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Job Description Job Summary Join our team as a Clinical Review Nurse, where you will play a crucial role in supporting the review of medical claims and appeals. You will ensure compliance with state and federal...

Employment Type: Full time Shift: Day Shift Description: NEW PAY RATES! Nurse - RNII -Cardiology Office - Phone Triage - Albany, NY -...

Immediate Hiring for Remote Clinical Review Nurses Immediate hiring for remote clinical review nurses. Review approximately 20 cases a day for medical necessity. Advocate for and protect members from unnecessary hospital admissions.

Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in...

Wolters Kluwer is a global leader in professional information services that combines deep domain knowledge with specialized technology. Our portfolio offers software tools coupled with content and services that customers need to make decisions...

Job Opportunity at Highmark Inc. This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization,...

CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to...

Fully Remote : Clinical Documentation Specialist Job Description Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers.

A healthcare provider is seeking a full-time Clinical Informatics System Analyst, RN, to improve clinical information systems. This role involves optimizing EMR applications, providing user support, and collaborating with clinical staff.

Job Type Full-time Description Gateway Rehab Center (GRC) has an outstanding opportunity for a Nurse Liaison Gateway Rehab who will be responsible for the pre-admission case management, ASAM level of care assessment, and...

LanceSoft is seeking a local contract nurse RN Utilization Review for a local contract nursing job in Torrance, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 03/02/2026 Duration: 8 weeks 40...

A healthcare organization is hiring a skilled Nurse Advice Line Clinical Triage Nurse for a part-time position. The role involves performing clinical triage and coordinating care based on inbound calls. The ideal candidate must hold an RN License...

Medical Solutions LTC is seeking a local contract nurse RN Rehabilitation for a local contract nursing job in Columbus, Ohio. Job Description & RequirementsSpecialty:...

divh2Certified Nursing Assistant/STNA/h2pFirst Community Village located in Columbus, OH is an independent living, assisted living and memory care community with a team of health care professionals that is unmatched in the area!/ppWe are owned and...

American Medical Staffing is seeking a Nurse Practitioner Family Practice for a local contract job in Columbus, Ohio. Job Description & Requirements Specialty: Family Practice Discipline: Nurse Practitioner Start Date: 02/16/2026 Duration: 13 weeks...

This range is provided by Insight Global. Your actual pay will be based on your skills and experience talk with your recruiter to learn more. Base pay range $140,000.00/yr - $170,000.00/yr Direct message the job poster from...

A leading healthcare organization is looking for a DRG/CVA Validation Auditor RN to audit inpatient claims by validating coding and reimbursement methodologies. The role offers flexibility to work remotely, requiring an Associates degree and...

A leading academic healthcare institution in Chicago is seeking a Patient Logistics RN to assign patients to beds and coordinate transfers within the hospital. The role requires a BSN and at least 5 years of clinical experience, strong...

Wolters Kluwer is a global leader in professional information services that combines deep domain knowledge with specialized technology. Our portfolio offers software tools coupled with content and services that customers need to make decisions...

City/State Charlottesville, VA Work Shift First (Days) Overview: Sentara Martha Jefferson Hospital is hiring a Clinical Nurse Specialist for a Full-Time role in Charlottesville, VA. About the position: Reporting directly to the CNO, the Clinical...

Leaderstat - Post Acute is seeking a local contract nurse RN Hospice for a local contract nursing job in Gahanna, Ohio. Job Description & Requirements Specialty: Hospice Discipline: RN Start Date: 02/10/2026 Duration: 6 weeks 40 hours per week Shift:...

Join Our Compassionate Team and Make a Difference in Health! This position is remote, and candidates must reside in Puerto Rico. As a Bilingual RN Care Manager, you will thrive in a telephonic environment where you assess and...

Pluto Healthcare is seeking a local contract nurse RN Home Health for a local contract nursing job in Columbus, Ohio. Job Description & RequirementsSpecialty: Home...

*Pay: $28.50/hr (Fixed rates, no opportunity for negotiation)* *Shift: *Monday- Friday- 8-4:30PM EST, MUST have flexibility twice a month to start as early as 7 and end as late as 7PM * * *Overview* We're hiring Clinical Quality...

JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...