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Supports the values of service excellence, teamwork, and integrity while managing patient care.Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers.Qualifications:Requires a current RN license, nursing diploma or...

Spectraforce Technologies, Inc. is seeking a Clinical Review Nurse - Prior Authorization to perform clinical reviews of authorization requests using established criteria, plan benefits, regulatory requirements, and internal policies.

JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to...

Gainwell Technologies is hiring a Senior Nurse Reviewer for a remote, home-based role across the continental US. The position focuses on reviewing medical claims, UB-04 forms, and itemized bills to ensure accuracy and proper billing, with emphasis...

SCP Health seeks a Senior Vice President, Anesthesia APP to lead multi-site CRNA teams and drive clinical leadership across the network. You will partner with hospital leadership, oversee performance and compliance, and help shape growth...

Our promise to you: Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is...

Volunteers of America Los Angeles seeks a Licensed Vocational Nurse (LVN) to provide professional nursing services in a residential substance use program. You will monitor withdrawal, support MAT, and conduct health assessments under supervision...

Primary Duties and Responsibilities Sets up exam room/procedure rooms appropriately based on patient visit needs Performs initial nursing intake and prepares patients for examination. Prepares patients for...

Optum is recruiting a remote Behavioral Health Utilization Review Specialist to support case management for behavioral health and substance use. You will review cases, determine levels of care, and coordinate transitions between inpatient and...

Bon Secours Mercy Health is seeking an RN Infection Prevention professional to manage system-wide IPC activities, ensuring compliance with regulatory standards. This role supports outbreak investigation, surveillance, and performance improvement...

Join us During a Time of Growth and Transformation Become a part of the Greater Los Angeles VA Healthcare System as it undergoes significant expansion and transformative change. This is a unique opportunity to contribute to a system...

Elwyn seeks a Licensed Staff (Licensed Vocational Nurse or Licensed Psychiatric Technician) to work with our team in residential group homes. Primary Function. The Licensed Vocational Nurse (LVN) and Licensed Psychiatric Technician (LPT) perform...

The Ohio State University is seeking a Staff Nurse (RN) for Oncology Continuing Care Triage. This remote phone triage role handles oncology patient calls, performs initial assessments, and uses triage algorithms to guide care. The nurse documents...

Aya Healthcare has an immediate opening for the following position: Outpatient Clinic in Beverly Hills, CA.We'll work with you to build the healthcare career of your dreams. Whether you want a job close to home or across the country, we've got...

A-Line Staffing Solutions seeks a Licensed Practical Nurse (LPN/LVN) for an Outpatient Clinic in Arcadia, CA. The position is 100% on-site, with pay rate $37.17/hr and 32–40 hours per week. Shifts are 7–10 hours, 2–3 weekdays and every other...

Children's Mercy Job Opportunity Do you envision finding a meaningful role with an inclusive and compassionate team? At Children's Mercy, we believe in making a difference in the lives of all children and shining a light of hope to the...

Department of Anesthesiology | City of Hope National Medical Center in Duarte, CA City of Hope Medical Group Seeks an Anesthesiologist to Join the Clinical Team The Department of Anesthesiology at City of Hope National...

Physicians East seeks a QEC Pre Procedure Screening Nurse for a part-time remote role based in Greenville, NC. The nurse will review patient charts, screen for procedural eligibility, and coordinate with physicians to ensure proper evaluation and...

Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make...

Trillium Health Resources is seeking a Compliance Nurse to perform clinical compliance reviews and evaluate claims to ensure adherence to regulatory and coverage requirements. The role requires an Associate's degree in Nursing, NC RN licensure,...

Virginia Mason Medical Center in the Puget Sound region seeks a Clinical Documentation Review Specialist (RN) to clarify patient records for appropriate reimbursement and care complexity. You will conduct concurrent reviews and engage with...

Ready to Make a Difference in Healthcare? At TruHealth, we're transforming care for seniors in long-term care with an innovative, proactive model that promotes dignity, independence, and quality of life. Join a team built on trust,...

Piper Companies is seeking a Clinical Appeals Nurse for a fully remote, long-term contract in the healthcare sector. The role focuses on clinical review, appeal resolution, regulatory compliance, and member/provider support within a complex health...

Actalent is seeking a Case Management Nurse to deliver client-centered case management across the continuum of care. The role blends direct patient contact with care coordination, education, advocacy and resource navigation to improve outcomes.

Yoh is seeking a Utilization Management Nurse Coordinator (RN or LVN) for a 6+ month remote contract with a managed care client based in Northern California. Training occurs onsite in Fairfield or Redding for three weeks, then transitions to fully...