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Ascension is seeking a remote Case Management RN to review admissions and service requests for medical necessity, coordinate discharge planning, and assist staff with coding, documentation, precertification, reimbursement and denials/appeals. The...

TEEMA Group is seeking a Clinical Quality Reviewer (RN or LCSW) for remote work in approved states. This role focuses on reviewing clinical cases, identifying quality or safety concerns, and supporting quality improvement initiatives across a...

MES Solutions is seeking a Clinical Quality Assurance Coordinator (RN/LPN) to review peer reports and ensure accuracy, compliance with client agreements, and regulatory standards. This 100% remote role aligns clinical expertise with quality...

School Nurse Under direction, to provide basic health services to students; to assist in the planning and implementation of school health programs in cooperation with medical authority and school administrative personnel; to evaluate the...

Summary: Uniti Med is looking for a Registered Nurse (RN) in Sylmar, California. This assignment lasts 16 weeks and is scheduled to start on 11-16-2026. Benefits: Day 1...

To support a specialized endoscopy clinic, the remote Minnesota Licensed RN Specialist will assess patient needs, implement nursing interventions, and evaluate care outcomes while coordinating with healthcare team members.Key...

ABOUT SOLACE Healthcare in the U. S. is fundamentally broken. The system is so complex that 88% of U. S. adults do not have the health literacy necessary to navigate it without help. Solace cuts through the red tape of healthcare by pairing...

A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and...

Description Under general supervision, performs review of patient charts as required by the Hospitals Utilization Management Review Plan. The Utilization Review Case Manager (UR CM) validates the patient's placement to be at the most appropriate...

Included Health is seeking experienced and mission-driven Nurse Practitioners to support our fast-growing virtual care team. If you're passionate about transforming healthcare and providing high-quality, accessible care to diverse...

Provide product and disease education to allied health professionals in oncology settings. Focus on patient management, dosing, administration, and side effect management. Key Responsibilities: Develop...

Pride Health is seeking an experienced Registered Nurse (RN) with Utilization Management experience to support clinical quality review and AI model development for prior authorization use cases. The ideal candidate will review records, apply...

Essentia Health in Duluth, MN is hiring for a Health Services professional to conduct Managed Care Programs in coordination with third party administrators. You will help implement referral, prior authorization, and precertification processes...

Nurse Navigator - Cancer Center Exams - 10 Hour Days Beverly Hills, CA, United States Job Description Do you have a passion for the highest clinical quality and patient happiness? Would you like to use your expert clinical...

POSITION SUMMARY The Perioperative Clinical Educator is a skilled and experienced professional Registered Nurse (RN) responsible for excellence in the provision of educational services . Reporting to the Director of...

Visiting After Hours Registered Nurse (RN) Our Visiting After Hours Registered Nurse (RN) work a rotational on-call after-hours schedule as part of the comfort care and after-hours team. They respond timely to afterhours calls from staff...

Job Category: Clinical Services Nursing Requisition Number: CERTI003229 Posted : September 15, 2026 Part-Time On-site Locations Showing 1 location ...

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...

AmeriPharma is seeking an Parenteral Services Clinical RN Specialist to provide expert nursing support for TPN and parenteral therapies. The role emphasizes clinical education, care coordination, and collaboration with nursing, pharmacy, and...

Summit Healthcare Staffing LLC is seeking a compassionate bilingual Registered Nurse (RN) to join the Intake team for a growing home health organization in Brooklyn, NY. The role starts on-site with potential to move to a remote role based on...

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...

Position Summary Care Navigator will be responsible for case management specific to kidney health management. The Care Navigator will complete activities for the continuum of care to facilitate and promote high quality,...

A leading healthcare provider is seeking a Registered Nurse for their LTSS department in New York. This role involves providing case management services, evaluating medical services, and managing appeals for denied services. Candidates must...

Utilization Review Nurse- Remote job at Gainwell Technologies LLC. North Carolina. 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...

Medix is seeking a Remote Utilization Review Registered Nurse (UR RN) to bridge clinical care and hospital operations from a remote setting. Join a team optimizing patient care while safeguarding revenue integrity, with a compressed 4-day week,...