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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,...

Utilization Review Rn Job Type: Travel Profession: RN Specialty: Utilization Review Shift Details: 8 Hour Days Job Order Details: Start Date 10/19/2026 End Date 01/18/2027 Duration 13 Week(s) Client...

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...

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

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...

A leading organization in healthcare quality is seeking a Clinical Quality Reviewer to review clinical cases and identify potential quality or safety concerns. This remote position is ideal for licensed clinical professionals with a strong...

Centene Corporation is seeking a remote healthcare professional in Missouri to coordinate care management for members, develop personalized care plans, and educate families on benefits and services. The role supports children with elevated blood...

Have you ever looked a medical bill and immediately noticed something was wrong? Were you itching to use your expertise to fix it? We've been there, too. In fact, that's how our business was born - and continues to thrive. Rising Medical Solutions...

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...

Company Overview 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...

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

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...

ExamWorks is seeking a self-driven RN or LPN to join our team as a Clinical Quality Assurance Coordinator. This 100% remote role supports peer review reports, ensuring high quality, evidence-based rationales, and compliance with client...

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...

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,...

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...

Partner with us in making a positive change! Join a team where your work truly matters. We're proud to have been certified as a Great Place to Work for 8 years by our own employees. We invite you to partner with us in...

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...

LVN Case Manager Under supportive supervision, the LVN Case Manager supports the physician and interdisciplinary team in the provision of patient care, with the underlying objective of enhancing the quality of clinical outcomes and...

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...

SCAN is seeking an Utilization Management Physician Medical Director to lead medical necessity determinations, prior authorizations, and reviews. This physician will influence policy, provide clinical mentorship, and ensure compliant,...

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:...

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...