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Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET Medix is supporting a healthcare technology organization that is adding...

Description At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing...

Elevance Health in Florida is seeking a Medical Management Nurse to review complex cases, apply nursing judgment, and determine medical necessity for services. This role combines remote work with required in-person training sessions and periodic...

Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations. The role involves collaborating with medical leadership, reviewing cases for appropriate treatments,...

Family Advocate Support Care - Senior Clinical Admin Nurse At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of...

Clinical Documentation Specialist Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit.

DRG Specialist UPMC Corporate Revenue Cycle is hiring a DRG Specialist to work on inpatient auditing within our Coding Department. This position will be a work-from-home position working during standard business hours Monday through...

TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective, appropriate utilization of Behavioral Health and Medical/Surgical services.

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...

HonorHealth in Phoenix is seeking an Utilization Review RN Specialist to review and monitor utilization, ensuring medically necessary care and appropriate discharge planning within Medicare, AHCCCS, Self-pay, and other payer guidelines. The...

POSITION SUMMARY MLK Community Healthcare is seeking a Registered Nurse (RN) Coordinator to be part of our MLKCH Enhanced Care Management program. The RN Coordinator will be responsible for coordinating the care of patients...

CVS Health is seeking a Nurse Consultant for Utilization Management in a 100% remote capacity. The role reviews inpatient and outpatient services using evidence-based criteria, authorizes care with providers, and escalates cases as needed.

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...

Field Based Nurse Case Manager – RN OHARA, LLC has an opening for a full-time Field Based Nurse Case Manager in the Kansas City, MO area. We are driven to facilitate prompt delivery of quality, cost-effective health care to...

Utilization Management Nurse Consultant Clinical Precertification RN (Medicare Home Care) Remote | Full-Time | Weekday Schedule We're building a world of health around every individual - shaping a more connected, convenient and compassionate...

Revive Therapeutic Services seeks a Nurse Case Manager to oversee patient care plans and coordinate services for individuals facing health challenges. You will collaborate with patients, families, and providers to ensure effective care delivery.

Lee Health is hiring for a Utilization Management RN position. This remote role begins onsite for the first 90 days and requires licensure in Florida. The nurse will perform utilization management duties, ensure regulatory compliance, and document...

This range is provided by Insight Global. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $140,000.00/yr - $170,000.00/yr Direct message the job poster from...

Position Summary The Care Navigator will be responsible for case management specific to kidney health management. The Care Navigator will complete activities for the continuum of care to facilitate and promote high quality, cost-effective...

Elevance Health seeks a Nurse Case Manager I to perform telephonic and on-site care coordination for members with complex health needs. The role supports plan adherence, discharge planning, and cross-functional collaboration with medical directors...

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. Part Time Southborough, MA, US Salary Range: $38.00 To $40.00...

Sagility is hiring an RN Utilization Management Reviewer for a fully remote, home-based role in the United States. You will perform day-to-day clinical and service authorization reviews for medical necessity and ensure compliance with CMS...

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system...

nirvanaHealth, a RxAdvance Corp. company, seeks a part-time Utilization Management Nurse for a remote role in the United States. You will perform prospective, concurrent, and retrospective medical necessity reviews and care coordination to ensure...

Elevance Health is seeking a Nurse Case Manager II to coordinate care for members with complex needs across multiple states. The role includes telephonic and on-site discharge planning, collaboration with Medical Directors, and development of care...