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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...

Clinical Documentation Improvement Specialist-RN- Remote The Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) assists with the identification of diagnoses, conditions, and procedures that are representative of the...

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...

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...

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,...

iMPROve Health seeks an RN Reviewer (Workers' Compensation Utilization Review) to perform independent external medical reviews remotely as an independent contractor (1099). The reviewer applies clinical expertise to evaluate cases, ensuring...

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.

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

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...

Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.00 - $34.00 / hour Department: HS -...

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...

Mist Registered Nurse (RN)Organization: SHSO-Population Health Services-UtahPosition Summary: The Multidisciplinary Inbasket Support Team (MIST) Registered Nurse is a highly skilled ambulatory care nurse who provides comprehensive, remote clinical...

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...

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...

Area Quality Specialist Registered Nurse Find your purpose giving patient care teams the knowledge and tools they need to better care for patients as an Area Quality Specialist Registered Nurse! This is a rare opening on a...

A healthcare organization in Connecticut is seeking an HCC Documentation Lead (RN) to coordinate and oversee documentation specialists. The ideal candidate must have a valid RN license, relevant coding credentials, and a minimum of three years'...

TurningPoint Healthcare Solutions is a rapidly growing and innovative healthcare company that supports several large national health plans to improve the quality and affordability of healthcare patients receive. We are looking for motivated...

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,...

Pay Range: $35.92 - $53.88 A successful candidate's actual pay rate will be based on several factors including relevant experience, skills, training, certifications and education. This position is responsible for the coordination of patients...

A healthcare solutions provider is looking for a qualified RN to perform medical reviews and coordinate care for members. This role involves assessing service needs, engaging in patient education, and ensuring compliance with healthcare...

BrightSpring Health Services affiliate Starting Point Nursing Services seeks a Tele-Triage Registered Nurse (RN) for remote, part-time work across multiple US locations. The RN will provide on-call triage, develop care plans, and coordinate with...

EMD Serono is seeking an experienced RN to join the Patient Support Hub as a remote RN, supporting patients and caregivers across the West Coast. The role focuses on clinical education, product training, and ongoing personalized support throughout...

Job Title: Registered Nurse (RN) Disease Manager Job Overview: The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of patients with chronic or...

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...

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...