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To support a mission-driven health organization, the full-time Utilization Review Nurse - RN will conduct medical necessity reviews, escalate non-certifications for secondary clinical review, and analyze clinical records to ensure timely and...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing, and evaluating the care of patients. The staff RN utilizes the nursing process by use of...

Performs an age specific plan of care for a designated group of patients using the nursing process of assessment, diagnosis, outcome identification, planning, implementation and evaluation of patient care. Collaborates with physicians and other...

BJC Medical Group seeks a Part-Time Clinical Triage Nurse to provide direct telephonic care to both adult and pediatric patients in a remote Access Center. The role relies on strong nursing judgment and assessment skills to direct patients to the...

After Hours Service Answer Line Rn The Answer Line After Hours Service provides after-hours exchange and nurse triage services for over 300 subscribing community pediatricians in the St. Louis and surrounding areas. Answer Line RNs...

Get AI-powered advice on this job and more exclusive features. This range is provided by The Judge Group. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range...

Job Description Do you have a passion for the highest clinical quality and patient happiness? Would you like to use your expert clinical competencies 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.

Job Description Job 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...

Salary : $105,247.44 - $157,542.24 Annually Location : Los Angeles County, CA Job Type: Full time Job Number: PH5230H Department: PUBLIC HEALTH...

Telephonic Registered Nurse We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care...

Blood Cancer United is seeking a nurse to support patients pursuing clinical trials and educate families on diagnostic and treatment options. You will collaborate with the IRC and trial staff, maintaining a caseload and contributing to materials...

CVS Health is seeking an experienced RN Case Manager for a remote role across the United States. The position involves telephonic case management of members, applying clinical guidelines, and coordinating care with care teams to optimize outcomes.

Title: Family Nurse Practitioner Base Salary Range: $142,000 - $145,000 plus benefits FTE: Full -Time - Exempt We are seeking a dynamic and experienced Family Nurse...

At St. Tammany Health System, delivering world-class healthcare close to home is our goal. That means we are committed to attracting and retaining the very best professionals for every position in our health system. We believe the pristine...

MedStar Health is seeking a Nurse Practitioner for the Diabetes Boot Camp. This remote role focuses on delivering intensive diabetes management and education via telehealth to patients with newly diagnosed or established diabetes. You will...

Case Manager Utilization RNWorks collaboratively with an MD to coordinate and screen for the appropriateness of admissions and continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the...

Qlarant, a nonprofit organization, seeks a Nurse Specialist II to perform medical record and claims review for Medicare, Medicaid, and other data. This remote role in the United States involves ensuring adherence to guidelines while assessing for...

Atrius Health, part of the Optum family, seeks a Registered Nurse to deliver effective care within a specialty, adhering to nursing standards. The role emphasizes education, care coordination, and EMR documentation, with remote work flexibility...

$5,000 Sign-on Bonus for External Candidates Telephonic After-Hours Call - Per Diem Active Nurse Practitioner license in Connecticut or Rhode Island Required Optum Home & Community Care, part of the Optum family of businesses, is creating...

ATC Candidate Medical Clearance Coordinator Serves as a member of a multidisciplinary team to provide assessment, planning, implementation, coordination, evaluation and monitoring of ATC Candidates throughout the medical clearance...

CVS Health is seeking an experienced Registered Nurse (RN) for Utilization Management in a remote, work-from-home role. You will review clinical data, apply guidelines and collaborate with care teams to ensure appropriate, high-quality,...

A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing...

Float Health is seeking an Intake Specialist to manage new patient referrals and coordinate start-of-care visits. This externally facing role requires quick action, clear communication, and meticulous attention to detail to ensure timely,...

The Veterans Health Administration at the Charleston VA Medical Center seeks a Nurse Manager (RN) to lead and supervise designated units within Community Care. The role emphasizes staff development, evidence-based practice, and collaboration with...