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A leading healthcare provider is seeking a Clinic Registered Nurse (RN) for their urology team in Omaha, Nebraska. This hybrid role allows for remote work after training. The RN will collaborate with a multidisciplinary team to provide...

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...

A leading health solutions company is seeking a Precertification Nurse Case Manager to evaluate medical necessity for procedures and coordinate care for members remotely. The role requires active RN licensure and 3+ years of clinical experience,...

A health services organization is seeking a Prior Authorization RN to join their Wisconsin Medicaid Market team. This role involves reviewing clinical appropriateness of prior authorization requests in accordance with Medicare/Medicaid guidelines.

Remote Clinical Review Nurse - Prior Authorization Location: Must be located in Central or Eastern time zones Employment Type: Full-Time About the Role We are seeking an experienced Registered Nurse to join our team within...

Immediate RN Clinical Consultant - ADA Medical Accommodation Review remote contract opportunity. This is a 100% remote/work from home position. Pay Rate: $85.00/hr Work Details: ...

Fully Remote: Clinical Documentation Specialist Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical...

A leading healthcare organization is seeking a Prior Authorization RN to join its team. This role entails reviewing prior authorization requests to ensure medical necessity and compliance with Medicare and Medicaid guidelines. Applicants should...

RN - Utilization Review Nurse | 3+ Years of Experience | Remote in IL | Contract Walker Healthforce is seeking a RN - Utilization Review Nurse with 3+ Years of Experience to support a Healthcare Payor Client based out of IL.

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to...

A leading claims management company is seeking a part-time nurse in Jefferson City, Missouri. This role involves triaging calls to assess patient needs and providing appropriate medical advice. Candidates must possess a BSN and an active RN...

A healthcare provider is seeking a Registered Nurse for care management coordination in Salt Lake City, UT. This role involves assessing member needs, developing care plans, and facilitating interdisciplinary collaboration. Candidates should have...

A healthcare organization in Washington, DC, is seeking a qualified nurse for clinical review and care coordination. This role requires evaluating medical services and ensuring effective patient care while maintaining communication with various...

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach...

We believe everyone should have confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care...

The Clinical Research Finance & Compliance (CRFC) Department plays a vital role in supporting the financial infrastructure of oncology clinical trials. CRFC is responsible for the full spectrum of financial operations, including project budgeting,...

Registered Nurses are encouraged to consider a part-time remote Nurse Reviewer position with Liberty Healthcare Corporation. Liberty Healthcare operates a statewide program in Idaho which assesses children and adults who are living with...

A leading pharmacy company is seeking a Clinical Outcomes Quality Assurance Nurse to ensure the quality of documentation and implement clinical best practices. Responsibilities include managing outcomes forms and communicating with patients and...

Description RN Utilization Review at Irvine, CA. This position is Part- time and will work Remote 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our...

Receives inquiry calls and assists the caller with scheduling a face-to-face assessment to triage to the appropriate community referral. Assesses or ensures assessment by a qualified mental health professional of patients who present for assessment.

Description & Requirements Be part of something great Maximus is a global organisation that specialises in providing health and employment services to millions of people every year. Here in the UK we employ...

The RN Case Manager is responsible for coordinating continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery, and compliance with medical regime. Essential Duties and...

Requirements Qualifications / Experience Current multi-state RN license with no restrictions; nurses currently holding a single-state RN license must obtain a multi-state license prior to being made a job...

Description As an RN Care Manager, you will function as a clinician, advocate, and educator to achieve optimal clinical and quality outcomes by effectively managing care and resources to reduce unnecessary utilization. The RN Care Manager...

JOB DESCRIPTION Job Summary Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically...