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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...

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...

Advocate Health is seeking an experienced Registered Nurse for a remote-based Transitional Care role focused on high-risk patients undergoing discharge and 30-day transitions. The role emphasizes comprehensive assessments, patient education, and...

BJC HealthCare is seeking a registered nurse to join a remote Utilization Review team. The role supports multiple hospital units with no patient communication, and it is designed for local remote work with weekend rotation. Responsibilities...

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...

Hone is a virtual medical clinic for men's/women's health, hormones, weight loss, and longevity.We are remote-first and fast-growing, focused on candid communication and joy.The Role:You will manage patient-doctor communications and clinical...

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...

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...

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...

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

Northwell Health is seeking a Registered Nurse CDI Auditor to validate acute inpatient coded charts and ensure documentation substantiates diagnostic information. This remote position in New York requires a NY RN license, a BSN, and strong...

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...

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...

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...

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.

Our promise to you: Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is...

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...

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...

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...

Emanate Health in Covina, CA, seeks a Utilization Review Nurse to evaluate medical records and determine medical necessity using policies and guidelines for urgent and standard reviews. You will document decisions and support claims reviews,...

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...

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.

Centene is seeking an RN with strong appeal review experience to act as liaison for statewide appeals, fair hearings, and review organizations. This fully remote role supports members and providers while ensuring compliance with State and NCQA...

Are you passionate about serving seniors? Do you want to be part of team that strives to create experiences that celebrate our seniors?

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...