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Utilization Review Registered Nurse Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine, one of the premier health delivery, academic, and research institutions in the United...

Summary 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...

RN Clinical Reviewer / IDR - Remote (#25310C) Location: Remote Employment Type: Full-time Hourly Rate: $50/hr...

49942352 Overview Remote Registered Nurse (RN) DH Direct Triage Part-Time, 20 hours per week Position Summary The RN - DH Direct Triage provides high-quality,...

Description Location: UCHealth Medical Center of the Rockies: Loveland, CO Department: MCR Rad Nursing Work Schedule: Full Time, 64.00 hours per pay period (2 weeks) Shift: Days Pay: $38.91 - $60.31 / hour. Pay is dependent on applicant's relevant...

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...

Job Posting The University of Saint Joseph invites applications for per diem positions to conduct site visits for the graduate nursing programs within the Department of Nursing. The department is actively recruiting family and psychiatric...

Nurse Reviewer At Commence, we're the start of a new age of data-centric transformation, elevating health outcomes and powering better, more efficient processes to program and patient health. We combine quality data-driven solutions that...

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),...

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 - Itemized Bill Review 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 know...

Focused on auditing outpatient and specialty claims, the full-time Clinical Auditor RN will utilize coding and clinical chart validation expertise to ensure accuracy, medical necessity, and appropriateness of services delivered, while working in a...

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,...

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...

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...

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: 16007319 Care Management Disease Management Shift: Day (United States of America)...

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:...

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...

Clinical Review Clinician Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people...

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...

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...

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...

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...

Public Health Nurse Make a Difference in Your Community The Department of Public Health for St. Louis County Government is actively looking to hire a Public Health Nurse (PHN) to join their team. This nursing position will provide...