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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 Dorsey .

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.

Virtual Medical is seeking qualified Registered Nurses to join our fully remote 24-hour On Call Center. We handle incoming calls for clients requiring immediate medical attention and provide assessment, guidance and disposition to the appropriate...

Essentia Health in Duluth, MN is hiring for a Health Services professional to conduct Managed Care Programs in coordination with third party administrators. You will help implement referral, prior authorization, and precertification processes...

IQVIA is seeking a Flex Nurse Educator to educate patients remotely and to provide in-field support as needed. This non-clinical role empowers patients to manage their disease and improve treatment compliance, with travel up to 50% and occasional...

CVS Health is recruiting for an RN Concurrent Review Nurse in a remote capacity, focusing on inpatient clinical expertise to ensure medically necessary care across the continuum. The role requires an active RN license and 5+ years of...

Redesigning heart health via virtual cardiac rehab for older adults.Mission-driven team of clinicians and engineers.Responsibilities:Review EMRs to determine eligibility and create orders.Conduct video intake assessments and treatment...

What You'll Do As an Enrollment Nurse, your primary responsibility is enrolling patients in a chronic care management program. You'll call eligible patients, educate them about the program, answer questions, and assist interested patients...

8 Hours POSITION SUMMARY The Clinical Staff Nurse is a skilled and experienced professional Registered Nurse (RN) responsible for excellence in the clinical practice of nursing and the management of patient care.

Novitas Solutions, Inc. seeks a Clinical Review Nurse to review and substantiate medical determinations for health claims. You will assess medical necessity, service levels, and appropriateness of care under national and local policies,...

Elevance Health is seeking a HEDIS Medical Record Review Project Nurse to support HEDIS data abstraction and quality review in a fully virtual role with occasional in-person training. The position requires residing in Florida, a BSN, and at least...

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...

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management) .Candidate must be authorized to work in USA without requiring sponsorshipLocation: 100% Remote for California...

As a Clinical Documentation Review Specialist (RN), you will help medical staff clarify patient records to ensure appropriate reimbursement and reflect care complexity. You will perform concurrent reviews and engage with physicians...

Trustaff is seeking a travel nurse RN Clinic for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: ClinicDiscipline:...

Baptist Health in Jacksonville, FL, is seeking a Registered Nurse for its Hospital At Home program. You will educate patients and families, advocate for patient needs, and coordinate care across medical and nursing teams in a home-based setting.

TRISTAR Company is seeking an experienced Utilization Review Nurse for a fully remote role across all states. The job focuses on workers' compensation utilization review—prospective, concurrent, expedited, and retrospective reviews—to...

About This Role The Utilization Management Nurse Consultant utilizes clinical experience to assess, plan, implement, coordinate, monitor, and evaluate healthcare services for members. This role is ideal for those looking to contribute to...

Humana is seeking a Behavioral Health Prior Authorization Nurse to join the Wisconsin Medicaid Market (iCare) team. This role involves reviewing the clinical appropriateness of prior authorization requests to ensure they meet medical necessity and...

TriHealth is seeking a Clinical Documentation Specialist RN to review inpatient records, ensuring accuracy of diagnoses, severity of illness and quality measures. You will educate physicians and nurses, collaborate with coding staff, and drive...

HBiz seeks a Clinical Appeals Nurse (RN) to remotely support revenue cycle operations. You will review denied claims for clinical accuracy, develop evidence-based appeal strategies, and draft payer-ready documentation to overturn denials and...

Centene Management Company LLC is seeking a Licensed Practical Nurse to analyze prior authorization requests and determine medical necessity in New York. You will work with healthcare providers and the authorization team to ensure timely,...

About HCSC At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be...

Prior Authorizations Nurse (RN) (Temporary) Remote in California OUR COMMITMENT TO A HUMAN HIRING PROCESS We believe every candidate deserves thoughtful consideration.That'swhy we do not use AI or automated...

Utilization Management Policy Initiatives Nurse RN II The Utilization Management Policy Initiatives Nurse RN II, under the purview of the Utilization Management (UM) Department Leadership Team, is responsible for managing, reviewing,...