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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...

Qlarant, a nonprofit organization, seeks a Nurse Specialist II to perform medical record and claims review for Medicare, Medicaid, and other data. This remote role in the United States involves ensuring adherence to guidelines while assessing for...

Job DescriptionJob Summary Provides support for clinical facility site reviews. Under the supervision of leadership, uses clinical judgement within appropriate scope to independently conduct reviews and other monitoring activities...

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...

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...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. This is a hybrid remote position with occasional float in-person at our Mount Auburn Primary Care offices in...

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...

Healthcare Management Solutions, LLC is seeking experienced CHSD Audit reviewers to conduct independent medical record reviews for the STS CHSD program. This remote, part-time role focuses on data accuracy, source verification, and adherence to...

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...

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...

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...

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 -...

UW Health in Wisconsin seeks a Telehealth Nursing Assistant (CNA/NA) to support remote care for critical patients within the eICU network. The role includes admitting, transferring and discharging patients via the eCareManager and ensuring...

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,...

Medica is seeking a Remote RN Care Coordinator to support Minnesota members with home-based assessments and telephonic care coordination. You will develop individualized care plans, coordinate services, and educate members on Medicare/Medicaid...

JOB DESCRIPTION Must reside in Florida Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established...

Abbott is seeking a per-diem RN trainer in the Durham, NC area to deliver Face-2-Face training for home testing customers. You will guide finger stick collection, explain PT/INR device use, and assist with reporting responsibilities. The...

Parenteral Services Clinical RN Specialist The Parenteral Services Clinical RN Specialist provides clinical support to the Parenteral Services team through advanced nursing expertise, education, care coordination, and operational...

Patient First in Maryland is seeking a Certified Nursing Assistant (CNA) to support physicians and nurses by preparing patients, taking vital signs, and helping with exams. The role uses an electronic medical record system and may require...

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...

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...

The Health Specialist role is to provide advanced and accurate clinical inquiry responses to health related, disease control and prevention issues, including questions related to bioterrorism, first responders and national emergency situations...

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...

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...

About the Role Mercor is hiring experienced Nurse Practitioners to help evaluate and improve cutting-edge AI systems. In this role, you'll evaluate AI-generated clinical content and workflows, leveraging your real-world expertise...