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Clinical Nurse Professional Development Educator Advanced How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At...

Concurrent Review Registered Nurse (RN) Location: Fully remote. Our client is seeking an experienced Concurrent Review Registered Nurse (RN) to join its Utilization Management team. In this role, you will perform concurrent...

Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented Utilization Management Registered Nurse (UM RN) to join our growing healthcare team. In this role, you'll perform both inpatient and outpatient...

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...

Central Intake Nurse Job Type: Full-Time Remote possible Benefits Offered: Healthcare Dental Vision PTO 401K Your Job Summary The Central Intake Nurse...

Clinical Documentation Integrity Specialist Evaluates the day to day documentation practices of the Medical Staff and healthcare team on a complex patient population, and offers education and recommendations in accordance with the...

Be part of a soul-hearted approach to healing Alsana is a national leader in eating disorder treatment, offering a holistic, soul-hearted approach to recovery for adults and adolescents of all genders. We exist to be a source of hope...

Licensed Vocational Nurse Case Manager The Department of Family Medicine of the Keck School of Medicine of USC provides care for every member of the family, across generations and over lifetimes. We aim to enhance the quality of life for...

*This role will require the successful candidate to work the shift of Monday to Friday, 1pm to 10pm Central (2pm to 11pm Eastern). The Utilization Review Clinician is responsible for reviewing medical records to determine medical necessity. This...

Clinical Guide Part A The weekly schedule choice is either Monday - Friday 10am-7pm EST OR Tuesday - Saturday 9am-6pm EST A bit about this role: The Clinical Guide Part A will be part of the Utilization Management team,...

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...

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...

Utilization Management Team Member Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high risk...

Admissions Nurse The Admissions Nurse is responsible for establishing and maintaining positive relationships with customers and referral sources within the community. The Admissions RN is also responsible for developing and increasing the...

Alliance Liaison If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One! We strive to be an employer of choice and establish a reputation for being a talent rich organization where...

100% REMOTE PAY: $47-$52/hr REQUIRED: Must have current RN licensing Post market medical device experience in either medical assessment, complaint handling, post market reporting – preference is actual medical device assessment Highly prefer...

Clinical Documentation Integrity Specialist II The Clinical Documentation Integrity Specialist II (CDI) is responsible for utilizing independent clinical judgement in facilitating the integrity, overall quality, accuracy, and completeness...

Habitat Health empowers older adults to experience more good days in their homes and communities. Through the Program of All-Inclusive Care for the Elderly (PACE), we provide comprehensive medical care along with support for daily needs such as...

Compliance Nurse Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders,...

Join The BILH Team When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. LPN's encouraged to apply! Pay Range: $30.00 – $44.58 The pay range listed for this position is...

Nurses - are you looking for a change? Want to work no nights, no weekends, and no holidays? Check out Hines & Associates! Experience in both medical and behavioral health and/or substance use disorder settings is...

Integra Partners seeks an experienced Utilization Management Nurse Supervisor to lead the UM nursing team, ensuring performance, accountability, and professional development. You will conduct regular 1:1s, manage performance reviews, and drive...

Concurrent Utilization Review (UR) Nurse NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health...

Immediate need for a talented Utilization Management RN - Prior Authorization. This is a 12+ Months Contract opportunity with long-term potential and is located in US (Remote). Please review the...

Cook Children's Health Plan in Fort Worth, TX seeks an experienced RN Reviewer for Utilization Management to coordinate care and ensure timely, quality services for plan members. The role focuses on behavioral health and ambulatory care, with...