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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...

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...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Population Health Services-Utah Position Overview: Aids patients in obtaining the correct level of care with the appropriate provider at...

Quality Assurance Registered Nurse This is a contract to hire position based out of Raleigh, NC. The pay range for this position is $29.00 - $31.25/hr. Eligibility requirements apply to some benefits and may depend on your job...

Resp & Qualifications PURPOSE: The Clinical Appeals Nurse completes research, basic analysis, and evaluation of member and provider disputes regarding adverse and adverse coverage decisions. The...

Overview The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in...

A healthcare organization in California seeks a Utilization Review Nurse to oversee inpatient utilization management. This position requires clinical expertise alongside experience in Utilization Management. The candidate should have a current RN...

Location: Avera McKennan Hospital Worker Type: Regular Work Shift: Rotating days/evenings ights/weekends/holidays (United States of America) Pay Range: The pay range for...

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...

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...

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...

$40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical...

Job Description: • Participates in the development and ongoing implementation of QM Work Plan activities. • Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet...

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...

Overview What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic...

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.

Type: Full-time, salaried, FLSA exempt Pay: $80,000 - $85,000 annually, plus bonus potential Location: US, remote; some evening hours, weekend hours, and travel are required...

CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to...

Overview Join Piedmont to move your career in the right direction. Stay for the diverse teams you'll love, a shared purpose, and schedule flexibility that frees you to live for what matters both in and outside of work. You'll...

A leading healthcare provider is seeking a Telephonic Registered Nurse to work from home, providing critical patient care through telephonic interactions. In this role, you will deliver education regarding medications and support patients with...

A leading health organization is seeking a Nurse Reviewer I to manage preauthorization and diagnostic imaging treatment reviews. With a focus on quality member outcomes, the role allows for virtual work with defined responsibilities, including...

Job Type Full-time Description Gateway Rehab Center (GRC) has an outstanding opportunity for a Nurse Liaison Gateway Rehab who will be responsible for the pre-admission case management, ASAM level of care assessment, and...

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position. ESSENTIAL...

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...

A leading technology services firm is seeking a Quality Assurance Registered Nurse for a 100% remote contract-to-hire position based in Atlanta, GA. The role entails performing quality assurance reviews, ensuring compliance with clinical...