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The Clinical Research Nurse (CRN) will provide direct patient care to patients enrolled in or considering a clinical trial. The CRN, in collaboration with the satellite physician(s), is responsible for the implementation and evaluation of clinical...

Job Title This is a remote, PRN position but will need onsite training in Mishawaka Indiana. Shift: Days - 8 hr shift LOCAL CANDIDATES ONLY! Why Choose Saint Joseph Health System? At Saint Joseph Health System, our values...

Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. As an inpatient review nurse, you will assist patients through the continuum of care in collaboration with the patient's primary care physician,...

NTT DATA, Inc. seeks a Clinical Reviewer Specialist to perform clinical and medical necessity reviews for member and provider appeals, evaluating records against NCQA standards and Medicaid requirements. Role offers remote work within...

Job Title Conducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital...

Clarity Pediatrics is seeking a Nurse Care Coordinator (RN) to join our remote care team. You will coordinate clinical appointments, educate families, manage medication authorizations, and serve as the primary contact between families, providers,...

THIS IS A REMOTE POSITION Part Time/Contract Position DUTIES: -Assess patient health problems over the phone and via secure video -Schedule appointments and refer patients -Advise and monitor...

UnitedHealthcare is seeking a Level2 Registered Nurse to deliver comprehensive diabetes self-management education and coordinate care for adults with type 2 diabetes. The role emphasizes patient education, telehealth visits, and collaboration...

WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant patient care. The role emphasizes adherence to HIPAA, state and federal regulations, and a...

Providence Tarzana Medical Center in Tarzana, CA is seeking a Certified Nursing Assistant for the Cardiovascular Unit. This Full-Time role requires CA Nursing Assistant Certification, BLS, and completion of the Nursing Assistant course, with...

Responsibilities SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

Centene is seeking a Clinical Review Nurse for a remote role supporting members in Pennsylvania. The candidate will perform concurrent reviews, assess care necessity, and contribute to discharge planning, leveraging case management or utilization...

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...

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...

AccentCare, Inc. is seeking a Licensed Practical Nurse (LPN) for full-time, field-based patient care in the Chicago area, covering from S. Chicago to Hyde Park. Under RN supervision, you will provide direct nursing care to pediatric through...

Housing Advocacy Vocational and Employment (HAVE) in Gaithersburg, MD is seeking a dedicated Registered Nurse/Delegating Nurse (RN/DN) to support individuals with developmental disabilities under Maryland's DDA program. Responsibilities...

Nurse Consultant Come join our Symbria Team! We are seeking a highly professional and dedicated individual to join our EMPLOYEE-OWNED TEAM as a Nurse Consultant in the pharmaceutical industry at our Pharmacy in Pennsylvania!

Ensemble Health Partners is seeking a Virtual Utilization Review Supervisor to lead utilization reviews, ensure medical necessity, and drive revenue integrity across the care continuum. You will work with physicians, nurses, and coding...

GQR Healthcare is seeking a local contract nurse RN DOU - Direct Observation Unit for a local contract nursing job in Panorama City, California. Job Description &...

Public Health Nurse We are pursuing qualified candidates to fill Public Health Nurse positions within the Department of Public Health. This position provides public health nursing services in a facility or in the field, at the individual,...

Position Title: Remote Telephonic RN Case Manager Mandatory Requirement: Must hold an Active Compact RN License and/or an Active California (CA) RN License to be considered. Pay Rate: $48.00 – $50.00 per hour...

IPRO in New Rochelle, NY seeks a Nursing Home Surveyor/Complaint Investigator to assist NYSDOH with surveillance and investigations at nursing homes and TCUs. The role involves reviewing abuse eglect allegations, preparing reports, and ensuring...

Job Description Description: Work Schedule: Day/evening, you will work six 10-hour shifts per pay period including weekend rotation. Holiday rotation required. Hours are based off...

Integra Partners seeks an experienced LPN/LVN to perform pre-service and post-service utilization reviews and appeals in a NCQA-compliant UM program. The role collaborates with the Medical Director to assess medical necessity and benefit coverage...

Registered Nurse (RN) Lake Regional Healthcare is currently seeking Registered Nurses (RN) to deliver the best possible nursing care in LRH's patient-focused setting. Summary: Utilize the nursing process to identify patient...