation, and...

Alliance Liaison If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One! We strive to be an employer of choice and establish a reputation for being a talent rich organization where...

Providing comprehensive medical reviews and analysis of disability claims, the full-time RN Clinical Consultant will work remotely to assess functional capacity based on medical data, collaborate with healthcare providers, and enhance the customer...

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...

Advertisement Closes 7/31/2026 (11:59 PM ET) 2603681 Nurse Consultant/Inspector Pay Grade16 Salary $52,283.52 - $78,425.28 Annually Employment Type EXECUTIVE BRANCH | FULL TIME |...

Optum Clinical Claim Review Nurse 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...

Nurse Consultant - Remote in California It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know...

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...

Appeals Nurse Consultant CVS Aetna is seeking a dedicated Appeals Nurse Consultant to join our remote team. In this role, you will play a critical role in ensuring fair and accurate resolution of clinical appeals by applying sound...

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Description & Requirements Maximus is hiring a Clinical Reviewer RN/LPN to support our LTSS Tennessee contract. Areas will include but are not limited to PASRR Level 1 and Katie Beckett. In this role, you will review...

Overview Carenet Health is not authorized to hire in certain states due to internal business considerations: CA, CO, NY, NJ, NV, OR, WA, MD, RI, WV, AK, HI, CT, DE, VT, or Puerto RicoAre you a compassionate, self-motivated registered nurse with...

Provides expert consultation and leadership in designated areas of expertise independently. Collaborates with interdisciplinary teams and stakeholders to address large scale projects and initiatives. Communicates advanced knowledge and best practices...

Talent4Health is seeking a travel nurse RN Case Management for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: Case...

Appeals Nurse Consultant 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...

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

Job Title RN Case Manager, Telehealth (RN) Company Archimedes Overview The RN Case Manager, Telehealth (RN) will focus on improving members' health and wellness via tele-pharmacy. In addition, the RN will...

Position Summary 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...

To support a growing team, the full-time remote Registered Nurse Bill Review will review facility and professional bills for accuracy, negotiate pre-surgical services, and provide expertise to claims staff while ensuring compliance with managed...

Job Title: Registered Nurse (RN) – Residential & Day Habilitation Programs Salary Range: $48–$50 per hour (based on experience) Education Requirements: Graduate of an accredited professional nursing program Licenses/Certifications Required:...

Job Title High-level duties and responsibilities include: This position potentially requires flexibility in schedule and assignments. Serves as a resource/consultant to service line staff regarding performance...

As an integral part of the interdisciplinary team, the Registered Nurse utilizes the nursing process to provide therapeutic care to a specific population of patients. The perioperative registered nurse uses the nursing process, designs, coordinates,...

Interested in working for the Golden Isles' healthcare provider and employer of choice? Throughout the many locations that make up the Southeast Georgia Health System network, there is a common thread that pulls everything...

Success Education Colleges (SEC) is a family of institutions comprised of Marsha Fuerst School of Nursing, North-West College, Glendale Career College and Nevada Career Institute. SEC is a leader in allied health education, and has been offering...

Overview Johns Hopkins Intrastaff is the internal staffing agency for the Johns Hopkins Health System and partner hospitals, providing temporary support to a variety of the Johns Hopkins locations. Our employees are the...