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Optum is seeking an Utilization Management Nurse to review medical records, extract key case details, and craft defensible appeal letters in line with process instructions and guidelines. The role requires an RN with an associate degree, 3+...

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

UnitedHealth Group is seeking a Utilization Review Nurse, RN to perform inpatient utilization management in California. The role involves reviewing inpatient criteria, preauthorizations, and ensuring medical necessity while applying evidence-based...

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...

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...

Job Description: This position is full time, with openings on both day shift and night shift. 6:00 am - 6:30 pm. Weekend rotation varies - every other to every third weekend. Self scheduling is offered in this position. Are you searching for a...

Overview Position Type: Full time Job Title: Care Review Clinician I Location: 100% Remote (Must reside in one of the following states: NV, AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater-NYC), OH,...

Molina Healthcare is seeking a Remote Medical Review Nurse (RN) to work within the Central Time Zone. The role requires several years of clinical nursing experience and specific utilization review/coding expertise. You will analyze...

Rochester Regional Health is seeking a Registered Nurse for the Communications Center (Central Triage). The role combines in-person duties at the Riedman Center with a remote option after completing an in-depth training program. Expect 40...

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...

Every effort has been made to identify the essential functions of this position. However, it in no way states or implies that these are the only duties you will be required to perform. The omission of specific statements of duties does not exclude...

BrightSpring Health Services seeks a part-time Tele-Triage Licensed Practical Nurse (LPN) to provide remote triage and care planning for populations in the assigned locations. Must hold an LPN compact license and have experience in home health or...

*Job Summary and Responsibilities* As our Registered Nurse (RN), you will be a pivotal healthcare professional, delivering compassionate, high-quality care that truly impacts our patients' well-being and recovery. Every day, you will...

Mist Registered Nurse (Rn) – Position Summary The Multidisciplinary Inbasket Support Team (MIST) Registered Nurse is a highly skilled ambulatory care nurse who provides comprehensive, remote clinical support to primary care patients and...

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...

Job Description Effect change daily! At Cedars-Sinai, the work you do every day directly affects others' lives. Our passionate and dedicated culture has earned us six Magnet designations for nursing excellence. Join us and...

Optum is seeking an Inpatient Care Management Nurse to assess and interpret member needs, guiding utilization of health services to improve outcomes. You will collaborate with clinicians, perform case reviews, and support discharge planning from...

UnitedHealth Group is seeking an experienced Utilization Management Nurse to ensure efficient and effective health services administration. The role involves assessing member needs, interpreting guidelines, and recommending appropriate care levels...

A leading health company is seeking a remote RN Case Manager responsible for assessing and coordinating case management activities for members. Candidates must possess an active RN license and have at least 3 years of acute care experience. Strong...

Job Description We are hiring an RN at our Primary Care Shoal Creek location! Monday - Friday, 8am-430pm No Nights, No Weekends, No Holidays Remote opportunity every other week after 4 months MO and KS RN license required BLS required Previous...

Join to apply for the Nurse Advocate - Remote- Kansas role at Synergy Healthcare USA, LLC We are seeking an experienced Case Manager to join our growing team and serve as a Nurse Advocate for our new client and their employees.

RN/Managed Care Coordinator - Remote Healthcare Columbia , South Carolina Contract Hybrid Aug 28, 2026 Case Management - RN Job at a Glance Title: Medical Case Management Nurse Location:Must live...

Your future role at a glance Location: Pensacola, FL | Remote Facility: Ascension Sacred Heart Department: Clinical Integrity Documentation Schedule:...

Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information...

EMD Serono is seeking an experienced RN to join the Patient Support Hub as a remote RN, West Coast-focused. You will provide individualized clinical education, product training, and ongoing support to patients and caregivers, leveraging AI-enabled...