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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...

About This Role As an Inpatient Care Management Nurse, you will be responsible for ensuring proper utilization of health services by assessing and interpreting member needs and identifying solutions to help members live healthier lives.

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse. The Utilization Review Nurse is...

About the jobMercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark , General Catalyst , Peter Thiel , Adam D'Angelo , Larry Summers , and Jack Dorsey...

The RN Certified Diabetes Care and Education Specialist has experience in diabetes care and education. The RN will contribute to developing, reviewing, and revising all diabetes education material. The RN promotes self-management to achieve...

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...

Fully Remote : Clinical Documentation Specialist Job Description Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers.

*Job Summary and Responsibilities* As our RN Trauma Performance Improvement, you will contribute significantly to our mission by leading proactive efforts to minimize traumatic injuries and support vulnerable patients. Your role elevates...

CVS Health is seeking a dedicated RN Case Manager in Massachusetts to coordinate comprehensive care for members, develop care plans, and communicate with providers and families. The role focuses on monitoring progress, advocating for patients, and...

First Connect Health is seeking a travel nurse RN Short Stay for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: Short...

CEI is seeking an RN/Managed Care Coordinator in Columbia, SC. The role trains onsite for 4 weeks, then remote work is possible under a hybrid model. W2 contracting with pay of $34/hour plus optional benefits. Responsibilities include...

Medix is partnering with a leading national healthcare organization to hire Registered Nurses for a fully remote Utilization Review team. The role offers a base salary of $63,100–$90,000 per year with a 5% target annual bonus and up to 20%...

GQR Healthcare is seeking a travel nurse RN Care Manager for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: Care...

Carle Health seeks a Registered Nurse to deliver high-quality care within the Illinois RN scope and to guide patients, families, and care teams. The role includes a required six months of in-office training at the Champaign location before...

RN opportunity with out the bedside burnout + sign on bonus. This Jobot Job is hosted by: Dexter Dionio Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $80,000 -...

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...

RN Utilization Review Review patient medical records to assess the appropriateness and medical necessity of hospital admissions, continued stays, and services, while coordinating with providers and payers to ensure compliance with...

TEKsystems seeks a Clinical Quality Assurance Specialist (RN/LPN) for a 100% remote, full-time role in the United States. The position offers a competitive hourly rate and a four-day work week with comprehensive benefits for full-time employees.

A healthcare staffing company in Torrance, CA is seeking a Senior Healthcare Recruiter for a remote RN position. The ideal candidate will have at least 1 year of Home Health experience and must possess an active CA RN License. Responsibilities...

DataForce by TransPerfect · Project listing Registered Nurse (California, Remote) Listed on DataForce by TransPerfect as “Registered Nurse (California, Remote)” Original posting from DataForce by TransPerfect Work...

Care Career is seeking a travel nurse RN Case Management for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: Case...

Sentara Health is seeking a part-time Registered Nurse for a physician practice/ambulatory clinic, with remote work options. The RN will assess patients, assist with procedures, administer meds and vaccines, and coordinate care across the care...

Inova Schar Cancer Institute is seeking a Registered Nurse for a fully remote PRN role. The position supports Oncology clinics with a flexible M-F schedule, 8:00–4:30 or 8:30–5:00, with no weekend, night shifts, or on-call hours. Inova...

*Job Summary and Responsibilities* As our Charge Nurse, you'll oversee a department of frontline nurses caring for patients. Your previous experience in acute care, LTC, or nursing homes adds tremendous value to our nursing team. Every day...

Humana is seeking a Utilization Management Registered Nurse to interpret and support coordination, documentation and benefit determinations for post-acute care services (SNF, Home Health, DME). You will report to the Manager of Utilization...