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Peraton's SafeGuard Services seeks a Nurse Reviewer to conduct medical record reviews, applying clinical judgment to claim payments and supporting fraud investigations. Telework is available from any state. The ideal candidate will hold a...

University of Miami Health System in South Florida seeks a Nurse Navigator to triage new patient appointments, coordinate scheduling, and guide patients through the cancer care continuum. You will educate patients, identify barriers to...

Senior Specialist, Quality Improvement (Registered Nurse) Reason for opening: FTE support needed for "Q4 Push" to close Medicare/MMP gaps in care with member & community events Will this role be fully remote? Yes Are there...

Staffmark Group is recruiting a Registered Nurse for a remote role. Primary duties include reviewing peer review reports, ensuring evidence-based rationales, and ensuring compliance with client, contract, and regulatory standards. The ideal...

To support clinical auditing efforts, the full-time Registered Nurse Auditor will perform retrospective chart reviews on Readmission and Place of Service Claims, utilizing clinical guidelines and proprietary systems, while maintaining productivity...

Cadence in Dallas, TX is seeking an RN Supervisor to lead a remote team of Registered Nurses in a high-volume triage environment. This role demands strong clinical judgment, operational management, and performance coaching to maintain quality...

A healthcare company is seeking a compassionate and detail-oriented RN Triage Nurse for a remote role based in Charlotte, NC. Ideal candidates will have at least 5 years of experience in nursing, particularly in emergency departments or call...

PRN Assessment Nurse The PRN Assessment Nurse is responsible for identifying current and future patient care needs; being able to recognize normal versus abnormal body physiology. The role requires critical thinking, attention to detail...

Optum is seeking a Utilization Review Nurse, RN, to lead inpatient utilization management, applying evidence-based guidelines and criteria to determine medical necessity for admissions and authorizations. The role requires 3+ years of...

Stryker Corporation in the United States is seeking a Clinical Documentation Integrity (CDI) Specialist – RN for a fully remote role. You will review inpatient records, issue physician queries, and collaborate with care teams to ensure accurate...

The Triage Registered Nurse is responsible for identifying and coordinating patient/family needs and for providing preventive and supportive care to the terminally ill patient/family unit. The Triage Registered Nurse provides continuity of care to...

TurningPoint Healthcare Solutions is a rapidly growing and innovative healthcare company that supports several large national health plans to improve the quality and affordability of healthcare patients receive. We are looking for motivated...

POSITION SUMMARY The Perioperative Clinical Educator is a skilled and experienced professional Registered Nurse (RN) responsible for excellence in the provision of educational services . Reporting to the Director of...

Nurse Navigator 1 The University of Miami/UHealth Department of Medicine has an exciting opportunity for a Full-Time Nurse Navigator 1 to work in the UHealth Campus. Core Job Summary: The Nurse Navigator 1 (H) liaises...

Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.00 - $34.00 / hour Department: HS -...

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...

Job Profile Summary Job Profile Summary This role focuses on providing professional and nonprofessional nursing care services in accordance with physician orders. In addition, this role focuses on performing the following duties:...

Adjunct Faculty For Doctor Of Nursing Practice Program The School of Nursing seeks an adjunct faculty member to deliver high quality learning experiences and education for students in the Doctor of Nursing Practice program. The selected...

Description Location: UCHealth UCHlth Anschutz Inpt Pavilion, US:CO:Aurora Department: Emergency Dept Work Schedule: Full Time, 72.00 hours per pay period (2 weeks) Shift: Nights Pay: $35.29 - $54.71 / hour. Pay is dependent on applicant's...

A prominent healthcare organization is seeking an A&G Clinical Specialist to manage health member complaints and appeals. This fully remote position requires expertise in clinical case management, understanding of regulatory compliance, and the...

Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff...

Job Summary Uses the electronic medical record and telecommunication technology to provide care remotely in an inpatient setting. Collaborates with patients and other members of the healthcare team to provide admission and discharge...

A healthcare quality organization is seeking a Nurse Reviewer to perform comprehensive medical necessity reviews for Medicaid claims. The ideal candidate will have a BSN and an active RN license, along with experience in medical record review.

Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant...

Cadence, the clinical AI company automating chronic disease management, is hiring an RN Manager, Alerts to lead nursing teams responsible for alert review and triage across our chronic care population. You will own staffing, scheduling, and...