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*Description* RN - Labor and Delivery at Providence Little Company of Mary Torrance in Torrance, CA. This position is Full Time and will work 12-hour, Day shifts. ...

An established industry player is seeking a dedicated Registered Nurse for a remote contract position focused on reviewing medical claims within the insurance sector. This role involves validating treatment plans using accepted criteria and...

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...

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...

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...

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...

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...

UnitedHealth Group seeks an Inpatient Care Management Nurse to ensure proper utilization of health services for members. You will assess needs, plan care, and collaborate with physicians to expedite appropriate levels of care. The role...

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,...

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.

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...

A healthcare quality organization is seeking a Nurse Reviewer to perform comprehensive medical necessity reviews for Medicaid claims. The ideal candidate will have a BSN and an active RN license, along with experience in medical record review.

A leading occupational healthcare provider is seeking a full-time Triage Registered Nurse to work from home in Baton Rouge, Louisiana. The role involves administering call intake, providing exceptional patient service, and documenting all...

Molina Healthcare is recruiting a qualified RN for a fully remote Utilization Management role requiring an active Illinois license. The position operates Monday–Friday, 8:30 AM–5:30 PM CST, with emphasis on clinical determinations using MCG...

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...

Piper Companies is seeking a Remote Utilization Management/Review Nurse to evaluate member cases, ensuring medical necessity and appropriate healthcare service utilization. The role requires clinical expertise and collaboration with providers to...

Humana Inc. in the United States is seeking a Part C G&A Nurse (Utilization Management Nurse 2) to support case preparation, review medical documentation and coordinate appeal determinations. This remote, full-time role requires an RN with...

City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plan is currently hiring a Medical Policy Research Specialist/ Registered Nurse (RN) - Remote in Virginia! ...

A healthcare organization is looking for a Senior Clinical Reimbursement Analyst to provide analytical guidance across segments. This role requires reviewing Medicare/Medicaid documentation, ensuring accuracy in MDS coding, and training staff on...

Inland Empire Health Plan (IEHP) seeks a Quality Program Nurse to implement and monitor quality management policies under the DHCS framework. Responsibilities include site reviews, medical record surveys, CAP oversight, and HEDIS data abstraction.

Medcor is seeking a full-time Registered Nurse for its remote 24/7 Occupational Health triage call center, with 8- or 10-hour overnight shifts (11:00pm–9:00am). The role requires strong phone skills, HIPAA-compliant documentation, and the...

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...

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...

Broadway Ventures, a veteran-owned SDVOSB headquartered in Mississippi, seeks an experienced Registered Nurse to perform medical review of complex claims, pre-authorization requests, appeals, and fraud referrals. You will apply clinical expertise...

National Brain Tumor Society (NBTS) is seeking a Patient Navigator to support brain tumor patients and caregivers, providing evidence-based information, treatment navigation, and connections to NBTS programs. The role requires an active RN...