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Humana is seeking a Pre-Authorization Nurse to review requests for medical necessity and level of care, working remotely from Virginia or a compact-licensed state. You will educate providers, document clinical data, and make independent...

POSITION SUMMARY Reporting to the Director, Ambulatory Services of Martin Luther King, Jr. Los Angeles (MLK-LA) Healthcare Corporation, the Ambulatory Clinical RN as the leader of the health care team, provides professional...

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...

Trillium Health Resources is seeking a Population Health Nurse to provide clinical care management and population health support for assigned members, focusing on prevention, wellness, and outcomes. The role uses nursing judgment as an RN to...

10-hour shifts POSITION SUMMARY The Clinical Staff PACU Nurse is a skilled and experienced professional Registered Nurse (RN) responsible for excellence in the clinical practice of nursing and the management of patient...

Bon Secours Mercy Health is seeking an RN Infection Prevention professional to manage system-wide IPC activities, ensuring compliance with regulatory standards. This role supports outbreak investigation, surveillance, and performance improvement...

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...

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...

JOB DESCRIPTION Job Summary Work Location: California - Ability to work remote, but selected candidate must reside in the state of California. This position requires California RN Licensure. Candidates must...

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...

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.

The Veterans Health Administration in East Orange, NJ seeks a Registered Nurse to serve as Community Care Coordinator. You will coordinate care across VA and community providers and guide Veterans through their care options.

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.

Case Manager Utilization RN 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...

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...

Clinical Documentation Integrity Specialist Evaluates the day to day documentation practices of the Medical Staff and healthcare team on a complex patient population, and offers education and recommendations in accordance with the...

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...

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...

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...

Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET Medix is supporting a healthcare technology organization that is adding experienced RNs to its clinical...

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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...

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...

Job ID: 32839 *Description* The Pediatric Pain & Palliative Care Nurse Practitioner (NP) is an advanced practice provider who delivers comprehensive, family-centered care to infants, children, adolescents, and young adults with acute,...