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CVS Health is seeking a Nurse Consultant for Utilization Management in a 100% remote capacity. The role reviews inpatient and outpatient services using evidence-based criteria, authorizes care with providers, and escalates cases as needed.

Arkansas Blue Cross and Blue Shield is seeking an Utilization Management Nurse to perform clinical reviews for prior approvals, network exceptions, and benefit inquiries. The role ensures medical necessity and promotes quality care with cost...

Position: Wellness Nurse ( Hiring for this position must be approved by VP of Health Services PRIOT TO POSTING) Shifts, Time, and Days: Tuesday-Saturday- Days / Evenings Pay Range: $29.00 -...

Find Your Calling At Mercy! Under the direction of the primary care operations team, the Primary Care Nurse works directly with Mercy Primary Care Providers to provide safe, timely, effective, efficient, equitable, patient-centered care...

Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team. Job Title: Nurse 3 Job Location: Redondo...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Clinical Reviewer RN - Alabama Alabama, US 30+ days ago Requisition...

Central California Alliance for Health is seeking a Prior Authorizations Nurse (RN) for a temporary, full-time role. This remote-in-California position reports to the Utilization Management Supervisor and involves ensuring PA requests comply with...

Job Description Registered Nurse (RN) - Los Angeles,CA Travel Package: Travel Rate (based on 40 hours): Hrly $32.94 Stipend (Lodging $1,337.00 + M&I $602.00 = $1,939.00 ...

Job Title This position is fully remote, however, you must reside in the State of Texas. The position is a contract for about 6 months. RN working in the insurance or managed care industry using medically accepted criteria to validate the...

We're looking for a detail-driven LPN Intake Specialist to join our team. In this role, you'll manage incoming referrals, ensure documentation is accurate and compliant, and help coordinate a smooth admission process for patients. This is a...

JOB DESCRIPTION AND POSITION REQUIREMENTS If you reside in one of the states listed in the above Notice to Out of State Applicants, please complete our SAFE‑T TeleSANE interest form. We accept qualified applicants from all states. Shape the next...

Guidehealth is a fully remote organization seeking a Care Manager to guide patients and families through complex health journeys from a Louisiana base. You will combine clinical expertise with holistic care, coordinating medical, behavioral, and...

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...

Carle Health is seeking a Registered Nurse to support telehealth triage and care coordination. The role begins with six months of in-office training at our Champaign, IL location before transitioning to remote work. You will manage triage,...

Integra Partners is seeking an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals for DMEPOS, in a NCQA-compliant UM program. The candidate will collaborate with our Medical Director on benefit and medical...

Requisition number: 2394000 Job category: Nursing Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health...

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...

Corrections Registered Nurse (RN) Setting: Corrections Job Type: Travel Pay: $2400 / Week Hours: 40.00 Location: Los Angeles, CA The Correctional RN works in collaboration with other healthcare...

Medlivo is seeking a travel nurse RN Utilization Review for a travel nursing job in Downey, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment...

Cassia is seeking an experienced Minnesota RN for an After-Hours triage role in Assisted Living, offering remote part-time work. You will triage calls from clinical staff, provide guidance, coordinate with hospitals and families, and document in...

Evergreen Nephrology is seeking a licensed practical nurse to conduct monthly CCM touchpoints, address clinical concerns, reinforce CKD care plans, and ensure accurate documentation across EHR and CCM systems. This remote role supports patients...

TeleMate Health INC. is seeking a compassionate Weekend Nurse (LPN/LVN) to provide patient-centered care remotely on weekends, including oversight, education, and coordination with the patient's healthcare team. A valid LPN/LVN license and...

Clinical Review Nurse - Concurrent Review TX All On-site Share on Job Description Location: 100% Remote - TX: RN only with TX license SHIFT: Tuesday – Saturday 8am-5pm CST- schedule is firm- no flexibility...

Summary Boise VA Medical Center (BVAMC) is an interdisciplinary teaching facility with service-lines serving medical, surgical, inpatients and outpatients, with an Emergency Department, and multiple community-based outpatient clinics...

Humana is seeking an Utilization Management Registered Nurse for a remote role. You will interpret clinical data to coordinate, document, and communicate medical services and benefit determinations, using Milliman Care Guidelines or InterQual...