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UnitedHealth Group is seeking a Clinical Grievances Nurse to review retrospective cases for appropriate care and address members' immediate needs. The role embraces remote PST hours with an on-site base in Mesa, AZ, requiring CA residency and an...

CVS Health Corporation seeks an experienced Registered Nurse (RN) to support 24/7 Utilization Management operations. You will review cases, assess medical necessity, coordinate care, and ensure members receive appropriate, high-quality healthcare...

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...

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 applies clinical judgment to assess documentation, determine...

*Job Summary and Responsibilities* As our Nurse Shift Manager, you will help lead and coordinate our exceptional nursing team so they can deliver timely, compassionate, and life-saving care to patients in critical situations. Every...

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

Optum is seeking a registered nurse in Hawaii to assess needs, interpret requirements, and identify solutions while working with minimal guidance. You will interpret clinical documentation, support care decisions, and coach peers as an expert...

*Job Summary and Responsibilities* As our Registered Nurse (RN), you will be a pivotal healthcare professional, delivering compassionate, high-quality care that truly impacts our patients' well-being and recovery. Every day, you will...

A technology and business consulting firm is seeking a Clinical Medical Review Nurse to analyze health data and provide insights for internal stakeholders. The ideal candidate has a Registered Nurse license, along with four years of clinical...

Job Title: Clinical RN Job ID: 90637 Location: North Hollywood, California Overview: Are you a dedicated Registered Nurse who excels in outpatient clinical care and thrives in a...

CVS Health is seeking an experienced Medicare Precertification Utilization Management Nurse Consultant (RN) to support coverage determinations remotely. The role requires collaborating with providers and care teams to coordinate treatment plans...

CommonSpirit Health is seeking a Connection Center Virtual Registered Nurse (RN) to deliver high-quality, patient-centered care remotely via phone and video. The role covers the full nursing process, from virtual assessments to planning and...

The RN Clinical Educator, Ancillary Services is an advanced clinical expert in Cath Lab and procedural-based services who supports the professional growth, development, and competency validation of staff in Ancillary Services including Cath Lab,...

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,...

Guidehealth, a data-powered healthcare company, is seeking a remote Care Manager (RN) to guide patients through complex health journeys. You will blend clinical expertise with holistic care, educate patients, and coordinate across providers to...

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...

Sentara Health Plans is hiring a Clinical Claims Reviewer/ RN - Remote! This full-time position supports utilization management, pre/post payment reviews, and authorizations across various care settings. The RN clinician must have a BSN and...

Humana is seeking a Pre-Authorization Registered Nurse for a remote, full-time role based in Virginia. The RN will review prior authorization requests, determine appropriate care settings, and educate providers on utilization and management...

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

Spectrumforce Technologies, Inc. is seeking a Care Manager (RN) to support Medicaid members remotely in Florida. The role involves reviewing referrals, proactive outreach, and guiding members through care management, education, and coordinated...

Registered Nurse Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Part-Time Shift: Evenings Job Description Join a team that's shaping the...

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management). *** Candidate must be authorized to work in USA without requiring sponsorship...

Charlotte, North Carolina, United States IMPORTANT: after you apply, please check your email. We sendyou a link to complete your application - it is not considered until that laststep is done. If you do not see it, check...

Registered Nurse (RN) For Immunization Program We are seeking Registered Nurses (RN) to support a large immunization program at retail pharmacy locations. The RN will administer state-approved immunizations, including pediatric...

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...