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Sentara Health Plans is seeking a Clinical Claims Reviewer/RN for a remote, full-time position. Responsibilities include utilization management, pre/post payment claim reviews, and authorization assessments across inpatient and outpatient cases,...

Certified Nursing Assistant (CNA) Coordinator Professional ExpertGlendale Community College is currently accepting applications for a Certified Nursing Assistant (CNA) Coordinator Professional Expert.Examples of DutiesProvides support in managing...

Molina Healthcare is seeking a Care Review Clinician (RN or LPN) for a remote, full-time position operating 8a-5p Pacific Time, Monday through Friday. You will support clinical member services review processes, verify medical necessity, and ensure...

OpTech is seeking a Registered Nurse (RN) to support utilization review and clinical review activities for a Michigan health plan. This role involves evaluating medical services for medical necessity, level of care, and clinical criteria. The...

LifeBridge Health's Sinai Hospital Utilization Review team is seeking a remote, full-time RN to conduct initial, concurrent and retrospective chart reviews, applying UR criteria to ensure hospital stays are appropriate and fully covered by...

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...

Compliance Nurse 2 - LTC Program (Metro Atlanta Region) The Georgia Department of Community Health (DCH) is one of Georgia's four health agencies serving the state's growing population of over 10 million people. DCH serves as the lead...

Job Description The Peer Review RN is responsible for facilitating the design, implementation and the ongoing evaluation of the physician peer review program and nursing peer review process in collaboration with physician...

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving...

RN Pediatric School Nurse (Paid Training) - Los Angeles Job Description: Are you a licensed RN with a passion for working with children? Do you want a role with a great schedule, competitive...

Benefits: 401(k) Competitive salary Paid time off Who We Are Wound and Burn Centers of America is the World's Leading Provider of Wound Healing Services. We are specialized in Complex Wound Healing, Burn Injuries,...

Abbott is seeking a per-diem RN trainer to deliver home-based training for Acelis Connected Health's PT/INR products across the United States. The role includes remotely scheduling sessions, traveling to patients' homes, and guiding caregivers on...

Registered Nurse (RN) – Downey,CA Local Pay: $52.65/hour (W2) Join our team and make a meaningful impact by delivering exceptional care in a professional healthcare setting.

Job DescriptionJob Summary Provides support for clinical facility site reviews. Under the supervision of leadership, uses clinical judgement within appropriate scope to independently conduct reviews and other monitoring activities...

Cincinnati Children's is seeking a Registered Nurse for the After Hours Helpline. This remote, full-time role operates when offices are closed from 4:30PM to 9:00AM, with MON-FRI and 24/7 weekend coverage, including holiday rotation. The...

Allegheny Health Network is seeking a Clinical Documentation Improvement professional to enhance inpatient medical record documentation and ensure accurate coding and reimbursement. The role involves extensive collaboration with physicians,...

Description Virtual coordination role to support front line clinical staff in care of patients receiving care in the home setting. Serve as an extension to front line staff in patient care logistics management including admission...

Peraton's SafeGuard Services seeks a Nurse Reviewer to conduct medical record reviews, applying clinical judgment to claim payments and supporting fraud investigations. Telework is available from any state. The ideal candidate will hold a...

WNS Healthhelp in the United States is seeking an RN/LVN Team Lead to oversee utilization management and case coordination. You will balance review work with leadership duties, monitor staffing, and ensure regulatory compliance across programs.

AccentCare is seeking a Regional Clinical Support Specialist IPC. The role supports hospice inpatient care programs with nursing teams across the Southeast region, emphasizing Florida and Georgia. This full-time, remote-friendly position requires...

LPN Position at Centerstone Centerstone is among the nation's leading nonprofit behavioral health systems with thousands of employees dedicated to delivering care that changes people's lives. A dynamic, well-established organization, we...

Concierge Home Care is seeking an experienced Utilization Review Specialist (RN) to join our remote home health team. This Florida-based role requires OASIS and coding certifications and supports QA and regulatory compliance. You'll review...

Improve the lives of others while Caring. Connecting. Growing together. Job Description - Preservice Review RN - Remote in HI (2392416) Preservice Review RN - Remote in HI - 2392416 Optum is a global organization that delivers...

Enlyte in Downey, CA is seeking a Field Case Manager (RN) to lead workers' compensation case plans, coordinating with physicians, employers, and patients to ensure effective and timely recovery and return-to-work.The ideal candidate has 2+ years...

Description: Centered in the heart of Boyle Heights, Adventist Health White Memorial is one of the area's leading healthcare providers since 1913. We are comprised of a 353-bed hospital, three medical office buildings, residency programs,...