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City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse. The Utilization Review Nurse is...

Title: Clinical Review Nurse Concurrent Review Location: Remote Duration: 12 months (Potential Extension) Schedule: Mon-Friday, 11AM to 8pm CST; Weekends and Holidays on a rotation basis based on...

HonorHealth is seeking an experienced Utilization Review RN Specialist for a remote-capable role serving the greater Phoenix area. The position focuses on reviewing medical necessity and coordinating reviews for diverse payers, ensuring...

CVS Aetna Appeals Nurse Consultant We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who...

Nurse Consultant I (NS) The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health,...

*Job Summary and Responsibilities* As our Director Nursing Perioperative Services at St. Mary Medical Center, you will be responsible for Surgical service departments including OR, PACU, GI, Short Stay (Pre and Post Op Outpatient Surgery), and...

Nurse - Clinical Review The Clinical Review Nurse makes prospective medical necessity determinations on prior authorization requests for HealthHelp's specialty programs, including Diagnostic Imaging, Cardiology, Musculoskeletal, Physical...

The Case Management Utilization RN works collaboratively with physicians to coordinate patient admissions and discharges, ensuring appropriate levels of care and compliance with regulations. This role is ideal for those who excel in a fast-paced...

Job Title Conducts admission concurrent and retrospective case reviews to ensure appropriate admit status and level of care by utilizing the nationally approved guidelines. Collaborates with medical staff and ancillary hospital...

The Licensed Vocational Nurse is responsible for providing direct or indirect nursing care to patients who present with urgent, emergent, or potential health problems;...

Agency Dept of Health and Human Services Division Health Service Regulation Job Classification Title Nurse Consultant II (NS) Position Number 65026151 Grade MH17...

Clinical Integrity Documentation Specialist Location: Remote Facility: Ascension Wisconsin Hospitals Department: Clinical Integrity Documentation Schedule: Days | Full-Time Salary Range: $79,511.52-$110,834.59...

Why This Role Matters Every determination you make decides whether a member gets the care they need, when they need it. This role sits at the exact point where clinical judgment meets real-world impact, translating evidence-based criteria...

*Job Summary and Responsibilities* As our Director Nursing Perioperative Services at California Hospital, you will be responsible for Surgical Services including Main OR, Pre-Op, PACU, GI, and SPD. We have 7 operating rooms and a robust surgical...

CVS Health Nursing Position We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care...

Partner Company is seeking a Case Manager – Utilization Review Specialist for a fully remote position based in the United States. You will oversee admission and concurrent utilization reviews, assess medical necessity, and coordinate appeals to...

*Job Summary and Responsibilities* As our Charge Nurse, you'll oversee a department of frontline nurses caring for patients. Your previous experience in acute care, LTC, or nursing homes adds tremendous value to our nursing team. Every day...

Job Title This position is fully remote, however, you must reside in the State of Texas. The position is a contract for about 6 months. RN working in the insurance or managed care industry using medically accepted criteria to validate the...

Summary VA Greater Los Angeles Healthcare System (VAGLAHS) is seeking to hire experienced Registered Nurses to work in our Case Management/Care Coordination Program. The Case Manager provides patient centered care with expertise in the...

Claims Medical Review Nursing Consultant Job No: 544045 Work Type: Full-time Location: REMOTE OPTIONS, VARIOUS-STATEWIDE, PHOENIX Categories: Healthcare/Medical Support Level,...

Job Title This is a remote, PRN position but will need onsite training in Mishawaka Indiana. Shift: Days - 8 hr shift LOCAL CANDIDATES ONLY! Why Choose Saint Joseph Health System? At Saint Joseph Health System, our values...

Job Title Real Job *Works with any department, if a patient complaint arises* *Experience in Critical Care or ED is a plus* *Weekends will not typically be required unless survey is on site* *2 years experience required, hard stop* *First...

SHIFT: Any (United States of America) Seeking Breakthrough Makers Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will...

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

Health Screener The primary responsibility of the Health Screener is to provide coverage in the field ensuring that health screenings are completed accurately and on time. Maintain a safe and professional environment for clients and...