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Managed Medical Review Organization is seeking a skilled registered nurse for a remote, home-office role. The position emphasizes telephonic/customer service, accurate documentation, and clinical review duties without face-to-face patient contact.

Baptist in Meridian, MS seeks a Specialist-Clinical Documentation III RN to evaluate day-to-day documentation practices and advise the clinical team on accurate diagnoses and coding. The role requires five years of acute care experience,...

Essential Duties and Responsibilities: Review requests for services including admission, discharges and continued stays for adherence to clinical criteria, state and federal policy, and related requirements. Issue...

Molina Healthcare is seeking a Wisconsin-licensed RN for a remote IRIS Self-Directed Personal Care (SDPC) role. You will oversee a group of IRIS participants, assess needs, and educate providers and participants in their homes and communities.

Ensemble Health Partners is seeking an RN Utilization Review quality professional to lead QA efforts within the VUR team. You will mentor staff, evaluate QA processes, and drive improvements across multiple clients and systems. The role...

Exceptional care starts with exceptional people. For us, this is more than a job– it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you...

A healthcare staffing company in Torrance, CA is seeking a Senior Healthcare Recruiter for a remote RN position. The ideal candidate will have at least 1 year of Home Health experience and must possess an active CA RN License. Responsibilities...

Memorial Hermann Health System is seeking a Clinical Documentation & Integrity Specialist for a remote role in Texas. The RN must hold a BSN or MSN and have at least five years of inpatient acute care experience, with ICU exposure preferred.

About the job Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark , General Catalyst , Peter Thiel , Adam D'Angelo , Larry Summers , and Jack...

Working remotely on a full-time basis, the Registered Nurse Clinical Documentation Specialist will conduct concurrent reviews of inpatient medical records to enhance documentation quality, ensure accurate coding, and collaborate with healthcare...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Schedule This is a per diem, fully remote opportunity offering flexibility and work-life balance. Minimum commitment of 16 hours per...

NTT DATA is seeking a BPO Clinical Review Specialist in the United States, with remote work available for Florida residents. The role requires an active RN license (Florida or Compact) and at least 3 years of appeals, utilization management, or...

HonorHealth is seeking an Utilization Review RN Specialist to review and monitor the utilization of health care services, ensuring medical necessity and appropriate levels of care. You will coordinate reviews for Medicare, AHCCCS, self-pay, and...

Highpoint Health Sumner is seeking a Registered Nurse (RN) Clinical Documentation Specialist to join as a remote FT (days). You'll contribute by applying plan-of-care interventions and driving patient-care innovations with advanced technology.

Improve the lives of others while Caring. Connecting. Growing together. Job Description - Preservice Review RN - Remote in HI (2392416) Preservice Review RN - Remote in HI - 2392416 Optum is a global organization that delivers...

UnitedHealth Group is seeking a SSBV Clinical Claims Review RN for a remote role nationwide. You will perform administrative reviews of inpatient hospital claims, document determinations, and ensure accurate use of screening criteria to support...

UCSF Health Medical Foundation is seeking an experienced Primary Care Telephone Triage Registered Nurse to work remotely from home. The role requires a California RN license, at least two years of full-time triage or acute care RN experience, and...

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 Summary This position is responsible for ensuring compliance with Utilization Management (UM) and Quality Review (QR) functions performed by the health plan. The role supports clinical review activities requiring 5+ years of...

Oregon Department of Corrections is seeking an experienced Institution Registered Nurse for a limited-duration role based in Salem, OR, with remote work options. The RN will review medical records, assess care adequacy, and coordinate services...

TEKsystems is seeking a Clinical Quality Assurance Specialist (RN/LPN) for a 100% remote, full-time role with hourly pay of $26.50–$28.50. Training will be conducted on a set schedule, with four 10-hour shifts and potential conversion to 4-day...

AIS Healthcare is seeking a Home Infusion RN to provide IVIG therapies in patients' homes in the Atlanta, GA area. This full-time role emphasizes high-quality, compassionate care delivered outside hospital walls. You will build one-on-one...

CVS Health is seeking an RN for utilization management, coordinating care and determining coverage for members. The role requires clinical judgment, strong communication with providers, and the ability to work in a fast-paced setting. The...

Comagine Health in Washington State is seeking an experienced Registered Nurse to join our remote Clinical Reviewer team. The role focuses on assessing medical necessity, appropriateness, and quality of care through prospective, concurrent, and...

Responsibilities: How you'll change lives ...