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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...

To support client care authorization processes, the part-time Temp Clinical Letter Writer will gather and review medical records, draft letters of medical necessity, and communicate with team members regarding client authorizations and...

Job Summary This position is responsible for ensuring compliance with Utilization Management (UM) and Quality Review (QR) functions performed by the health plan. The role supports clinical review activities requiring 5+ years of...

CVS Health is seeking an RN for utilization management, coordinating care and determining coverage for members. The role requires clinical judgment, strong communication with providers, and the ability to work in a fast-paced setting. The...

Job Title: Nurse, Clinical Medical Review Location: Columbia, MD (Primarily remote, but hybrid) Duration: 6 Months Contract PURPOSE: We are seeking a qualified RN or LPN with experience supporting HEDIS reporting and abstraction processes in a...

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...

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 consistent...

Freeman Health System is hiring for a remote/hybrid position in Utilization Review and Case Management. The role focuses on assisting Emergency Department patients with their social and discharge needs. Candidates must be licensed RNs with strong...

Compensation: $85,000 – $92,000 Hourly Equivalent: ~$41–$44/hr Location: Remote Schedule: Must work AZ hours (typically 1st shift) CLIENT NOTES / EXPECTATIONS Candidates must meet required AND preferred...

Baptist Health is seeking a remote Clinical Documentation Specialist to evaluate physician documentation and ensure accurate illness severity portrayal for coding precision. The role requires an active Kentucky license and involves guiding...

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 beauty...

Ethos Risk Services is seeking a full-time Clinical Recruiter (REMOTE) to lead hiring for the Case Management division. You will own full-cycle recruiting for nurse case managers and other clinical pros, from posting to onboarding, ensuring a...

Sentara Health Plans seeks an RN Clinician to perform utilization management and claim reviews across inpatient and outpatient settings. The role supports pre/post payment reviews and authorization assessments, ensuring compliance with policy and...

Registered Nurse (RN)– Downey,CA Local Pay: $52.65/hour - (W2) Join our team and make a meaningful impact by delivering exceptional care in a professional healthcare...

Oregon Department of Corrections is seeking an experienced Institution Registered Nurse for a limited-duration role based in Salem, OR, with remote work options. The RN will review medical records, assess care adequacy, and coordinate services...

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...

Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges.

8 Hours POSITION SUMMARY The Clinical Staff Nurse is a skilled and experienced professional Registered Nurse (RN) responsible for excellence in the clinical practice of nursing and the management of patient care.

UnitedHealth Group is seeking a SSBV Clinical Claims Review RN for a remote role nationwide. You will perform administrative reviews of inpatient hospital claims, document determinations, and ensure accurate use of screening criteria to support...

Managed Medical Review Organization is seeking a skilled registered nurse for a remote, home-office role. The position emphasizes telephonic/customer service, accurate documentation, and clinical review duties without face-to-face patient contact.

Amerit Consulting is seeking an experienced Utilization Management Nurse (RN) in California for a remote 6-month contract. The incumbent will support inpatient utilization review, medical necessity determinations, and facility claims compliance,...

Improve the lives of others while Caring. Connecting. Growing together. Job Description - Preservice Review RN - Remote in HI (2392416) Preservice Review RN - Remote in HI - 2392416 Optum is a global organization that delivers...

Memorial Hermann Health System is seeking a Clinical Documentation & Integrity Specialist for a remote role in Texas. The RN must hold a BSN or MSN and have at least five years of inpatient acute care experience, with ICU exposure preferred.

CVS Health is seeking an experienced Registered Nurse for Medicare Precertification Utilization Management in a remote, full-time weekend schedule. The role emphasizes ensuring appropriate care, coordinating with providers, and applying guidelines...