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City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse. The Utilization Review Nurse is...

CVS Health is seeking a Registered Nurse to join our Utilization Management team in a remote role with afternoon/evening shifts. You will review clinical information, apply criteria, coordinate care, and support coverage determinations while...

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 you...

Humana seeks a Utilization Management Registered Nurse to interpret and support medical services coordination, documentation, and benefit determinations. You will work remotely, reporting to the Manager of Utilization Management as part of the One...

This is a fully remote position, open to candidates based in United States. Pay: $60–$70/hr Role Title: Registered Nurse Role Type: Contractor Location: United States,...

Details Client Name PIH HEALTH Job Type Travel Offering Nursing Profession Registered Nurse Specialty...

Improve the lives of others while Caring. Connecting. Growing together. Job Description - Clinical Grievances RN - Remote in CA (2381848) Clinical Grievances RN - Remote in CA - 2381848 At UnitedHealthcare, we're simplifying the...

City/State Norfolk, VA Work Shift First (Days) Overview: _ Sentara Health Plansis hiring a Utilization Review Nurse/ RN for Imaging/Commercial- Remote! _ Status:...

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 -...

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...

Get AI-powered advice on this job and more exclusive features. This range is provided by Medix. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $37.00/hr...

*Job Summary and Responsibilities* As our RN Trauma Performance Improvement, you will contribute significantly to our mission by leading proactive efforts to minimize traumatic injuries and support vulnerable patients. Your role elevates...

Elevance Health seeks a Telephonic Nurse Case Manager II for California, primarily remote with required in-person training. The role involves assessing, coordinating, and evaluating care plans for members with complex needs, telephonically.

DataForce by TransPerfect · Project listing Registered Nurse (California, Remote) Listed on DataForce by TransPerfect as “Registered Nurse (California, Remote)” Original posting from DataForce by TransPerfect Work...

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...

Asante is seeking a Utilization Review Nurse to monitor utilization from preadmission to discharge, ensuring cost-effective, quality patient care and regulatory compliance in a remote, full-time role. The position includes a set weekend schedule...

Job Description: The Intake Coordinator is a Registered Professional Nurse who takes referrals and processes appropriate home care services. To maintain open lines of communication with referral sources and within Americare...

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Registered Nurse, Phone Triage Remote + Sign on Bonus! Clinical Full Time...

Vail Health is hiring a Triage RN to perform care coordination and triage, assessing patient health concerns and directing dispositions to emergency care, urgent care, or clinics. You will triage calls and portal messages, document assessments in...

Curana Health seeks an experienced Utilization Management Nurse to review and monitor members' use of healthcare services, ensuring high-quality, cost-effective care. The role emphasizes concurrent review, discharge planning, and high-dollar...

Actalent is seeking an experienced Utilization Review RN for a remote MondayFriday opportunity with a CA-based license requirement. The role reviews clinical information, applies criteria, and makes first-level recommendations to ensure regulatory...

Supports the values of service excellence, teamwork, and integrity while managing patient care. Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers. Qualifications: Requires a...

Job Description SummaryCome join our MUSC Marion team!EntityMedical University Hospital Authority (MUHA)Worker TypeEmployeeWorker Sub-TypePRNCost CenterCC001637 MAR - MedSurg 2nd Floor (MMC)Pay Rate TypeHourlyPay GradeHealth-19Scheduled Weekly...

CVS Health is seeking a dedicated RN Case Manager in Massachusetts to coordinate comprehensive care for members, develop care plans, and communicate with providers and families. The role focuses on monitoring progress, advocating for patients, and...