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Vail Health has become the world's most advanced mountain healthcare system. Vail Health consists of an updated 520,000-square-foot, 56-bed hospital. This state-of-the-art facility provides exceptional care to all of our patients, with the most...

Sentara Health is hiring an Integrated Case Manager, RN. This remote role requires travel to Roanoke, VA for in-person assessments and periodic member visits. You will manage care plans, coordinate services, and collaborate with medical directors...

The VITAS Telecare RN is a member of the interdisciplinary team who is the pivotal person responsible for identifying the physical, psychological, social, and spiritual needs of those patients and families needing assistance after normal business...

BlueCross and BlueShield of South Carolina seeks an RN Medical Reviewer II to join the Palmetto GBA Medical Review team. You will perform medical reviews using clinical information, apply guidelines, and help ensure accurate coverage and payment...

We are looking for a Travel CVOR RN for a great Travel nursing job in Los Angeles, CA. This CVOR Travel nursing job pays for 36 hours a week for 13 weeks. With Wanderly you can compare...

Wellstar is seeking a Remote RN to join an interdisciplinary team delivering high-quality patient care via phone or secure messaging. This role is fully remote and led by a nurse supervisor. An active RN license and BLS are required, with Georgia...

Sentara Health is hiring a Remote Utilization Review Registered Nurse to perform prior authorization and utilization review for inpatient and outpatient services. Candidates must reside in Virginia and hold an active Virginia RN license. As...

Peraton, through SafeGuard Services (SGS), is seeking a Nurse Reviewer to conduct medical record reviews and determine claim payments with sound clinical judgment. The role involves researching Medicare regulations, identifying billing issues, and...

Manage patients assigned to your Care Team, ensuring visit frequencies align with acuity levels. Communicate via phone and video conferencing, assess and enroll patients, and develop care plans. Manage medications,...

TriWest Healthcare Alliance is seeking a Utilization Management Clinical Review nurse to assess medical necessity and manage prior authorizations for Behavioral Health and Medical/Surgical requests. You will apply InterQual criteria, document in...

Sedgwick is seeking an RN Telephonic Case Manager to support injured workers remotely. You will partner with workers, employers, and medical providers to develop care plans that promote medical recovery and a successful return to work. The...

Apply clinical expertise to the intersection of healthcare and legal services as a Legal Nurse Consultant.Support attorneys by analyzing medical records, evaluating injury-related cases, and providing objective medical insights.Work independently...

UnitedHealthcare is seeking an HSS Clinical Coordinator RN to serve as the primary care manager for a panel of members with complex health needs, including behavioral health, with a focus on coordinating medical, behavioral, and social...

Buena Vista Home Health, Palliative Care & Hospice (BV) is seeking an experienced OASIS Review Nurse (RN) for a remote, part-time QA role. The RN will ensure OASIS assessments are accurate, complete, and compliant with CMS regulations and state...

Conduct telephonic nursing assessments and triage using protocols.Provide health education and referrals to diverse patient populations.Work Schedule:Full-time evenings with weekend shifts every two weeks.Virtual training for 2-4 weeks, 100%...

AuthoraCare Collective is seeking an RN for our After-hours Triage department serving our Burlington and Greensboro service areas. This is a remote part-time position; Every other Saturday and Sunday 10:00am - 4:00pm. Must reside in the...

Trinity Health At Home is seeking a Virtual Care Coordinator RN to deliver telehealth hospice care and coordinate individualized care plans for patients and families from a remote setting. The role involves monitoring patient conditions,...

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.

HCSC is seeking a remote QOC Nurse under the supervision of the QOC Manager to conduct review and investigation of quality of care issues. The role supports quality improvement activities in compliance with CMS, NCQA and other regulatory...

The University of Texas MD Anderson Cancer Center is seeking a Denials Management Coordinator to support revenue cycle operations by coordinating review, analysis, and resolution of insurance denials and to help secure accurate reimbursement. This...

5K Sign On Bonus!Southwest Care Center employees can answer yes to these 3 questions: 1. Do you want to make a difference? 2. Do you believe everyone is entitled to quality healthcare? 3. Do you desire to serve the...

Intermountain Health is seeking an RN Utilization Review Care Management I for remote work. The role focuses on screenings, assessments, and evaluations to ensure cost-effective, high-quality care while coordinating with patients, families,...

Responsibilities Plans, implements, coordinates, and evaluates comprehensive care for designated patients to ensure quality of care and continuity of care delivery through telehealth platforms. QualificationsMinimum...

Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to...

Omega Healthcare in the United States is seeking an experienced RN with UR/UM leadership to drive utilization management programs. You will mentor staff, coordinate workflows, and partner with physicians and hospital leadership to optimize patient...