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*Job Summary and Responsibilities* As our Intensive Care Nurse, you will monitor patients who are critically ill and unstable following extensive injury surgery or life-threatening disease. Every day you will begin each shift by...

Optum is seeking a SSBV Clinical Claim Review Nurse Manager – Remote to lead a team conducting clinical reviews and ensure determinations meet guidelines and regulatory requirements. The role supports a fast-paced, production-driven environment...

To support effective utilization management, the part-time Senior Utilization Review Specialist will conduct concurrent and retrospective reviews of hospital services, ensuring compliance with medical necessity and payer authorization while...

Stanford Health Care in Palo Alto is seeking an Oncology Nurse Navigator to coordinate care from diagnosis through survivorship. As a licensed RN with oncology experience, you will partner with physicians, social workers, nutritionists, and...

Summary We are currently hiring for a Managed Care Coordinator I to join BlueCross BlueShield of South Carolina. In this role as a Managed Care Coordinator I, you will review and evaluate medical or behavioral eligibility...

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability,...

Overview The RN - Pre-Anesthesia Assessment Center is responsible for ensuring that all pre-anesthesia requirements are fulfilled for each surgical patient. Acts as an advocate to assist patients/families/caregivers...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. **This position is remote. Candidates must be local to New England States for consideration** The Clinical...

Documentation Integrity Specialist IV, Clinical Licensure-Risk Adjustment-RN Primary Location Pleasanton, California Employee Status: Regular Schedule Full-time Scheduled Weekly Hours: 40 Shift Day Salary $133100 - $172150 / year Job...

Senior Quality Improvement Specialist (RN) Location: NYCLAY (100% remote) Duration: 45 W, 3 D Client: Molina Healthcare 100% remote- candidates can work from anywhere. Will be M-F 8-5pm EST NO OT. Must Have requirements: RN,...

A technology and business consulting firm is seeking a Clinical Medical Review Nurse to analyze health data and provide insights for internal stakeholders. The ideal candidate has a Registered Nurse license, along with four years of clinical...

Novant Health is seeking an RN Coach for telephonic virtual care to help patients navigate their healthcare journey through chronic-care management, self-management support, and acute triage, collaborating with physicians and care teams to deliver...

Join Us at our Virtual Job Fair to learn more about this position! Wednesday, October 7th | 12pm - 2pm EDT Register here: UHC Community & State Massachusetts Virtual Job Fair ...

RN Clinical Documentation Integrity Specialist Remote Key Responsibilities: Ensuring Clinical Documentation Meets Quality And Regulatory Standards. Working With Medical...

Event Details Join us for an Interview and Hiring Day! Registered Nurses welcomed! Location : 1680 E. 120th Street, Los Angeles, California 90059 Date : Tuesday, September 29, 2026 Time : 9:00 am to 2:00 pm Directions/Parking: Our main lobby entrance...

Guidehealth is a fully remote organization seeking a Care Manager to guide patients and families through complex health journeys from a Louisiana base. You will combine clinical expertise with holistic care, coordinating medical, behavioral, and...

Kaiser Permanente is seeking a Hospital Bed Control Coordinator RN in Baldwin Park, CA. The role collaborates with physicians to coordinate admissions and discharges, ensuring appropriate care levels and regulatory compliance.It suits a nurse with...

Nurse Consultant I (NS) The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health,...

Building Location: St Marys Hospital - Detroit Lakes Department: 3063470 PACU - DL HOSP Job Description: Responsible for organizing and providing nursing care to patients through the process of assessment, planning, intervention, and evaluation.

Working remotely in a full-time capacity, the Market Clinical Quality Specialist II will complete case reviews to ensure compliance with regulatory requirements and Standard Operating Procedures (SOPs), while identifying training opportunities and...

A leading healthcare provider is seeking an Associate RN for a remote role dedicated to acting as a care guide and advocate for patients. The candidate must hold a valid RN license in a compact state or California. Responsibilities include...

PIH Health Downey Hospital is seeking an RN Case Manager to guide patients from pre-admission through post-discharge, ensuring smooth transitions and appropriate utilization of hospital services.You will focus on maximizing reimbursement from...

Humana is seeking a Telephonic Registered Nurse Care Manager to support patients transitioning into and out of Humana's home-based services. This remote role reports to the Manager, Care Management and focuses on post-acute levels of care,...

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through...

Actalent is seeking a remote Utilization Review Registered Nurse to perform concurrent reviews, validate medical necessity, and ensure appropriate care settings. You will partner with providers and internal teams to support decisions and discharge...