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Professional Review Nurse The Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical...

Performs under the supervision of a licensed nurse, provides individually assigned patient care activities based upon established patient care policies, procedures, state, federal, and regulatory board requirements. Active and enthusiastic member of...

About the job Remote | Nursing Clinical Review Expert - $65-$95/hour We are sharing a specialised part-time consulting opportunity for nursing professionals experienced in patient care, clinical monitoring, medication administration,...

yourcommission is looking for a Utilization Management Review Nurse to evaluate and ensure the effectiveness of medical services in Texas. This role supports the healthcare system by leveraging clinical expertise and management skills.Candidates...

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 support to...

Working remotely in a full-time capacity, the Registered Nurse Clinical Auditor will conduct clinical audits and reviews related to fraud, waste, and abuse, analyzing care services, coding requirements, and resource utilization while collaborating...

City/State Norfolk, VA Work Shift Multiple shifts available Overview: Sentara Health Plansis hiring a Clinical Compliance Consultant/LPN/RN/LCSW/LPC - Remote in Virginia! Status:...

Appeals Analyst We are currently hiring for an Appeals Analyst to join BlueCross BlueShield of South Carolina. In this role as Appeals Analyst, you will research the substance of complex appeal or retrospective review requests including...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh...

OverviewPosition Type: Full timeJob Title: Care Review Clinician ILocation: 100% Remote (Must reside in one of the following states: NV, AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater-NYC), OH, TX, UT, WA (outside greater-Seattle),...

MSA Nurse Reviewer We are seeking a MSA Nurse Reviewer with experience in preparing Medicare Set Asides and Medical Cost Projections. This includes reviewing records, preparing the narrative and an appropriate allocation for medical...

Location: Avera McKennan Hospital Worker Type: Regular Work Shift: Rotating days/evenings ights/weekends/holidays (United States of America) Pay Range: The pay range for...

Work From Home Nurse Practitioner (PMHNP - Telehealth - Flexible Schedule)Join to apply for the Work From Home Nurse Practitioner (PMHNP - Telehealth - Flexible Schedule) role at NPHireBase pay range$175,000.00/yr - $200,000.00/yrAbout the RoleA...

Nurse Navigator Join an innovative startup health plan based in Wisconsin that is revolutionizing healthcare and empowering companies to combat the relentless rise in healthcare costs. Our mission is to provide accessible, high-quality...

Nurse Reviewer – State of Illinois Location: Remote with on-site visits across Illinois We are currently seeking Nurses who reside in Central Illinois - preferably in McLean and Sangamon Counties. Position Overview...

Job Category: Executive Leadership, Revenue Cycle Work Shift/Schedule: 8 Hr Morning - Afternoon Northeast Georgia Health System is rooted in a foundation of improving the health of our communities. ...

Nurse Reviewer Appeals and Hearings- Remote It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We...

Do you enjoy being at the beginning of the journey? The Admissions Nurse is responsible for establishing and maintaining positive relationships with customers and referral sources within the community The Admissions RN is also responsible for...

Personal Health Nurse CCCS uses a holistic approach to medical management. The Personal Health Nurse (PHN) works within a team to move the member through the continuum of medical management with the goals of facilitating quality health...

School Nurse Published Date: Jun 8, 2026 Location: US Company: Los Angeles Unified School District SALARY DETAILS All Salary Tables located at School Nurse Salary Table - N Table APPLICATION FILING DATES...

Mobile Van Logistics Coordinator Responsible for van logistics, which includes transporting staff and community screening equipment, performs and oversees logistical and maintenance tasks, and ensures the mobile unit is ready for service.

Registered Nurse Remote Triage Professional Guideway Care is The Patient Activation Company™. We don't just "engage" patients; we activate them. By utilizing our proprietary Motivational Patient Guidance (MPG) model and AI-powered...

Nursing Opportunities - All Experience Levels AlediumHR is actively partnering with leading healthcare organizations across the U.S. and Canada to connect exceptional nursing professionals with meaningful career opportunities. We...

Overview As an Enrolled Nurse , you will work under the supervision of a Registered Nurse to deliver high-quality nursing care and achieve positive outcomes for residents, in line with Arcare's values and standards.Key Responsibilities Personal...

Location Address: 2925 Chicago AveLoading DockMinneapolis, MN 55407-1321 Date Posted: June 15, 2026 Department: 16007317 System Complex Care Management Shift: Day (United States of America)...