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Get AI-powered advice on this job and more exclusive features. This range is provided by Medix. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $37.00/hr...

Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in accordance with established standards of care, policies, and procedures. Demonstrates performance...

Case Manager Utilization RN, 32 Day Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate...

Trillium Health Resources is seeking a Registered Nurse to join our Utilization Management team in North Carolina. The UM reviews, coordinates care, and supports discharge planning to improve outcomes and ensure appropriate utilization of...

BJC HealthCare in Missouri is seeking an experienced RN for a remote Utilization Review role supporting hospital units nationwide. The position requires patient-care experience in hospitalized settings and UR background, with no patient...

As a Clinical Documentation Review Specialist (RN), you will help medical staff clarify patient records to ensure appropriate reimbursement and reflect care complexity. You will perform concurrent reviews and engage with physicians...

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Clinical Documentation Improvement Specialist-RN- Remote The Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) assists with the identification of diagnoses, conditions, and procedures that are representative of the...

TEEMA partners with a top healthcare organization to recruit a Clinical Quality Reviewer. You will review medical records for quality and utilization concerns, and prepare clear recommendations for quality improvement. Remote or onsite...

Job ID: 25833 *Description* The staff RN PD is a professional caregiver who assumes responsibility and accountability for the surgical patient. Under minimal supervision, functions as a scrub and circulating nurse. Participates in call...

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...

Sagility is hiring an RN Utilization Management Reviewer for a fully remote, home-based role in the United States. You will perform day-to-day clinical and service authorization reviews for medical necessity and ensure compliance with CMS...

JOB DESCRIPTION - REGISTERED NURSE (A) Job Summary: The Registered Nurse provides patient care on a supplemental basis to our client facilities. With the delivery of safe, quality patient care as...

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...

ExamWorks is seeking a self-driven RN or LPN to join our team as a Clinical Quality Assurance Coordinator. This 100% remote role supports peer review reports, ensuring high quality, evidence-based rationales, and compliance with client...

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...

Overview TEEMA is partnering with a leading organization supporting a large-scale federal healthcare program to identify a Clinical Quality Reviewer. This role focuses on reviewing clinical cases, identifying potential quality or safety...

Abbott is seeking a per-diem RN trainer in the Durham, NC area to deliver Face-2-Face training for home testing customers. You will guide finger stick collection, explain PT/INR device use, and assist with reporting responsibilities. The...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Job Summary: Works 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 medical...

Humana is seeking a Pre-Authorization Nurse to review and authorize care requests in a remote role based in Virginia or a compact-license state. You will evaluate medical necessity, coordinate with internal stakeholders, and educate providers on...

Authorization Nurse Do you have clinical care experience? Are you an RN looking to grow your career? UPMC is hiring a full-time Authorization Nurse. This position works Monday through Friday, as well as rotating weekends (typically 1...

Job DescriptionRegistered Nurse (RN) Care Management Specialist Location: Remote- Onsite for Training (Must reside within 2 hours of Columbia, SC) Pay Rate: $30/hour ScheduleMonday through...

Spectraforce Technologies, Inc. is seeking a Clinical Review Nurse - Prior Authorization for a 12-month assignment. The role is remote (PST/CST) with scheduling across multiple shifts, supporting national guidelines and contractual requirements.

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...