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U.S. Army Family Nurse Practitioners perform the highest level of quality care for Army Soldiers, retirees, and their families. If you are looking to combine your skills as a family nurse practitioner and your passion for...

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...

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...

JOB DESCRIPTION Opportunity in Southern California for an experienced Managed Care Leader to join our health plan in California. Candidates must have a minimum of 7 years of healthcare experience, 3 of those should be with a Managed Care...

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...

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...

Responsibilities: How you'll change lives ...

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...

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...

Provides direct nursing care including: assessment, plan of care, education, and evaluation for assigned patients. Performs patient duties necessary to maintain the flow of...

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...

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...

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...

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.

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...

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...

CVS Health is seeking an RN Nurse Consultant for a remote role focused on utilization management and benefit coordination. The position emphasizes evidence-based decision making and collaboration with providers to ensure appropriate patient care.

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...

Care Career is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Torrance, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 10/26/2026 Duration: 13 weeks 40...

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

We are so glad you are interested in joining Sutter Health! Position Overview: Aids patients in obtaining the correct level of care with the appropriate provider at the right time. Provides advance clinical telephone...

WORK REMOTELY after training! CANDIDATE MUST RESIDE IN THE METROPOLITAN NEW YORK AREA! !! Process all requests for services in accordance with Medicare and NYS Medicaid guidelines as well as departmental criteria and...

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...