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VitaCare Living seeks an experienced Registered Nurse (RN) to support our assisted living and memory care communities in Ladysmith, Wisconsin, as a contracted RN Consultant. You will oversee clinical practice, ensure regulatory compliance, educate...

Job ID: 33022 *Description*Take on a key role within an award-winning health system. Help improve patient experiences as part of a world-class healthcare team. Take your career in an exciting new direction. You can do all this and more at UCLA...

CVS Health is seeking a registered nurse to assess, plan, implement, coordinate and evaluate healthcare options for members. The role focuses on coverage determination and coordination within the utilization management framework. The...

UnitedHealth Group is seeking a Registered Nurse in the Weslaco, TX area to assess, plan, and implement person-centered care strategies while coordinating with providers and community resources. Remote work flexibility is available within the...

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...

Full-time Company Description WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare...

American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing home...

PIH Health seeks a Nursing Instructor to teach in the Associate Degree Nursing program at Cerritos College and PIH Health during academic breaks. The instructor will deliver didactic and clinical instruction, participate in curriculum development,...

Guardian Life Insurance Company seeks an experienced RN Clinical Consultant to evaluate short- and long-term disability claims, analyze medical information, assess functional capacity, and support claim decisions. You will collaborate with...

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. Clinical Reviewer RN - Alabama Alabama, US 30+ days ago Requisition...

Guardian Life Insurance is seeking an RN Clinical Consultant to serve as a clinical expert supporting short-term and long-term disability claim evaluations. You will analyze medical information, assess functional capacity, and provide guidance to...

Summary Home Telehealth Care Coordinator (HTCC) Registered Nurse (RN) demonstrates leadership - experience - and creative approaches to management of complex patient care. The HTCC is responsible for coordination of health care for a...

Arkansas Blue Cross Blue Shield is seeking an experienced Utilization Management Nurse to perform clinical reviews of prior approvals, network exceptions, and inpatient/outpatient procedures. The role ensures medical necessity and cost-effective...

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. Director Nursing Practice & Workforce Solutions (Remote) EDUCATION &...

Fully Remote : Clinical Documentation Specialist Job Description Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers.

Agency Dept of Health and Human Services Division Health Service Regulation Job Classification Title Nurse Consultant I (NS) Position Number 60090392 Grade MH16...

Comagine Health is seeking an experienced Registered Nurse to serve as a Clinical Reviewer for the Washington Labor & Industries (L&I) contract. This remote role utilizes nursing expertise to evaluate medical necessity and quality of care,...

Sedgwick is hiring for a Clinical Consultation Triage Nurse in a remote, full-time role. You will triage calls, assess needs, and provide care guidance to determine the appropriate level of care, while supporting return-to-work goals. The...

Job Summary and ResponsibilitiesAs our Educator in Critical Care Emergency, In accordance with our mission and core values of integrity, compassion, collaboration, and excellence, this position is established to serve as a consultant/resource...

APremium Healthcare Solution, LLC seeks a Virtual Nurse Consultant to join our Conyers, GA team in a full-time, remote capacity. You will provide virtual nursing consultations, assess patient needs, and coordinate care with physicians and...

University Health is seeking a Utilization Management Nurse RN for UH Truman Medical Center in Missouri. The role manages resource use, supports care transitions, and advises care teams on documentation and discharge planning to improve patient...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

Supports the values of service excellence, teamwork, and integrity while managing patient care. Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers. Qualifications: Requires a...

#SRNThis position represents 2 openings. Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the...

American Health Plans Franklin, TN 37067, USA Description American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors...