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A company is looking for a Utilization Review Clinician - Behavioral Health.Key ResponsibilitiesEvaluate member's treatment for mental health and substance abuse to ensure medical appropriatenessPerform prior authorization reviews and concurrent...

Overseeing hospice intake compliance, the full-time remote Hospice Clinical Compliance & Audit Associate Director will manage clinical audit activities to ensure documentation accuracy, regulatory compliance, and claim readiness while...

Utilizing medical knowledge and patient care experience, the part-time RN Clinical Sales Specialist will guide interested individuals seeking innovative healthcare solutions, working remotely with a flexible schedule to assist clients in making...

To support the growth of a mobile IV therapy team, a part-time to full-time Registered Nurse Recruiter will source and recruit qualified nurses, manage talent pipelines, and ensure a positive candidate experience in a remote work environment.Key...

A company is looking for an RN-to-BSN Academic Advisor.Key ResponsibilitiesServe as the primary advisor for nursing students from onboarding through graduationBuild strong relationships with students to enhance engagement, retention, and program...

A company is looking for a Massachusetts Licensed Psychiatric Mental Health Nurse Practitioner (PMHNP).Key ResponsibilitiesProvide clinical care through telehealth, including Psychotherapy and Psychopharmacology servicesConduct comprehensive...

Evaluating medical necessity and appropriateness for claims, the full-time State Licensed Legal Nurse will review liability demand packages, analyze medical records, and support negotiation and litigation efforts in a remote environment.Key...

Offering a flexible remote opportunity, the Nebraska Licensed PMHNP will provide high-impact tele-psychiatry services with minimal administrative tasks and the ability to choose their own hours on a 1099 basis.Key responsibilitiesDeliver...

Ohio RN Clinical Finance Specialist is a full-time remote position responsible for implementing clinical finance strategies, securing pre-authorizations, and managing clinical denials.Key ResponsibilitiesImplement and support clinical finance...

A company is looking for a Nurse Auditor.Key ResponsibilitiesPerform charge audits and assessments to resolve incorrect or missing chargesMonitor revenue loss reports and identify documentation needs to support charge captureEducate stakeholders...

Passionate about shaping future health care leaders, the part-time Adjunct Nursing Research and Evidence Based Practice Faculty will deliver engaging online instruction, maintain accreditation compliance, and facilitate meaningful classroom...

Working remotely in a full-time capacity, the Registered Nurse Clinical Auditor will conduct clinical audits and reviews related to fraud, waste, and abuse, while collaborating with various Health Plan departments and utilizing fraud detection...

To support members with complex or chronic conditions, the full-time Oncology Case Manager Nurse will provide proactive telephonic case management, develop individualized care plans, and advocate for appropriate services while working remotely...

Leading clinical operations across multiple states, the full-time Regional Clinical Services Director - RN will provide nursing leadership, consultation, and resources for patient care departments while ensuring compliance with diverse regulatory...

To ensure effective treatment of patients, the full-time virtual Tennessee or Virginia Nurse Practitioner Manager will oversee clinical program operations, manage patient caseloads, and provide direction to Nurse Practitioners while working Monday...

To support the education of future healthcare leaders, the part-time Arizona Licensed Nurse Educator will teach Advanced Pathophysiology and Pharmacology online, delivering high-quality instruction while maintaining compliance with accreditation...

RN Clinical Consultant, a full-time remote position, provides clinical expertise in reviewing disability claims, assessing medical conditions, and collaborating with healthcare providers to enhance treatment outcomes.Key ResponsibilitiesReview and...

To enhance nursing education initiatives, the full-time New York Licensed Clinical Nurse Educator will assess, plan, implement, and evaluate educational programs while providing direct patient care and support in a hybrid role across various...

Providing advanced clinical appeal services, the full-time Remote Clinical Financial Case Manager RN will manage complex patient account denials, conduct clinical reviews, and assist in developing denial prevention strategies while supporting the...

Providing telephonic care and support, the part-time Telephonic Nurse Practitioner - OH, MO, WI, IN Licensed will manage patient assessments, coordinate care, and ensure quality documentation while working remotely with flexible scheduling,...

Focused on Coding and Clinical Chart Validation, the full-time Clinical Auditor Licensed RN will independently audit outpatient and specialty claims, ensuring coding accuracy and medical necessity while utilizing advanced audit tools and...

To support financial objectives, the full-time California Licensed Revenue Cycle Auditor RN will provide patient-focused, standardized revenue cycle support remotely while ensuring compliance and efficiency in processes.Key responsibilitiesConduct...

To support clinical auditing efforts, the full-time RN Clinical Auditor will perform retrospective chart reviews on Readmission and Place of Service Claims, utilizing clinical guidelines and proprietary systems while maintaining productivity and...

Providing professional nursing care in a remote full-time capacity, the Nurse Consultant II will support members through assessment, planning, and evaluation to enhance the member experience and ensure effective healthcare services.Key...

To maximize client savings, the full-time Illinois Licensed Nurse Auditor will remotely review medical bills, ensuring appropriate billing, coding, and treatment while maintaining compliance with fee schedules and identifying erroneous charges.Key...