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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...

Clinical Documentation Improvement Specialist-RN- Remote The Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) assists with the identification of diagnoses, conditions, and procedures that are representative of the...

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...

CVS Health is seeking a remote Appeals Nurse Consultant to review and resolve clinical appeals with sound clinical judgment and regulatory knowledge. The role supports a remote team with standard Monday–Friday hours and occasional on-call.

Molina Healthcare is seeking a Registered Nurse licensed in Wisconsin to become our IRIS Self-Directed Personal Care (SDPC) RN. This remote role collaborates with individuals enrolled in Wisconsin's IRIS program, providing oversight, education,...

RN opportunity with out the bedside burnout + sign on bonus. This Jobot Job is hosted by: Dexter Dionio Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $80,000 -...

Trinity Health is seeking a Night Shift RN Utilization Review in Grand Rapids, MI, offering full-time work with remote options. You will review assigned cases against criteria and payor guidelines to ensure proper reimbursement and medical...

Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations. The role involves collaborating with medical leadership, reviewing cases for appropriate treatments,...

Home Health Clinical Referral NurseOrganization: SCAH-Sutter Care at Home - UTPosition Overview: The Home Health Clinical Referral Nurse serves as the initial point of contact for potential home health patients, working closely with our clerical...

Nurse Consultant Come join our Symbria Team! We are seeking a highly professional and dedicated individual to join our EMPLOYEE-OWNED TEAM as a Nurse Consultant in the pharmaceutical industry at our Pharmacy in Pennsylvania!

A technology and business consulting firm is seeking a Clinical Medical Review Nurse to analyze health data and provide insights for internal stakeholders. The ideal candidate has a Registered Nurse license, along with four years of clinical...

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...

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...

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...

VA Greater Los Angeles Healthcare (VAGLAHS) seeks two RN professionals for Remote Patient Monitoring - Home Telehealth. You will oversee the nursing process, care coordination, patient education, and health promotion, collaborating with the...

Humana is seeking an RN, Field Care Manager 2 (Physical Health) to assess member needs, develop care plans, and coordinate services across the care team. This role operates primarily in the field with remote/home office duties when not visiting...

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...

Molina Healthcare in Illinois seeks a licensed RN Case Manager to support Medicare members. This telephonic position may require occasional face-to-face visits; 25–40% travel may be needed depending on state requirements. You will assess, plan,...

Stanford Health Care in Palo Alto is seeking an Oncology Nurse Navigator to coordinate care from diagnosis through survivorship. As a licensed RN with oncology experience, you will partner with physicians, social workers, nutritionists, and...

Turing is looking for candidates who have solid experience in nursing care, patient assessment, and clinical documentation, particularly at the level expected for licensed registered nurses working in hospital or outpatient care...

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,...

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,...

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...

The Ohio State University is seeking a Staff Nurse (RN) for Oncology Continuing Care Triage. This remote phone triage role handles oncology patient calls, performs initial assessments, and uses triage algorithms to guide care. The nurse documents...

Titanium Healthcare is seeking an RN Clinical Consultant to lead clinical oversight within the Enhanced Care Management (ECM) program for Medi-Cal members in California. You will collaborate with Lead Care Managers and the interdisciplinary team...