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TALENT Software Services is seeking a Clinical Quality Reviewer to join our CA-based remote team. You will review PQI allegations and coordinate multi-level reviews, applying clinical judgment to determine escalation paths and final...

Nurse Care Manager - Telephonic (Local Remote) Tandigm Health, a transformational leader in population health management, is looking for a Nurse Care Manager - Telephonic in the greater Philadelphia area. We offer a competitive...

Pay: $30 - $35 / hour Weekly Pay | Flexible Scheduling Provide Care One Patient at a Time Join Maxim Healthcare and deliver personalized 1:1 nursing care in patients' homes. Enjoy consistent assignments, a manageable pace, and...

Job Opportunity Our client is a private health management company devoted to providing an exceptional clinical team in the comfort, and privacy of a patient's own home. We are seeking dynamic, experienced, and compassionate Registered...

About Carisk Partners, Inc. Carisk Partners, a Best Places to Work award winning organization, is a specialty risk transfer, care-coordination company servicing insurers, government entities, self-insured plan sponsors...

Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13298 Salary Range:...

Nurse Advocate Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris...

Registered Nurse Care Coordinator Company: Merrimack Health Work Type: Remote Employment: Temporary Location: US Seniority: Mid Level Technologies: InterQual Requirements: BSN preferred; Massachusetts RN license; minimum 5 years clinical nursing;...

Delivering high-quality nursing care from a remote setting, the full-time Remote Care Nurse II will conduct patient assessments, develop care plans, and coordinate with multidisciplinary teams to optimize health outcomes using telehealth...

Your Role The Utilization Management team independently manages complex utilization and retrospective clinical reviews across multiple lines of business, assessing medical necessity, coding accuracy, treatment plans,...

Availity, a leader in healthcare technology, is hiring a UM Nurse Analyst (Clinical Informaticist) to interpret payer medical policies and build AI-enabled decision trees for automated prior authorization. You'll collaborate with Product,...

Remote Care Management Nurse (Future Opportunities) Work from home within Oregon, Washington, Idaho or Utah *Please be advised that this role is part of our candidate pool, which allows us to identify...

Details Client Name Mass General Brigham - Somerville Job Type Travel Offering Nursing Profession RN...

Job Details: Job Location: Curawest LLC - Denver, CO, Position Type: Full Time, Education Level: High School Diploma or Equivalent, Salary Range: $55000.00 - $60000.00Salary, Travel Percentage: None, Job Shift: Day (First Shift), POSITION PURPOSE:...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...

Registered Nurse - Case Management - Travel | Somerville, Massachusetts Estimated Weekly Pay: $1984.31 Start Date: 10/15/2026 | Duration: 11 Weeks Shift:...

Job Title Utilization Management Team Leader Job Description The Utilization Management team independently manages complex utilization and retrospective clinical reviews across multiple lines of business, assessing medical...

Job Summary: Responsible for the oversight and management of skilled patients and temporary skilled patients in rehabilitation in contracted Skilled Nursing facilities; this includes checking benefits, managing up to discharge and issuing denial...

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the "12...

Job Title Employment Type: Full time Shift: Rotating Shift Description: This is a remote position but will need onsite training in Mishawaka Indiana. Shift: Days - 8 hr shift LOCAL CANDIDATES ONLY! Why Choose Saint...

RN Coordinator Utilization Management The RN Coordinator Utilization Management will review submitted authorization requests for medical necessity, appropriateness of care, and benefit eligibility. This position reviews applicable...

Utilization Review Nurse Auditor Fully Remote • Mount Laurel, NJ 08054 Salary Range $33.00 - $46.00 Hourly Position Type Full Time Travel Percentage 10% ExamWorks is looking for a Utilization Review Nurse Auditor to join...

MES Solutions is seeking a Clinical Quality Assurance Coordinator to ensure exceptional quality in peer review case reports. This remote role involves working Monday to Friday, performing quality assurance reviews, and maintaining regulatory...

Care Manager, RN Shriners Children's is an organization that respects, supports, and values each other. Named as the 2025 best mid-sized employer by Forbes, we are engaged in providing excellence in patient care, embracing...

Clinical Reviewer, Precertification RN The Clinical Reviewer, Precertification RN, is a licensed Registered Nurse that is expected to function independently in her / his role and is responsible for managing a clinically complex caseload...