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Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical Nurse - Work from Home! Get AI-powered advice on this job and more exclusive features.Direct message the job poster from BroadPathGlobal Talent Attraction...

Providence Home Services Oregon is seeking a Clinical Documentation Specialist, Registered Nurse (RN) for a full-time, day-shift remote role open to multiple states. You will review OASIS admission documents and Plans of Care to ensure CMS...

Turing is looking for candidates who have solid experience in nursing care, patient assessment, and clinical documentation, particularly at the level expected for licensed registered nurses working in hospital or outpatient care...

Walker Healthforce, LLC seeks a Medical Claim Review Nurse for a fully remote contract based in Washington. The role focuses on retrospective medical necessity reviews, appeals, and payment integrity within Molina Healthcare of Washington.

The Triage Registered Nurse is responsible for identifying and coordinating patient/family needs and for providing preventive and supportive care to the terminally ill patient/family unit. The Triage Registered Nurse provides continuity of care to...

A leading healthcare organization is seeking a Care Manager RN for a remote role primarily serving the state of Washington. This per diem position involves crucial utilization management activities, ensuring compliance with payer requirements and...

The Registered Nurse provides expert professional nursing care; assesses, plans, implements and evaluates the care rendered to patients with urgent, emergent or potential...

St. Louis Children's Hospital is seeking an RN for after-hours triage and nursing support via the Answer Line. The role involves assessing patient needs, guiding care plans, and educating families within established guidelines. Part-time...

Sportmed is seeking a part-time RN/LPN to triage patients remotely in Chattanooga, TN. This position allows for a flexible schedule with no nights, weekends, or holidays, and is perfect for professionals looking for work-life balance. The...

aitrainer is seeking a Remote Registered Nurse (RN) to conduct health screenings for a health study. This role involves remote assessments, eligibility determination, and scheduling onsite sessions, all while ensuring HIPAA compliance.

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of the...

WPS Health Solutions in Columbus, OH, is seeking an Appeals Nurse to review medical records and Medicare claims for first-level appeals to determine medical necessity and coverage alignment. The role collaborates with Appeals Examiners to...

CareXM is expanding our remote nursing team to include an early morning triage RN (Remote). This role focuses on after-hours telephone triage for hospice and home health partners, delivering calm clinical guidance while working entirely from home.

CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full-time position open to MST/PST residents. You will coordinate and document utilization and benefit management activities, ensuring timely,...

A healthcare company is seeking a compassionate and detail-oriented RN Triage Nurse for a remote role based in Charlotte, NC. Ideal candidates will have at least 5 years of experience in nursing, particularly in emergency departments or call...

A staffing and recruiting firm is seeking a HEDIS Nurse (RN or LPN) for a remote position which allows for a flexible schedule. This high-impact role involves ensuring accurate HEDIS reporting and quality improvement initiatives. Candidates should...

EMD Serono is seeking an experienced RN Patient Support Specialist to educate patients, provide product training, and deliver personalized support throughout treatment journeys. This remote role requires clinical nursing judgment and collaboration...

Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant...

R1 RCM Inc. is seeking a Clinical Coding Appeals Nurse to review medical records and draft appeals for denied and underpaid claims. The role focuses on accurate coding using ICD-9/10, CPT, HCPCS, and NCCI guidance, and requires inpatient...

Vaya Health seeks a Physical Health Registered Nurse to perform clinical reviews for authorization requests and medical necessity. You will reference standardized criteria and coordinate with physician peers when needed. This role is part of a...

To ensure the highest quality and integrity of peer review case reports, the full-time Remote RN Clinical QA Coordinator will perform quality assurance reviews, verify compliance with client specifications and regulatory standards, and support the...

We believe everyone should have confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care...

Unknown CDI team is seeking a Clinical Documentation Integrity (CDI) Specialist – RN for a 100% remote position based in the United States. You will drive accurate inpatient documentation, engage physicians, and ensure alignment with quality and...

A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The...

Cadence in Dallas, TX is seeking an RN Supervisor to lead a remote team of Registered Nurses in a high-volume triage environment. This role demands strong clinical judgment, operational management, and performance coaching to maintain quality...