Search Nursing Jobs

JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member...

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...

Case Manager Utilization RNWorks collaboratively with an MD to coordinate and screen for the appropriateness of admissions and continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the...

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...

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...

Lead the day-to-day operations of a remote team of RNs and LPNs responsible for reviewing and resolving real-time patient alerts across remote monitoring workflows.Monitor queue performance, alert resolution times, throughput, billable activity,...

Humana Inc. is seeking a Telephonic Nurse Care Manager for CenterWell Home Health, a remote, home-based role. You will guide patients transitioning from services, manage post-acute care options, and ensure timely follow-up with the clinical team.

Supports the values of service excellence, teamwork, and integrity while managing patient care.Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers.Qualifications:Requires a current RN license, nursing diploma or...

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...

Ochsner Health, a leading not-for-profit healthcare provider in the Gulf South, seeks an experienced RN for a remote case management role. You will coordinate care by liaising with patients, caregivers, multidisciplinary teams, and payers to...

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...

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. **This position is remote. Candidates must be local to New England States for consideration** The Clinical...

Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical...

Virtua Health is seeking a remote RN to support the application of medical necessity tools, ensuring compliance and achieving positive patient outcomes. You will collaborate with Physician Advisors, manage denials, and document review activities...

Sedgwick seeks a US Telecommuter RN Telephonic Case Manager to coordinate medical care and facilitate recovery for injured workers. This full-time role enables advocacy, clear communication with providers, and timely return-to-work planning from a...

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...

Lee Health is hiring for a Utilization Management RN position. This remote role begins onsite for the first 90 days and requires licensure in Florida. The nurse will perform utilization management duties, ensure regulatory compliance, and document...

The Veterans Health Administration at the Charleston VA Medical Center seeks a Nurse Manager (RN) to lead and supervise designated units within Community Care. The role emphasizes staff development, evidence-based practice, and collaboration with...

Overview Utilization Management for the assigned inpatient Care Management population. This position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial...

Humana is seeking a skilled Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations for post-acute care such as SNF, Home Health, and DME. You will report to the Manager of Utilization...

Staffmark Group is recruiting a Registered Nurse for a remote role. Primary duties include reviewing peer review reports, ensuring evidence-based rationales, and ensuring compliance with client, contract, and regulatory standards. The ideal...

Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make...

JOB DESCRIPTION Opportunity in Southern California for an experienced Managed Care Leader to join our health plan in California. Candidates must have a minimum of 7 years of healthcare experience, 3 of those should be with a Managed Care...

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,...