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UnitedHealth Group is seeking a Utilization Review Nurse, RN to perform inpatient utilization management in California. The role involves reviewing inpatient criteria, preauthorizations, and ensuring medical necessity while applying evidence-based...

Senior Specialist, Quality Improvement (Registered Nurse) Reason for opening: FTE support needed for "Q4 Push" to close Medicare/MMP gaps in care with member & community events Will this role be fully remote? Yes Are there...

*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...

Job Description \n WellBe Senior Medical is seeking a Registered Nurse (RN) Home Health for a nursing job in Lawrenceville, Georgia. Job Description & Requirements\n \n Specialty: Home Health \n Discipline: RN \n Duration: Ongoing \n Employment...

University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization, coordinating with the care team for timely and...

Job ID: 26682 *Description* **Now offering sign-on bonuses up to $20,000** Under the supervision of an anesthesiologist, the Nurse Anesthetist (NA) will perform safe anesthesia care, consisting of the following: pre-operative...

Registered Nurse In Labor And Delivery Make a difference every single day! When the work you do every single day has a crucial impact on the lives of others, every effort, every detail, and every second matters. This shared culture...

*Lahey Clinic | Beth Israel Lahey Health* Londonderry, NH | Full-Time, Hybrid (3 days in-person / 2 days remote) *About the Role* Join our collaborative team of physicians, APPs, behavioral health specialists, and registered dietitians dedicated...

Job TitleCHA Hollywood Presbyterian Medical Center is committed to serving local multicultural communities with quality medical and nursing care. With more than 500 physicians representing virtually every specialty, HPMC strives to distinguish...

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.

Humana is seeking to fill the Compliance Audit Nurse role to audit care management activities and documentation for regulatory compliance. The position involves independent determination of appropriate courses of action, data collection and...

Posting Date 09/09/ Prospect St, East Orange, New Jersey, , United States of America Are you a Nurse Practitioner ready to transform lives and make a real difference for patients with complex kidney conditions? DaVita IKC is...

Self Fund Health Nurse Navigator Remote · Full time The Nurse Navigator is a remote WI-based RN who acts as the member's single point of contact through the healthcare system — coordinating care, advocating for patients, and steering...

Job Description Do you have a passion for the highest clinical quality and patient happiness? Would you like to use your expert clinical competencies with an organization known nationally for excellence in cancer treatment,...

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...

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 -...

Back Medical Claim Review Nurse | Remote | Washington | Contract Business & Care Management Long Beach , California Contract Aug 11, 2026 Medical Claim Review Nurse | Remote (Washington) | Contract Walker Healthforce is seeking a...

JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member...

About Us At Prenuvo, we are on a mission to flip the paradigm from reactive "sick-care" to proactive health care. Our award-winning whole body scan is fast (under 1 hour), safe (MRI has no ionizing radiation), and...

Working as a Nurse Case Manager at Cunningham Childrens Home means youll be part of team that is dedicated to supporting youth in critical need of emotional, psychological, and physical care. Located in Urbana, IL, Cunningham Children's Home is a...

Providing clinical review support on a full-time remote basis, the RN Clinical Review Specialist will review medical records for medical necessity, authorization compliance, and payer guideline alignment, while preparing high-quality appeals and...

Description Location: UCHealth Anschutz Inpatient Pavilion - Aurora Department: Labor & Delivery Metro Denver Women and Infants (W&I) Float Pool RNs will support patients and teams at Highlands Ranch Hospital, Longs Peak Hospital, and University...

Job Description \n \n Perm Staff Jobs is seeking a Registered Nurse (RN) Case Manager, Utilization Review for a nursing job in Independence, Missouri. Job Description & Requirements\n \n Specialty: Utilization Review \n Discipline: RN \n Duration:...

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...

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...