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CVS Health is seeking an experienced Utilization Management RN to join our remote team. You will review authorization requests, assess medical necessity, and apply clinical criteria to determine appropriate care while maintaining compliance with...

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management) .Candidate must be authorized to work in USA without requiring sponsorshipLocation: 100% Remote for California...

JOB DESCRIPTION Job Summary Work Location: California - Ability to work remote, but selected candidate must reside in the state of California. This position requires California RN Licensure. Candidates must...

UnitedHealth Group is seeking a Registered Nurse in the Weslaco, TX area to assess, plan, and implement person-centered care strategies while coordinating with providers and community resources. Remote work flexibility is available within the...

#SRNThis position represents 2 openings. Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the...

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management) .Candidate must be authorized to work in USA without requiring sponsorshipLocation: 100% Remote for California...

Exceptional care starts with exceptional people. For us, this is more than a job– it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you...

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

Join Us at our Virtual Job Fair to learn more about this position! Tuesday, November 3rd | 12pm - 2pm CDT Register here: At UnitedHealthcare, we are simplifying the health...

CVS Health is seeking an experienced RN Utilization Management Nurse Consultant for Medicare joint procedures. This remote, full-time role follows a Monday–Friday schedule (9:00 am–5:30 pm in your time zone) with occasional evenings/holidays,...

A healthcare staffing company is seeking a Clinical Review Nurse for Prior Authorization Review. This remote role demands conducting reviews, collaborating with healthcare teams, and ensuring compliance. Candidates need an active RN license and...

Registered Nurse-Remote Patient Monitoring Home Telehealth Case Manager Department: Department of Veterans Affairs The Remote Patient Monitoring Home Telehealth Case Manager delivers fundamental knowledge-based...

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...

Position: Remote Nurse Consultant Company Overview: Absolute Elder Care is a leading provider of in-home care services for seniors. Our mission is to provide compassionate, personalized care to help seniors maintain their...

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...

Details Client Name PIH HEALTH Job Type Travel Offering Nursing Profession Registered Nurse Specialty...

American Health Plans Franklin, TN 37067, USA Description American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors...

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...

Summary Home Telehealth Care Coordinator (HTCC) Registered Nurse (RN) demonstrates leadership - experience - and creative approaches to management of complex patient care. The HTCC is responsible for coordination of health care for a...

Bring your clinical expertise. Raise the standard. Add LIFE to the years of the people we serve. VitaCare Living is seeking an experienced Registered Nurse (RN) to support our assisted living and memory care communities in Stratford,...

Jobgether, on behalf of a partner organization, seeks an experienced Registered Nurse for a remote Utilization Management role. You will review cases, assess medical necessity, and support prior authorization decisions while collaborating with...

About This Role As an Inpatient Care Management Nurse, you will be responsible for ensuring proper utilization of health services by assessing and interpreting member needs and identifying solutions to help members live healthier lives.

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 you've honed your career in a fast-moving...

Sentara Health Plans seeks a Clinical Claims Reviewer RN for remote work. You will perform utilization management, review pre/post payment claims and authorizations for inpatient/outpatient cases, and address provider inquiries with appropriate...

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through...