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CVS Health is hiring a fully remote Clinical Claim Review Nurse. The role follows a Monday–Friday, 8am–5pm schedule in the candidate's time zone. You will review outpatient therapy records, interpret data, and apply clinical criteria in line...

Jobgether is seeking a Case Manager – Utilization Review Specialist for a remote United States position. You will use your nursing expertise to evaluate medical records, assess medical necessity, and manage appeals to support patient care and...

Inova's Outpatient Primary Care - Anytime Program seeks an experienced Registered Nurse (RN) to provide virtual on-demand triage after hours (5pm–5am) and on weekends/holidays. Remote role; must reside in the DMV area and be available for...

Explore opportunities with Amedisys, part of the Optum family of businesses. We provide home health, hospice and community-based services that help people receive quality care where they feel most comfortable: at home. Rooted in personalized care,...

Medix™ is seeking a clinically strong, detail-oriented Registered Nurse to join our Utilization Review team in a fully remote role. You will conduct medical necessity reviews, determine appropriate patient status, and collaborate with physicians...

Sentara Health Plans is hiring a Utilization Review RN for Imaging/Commercial with remote flexibility. The role requires a Virginia- or compact-licensed RN, a Bachelor's degree preferred, and at least 3 years in acute care with utilization review...

WORK REMOTELY after training! CANDIDATE MUST RESIDE IN THE METROPOLITAN NEW YORK AREA! !! Process all requests for services in accordance with Medicare and NYS Medicaid guidelines as well as departmental criteria and...

Medasource is seeking a Clinical Documentation Improvement (CDI) Nurse for a 6-month, fully remote contract in the United States. You will perform concurrent and retrospective reviews of inpatient records to improve documentation quality, support...

A healthcare staffing company is seeking a Clinical Review Nurse for Prior Authorization Review. This remote role demands conducting reviews, collaborating with healthcare teams, and ensuring compliance. Candidates need an active RN license and...

Provide essential clinical and administrative support to a remote healthcare team across Canada. Manage laboratory results, pharmacy communications, referrals, and patient follow-ups. Requirements: Current...

Corrections Registered Nurse (RN)Setting: CorrectionsJob Type: TravelPay: $2400 / WeekHours:...

RN opportunity with out the bedside burnout + sign on bonus. This Jobot Job is hosted by: Dexter Dionio Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $80,000 -...

RN Status Review Specialist It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: Use your nursing expertise in a strategic, non-bedside role. As an RN Status Review Specialist, you'll evaluate patient...

CVS Health is seeking a Utilization Management Nurse Consultant (Medical Review) to ensure members receive timely, medically necessary care through thoughtful clinical review and collaboration with providers. This fully remote role leverages your...

A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and...

A healthcare staffing company in Torrance, CA is seeking a Senior Healthcare Recruiter for a remote RN position. The ideal candidate will have at least 1 year of Home Health experience and must possess an active CA RN License. Responsibilities...

Centene Corporation is seeking a fully remote Utilization Management/Case Management nurse to perform concurrent reviews, discharge planning, and medical necessity assessments. The role requires 2+ years of acute care nursing and prior UM/CM...

SHIFT: Any (United States of America) Seeking Breakthrough Makers Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will...

Compensation: $85,000 – $92,000 Hourly Equivalent: ~$41–$44/hr Location: Remote Schedule: Must work AZ hours (typically 1st shift) CLIENT NOTES / EXPECTATIONS Candidates must meet required AND preferred...

Inova Health System is seeking a Registered Nurse (RN) for Virtual Acute Care in Virginia. This full-time role requires 36 hours weekly with a rotating schedule and four weekend shifts every six weeks. One day of remote work is available after 6...

City/StateNorfolk, VAWork ShiftFirst (Days)Overview:Sentara Health Plans is hiring a Utilization Review Nurse/ RN for Imaging/Commercial- Remote!Status: Full-time, permanent position (40 hours)Standard working hours: 8am to 5pm EST, M-F. Weekend...

The Case Management Utilization RN works collaboratively with physicians to coordinate patient admissions and discharges, ensuring appropriate levels of care and compliance with regulations. This role is ideal for those who excel in a fast-paced...

Job Description Provides support for clinical facility site reviews. Under the supervision of leadership, uses clinical judgement within appropriate scope to independently conduct reviews and other monitoring activities for primary care...

About This Role As an Inpatient Care Management Nurse, you will be responsible for ensuring proper utilization of health services by assessing and interpreting member needs and identifying solutions to help members live healthier lives.

Inova Health seeks an Outpatient Registered Nurse (RN) for the Anytime Program to provide Virtual On Demand care/triage when practices are closed, typically 5pm–5am with weekend and holiday coverage. Remote work is possible if based in the DMV...