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Molina Healthcare of California is hiring a Transition of Care Coach LVN/LPN. This role is remote; however, candidates must have a valid and unrestricted California LVN/LPN licensure. The hours will be Monday through Friday...

RN opportunity with out the bedside burnout + sign on bonus. This Jobot Job is hosted by: Dexter Dionio Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $80,000 -...

Centene Corporation seeks a Nurse Reviewer to analyze prior authorization requests and determine medical necessity in line with regulatory guidelines and member benefits. You will collaborate with medical directors, providers, and the...

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...

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...

This position will be paying $26.50/hr for an LPN and $28.50/hr for an RN Job Description The Clinical Quality Assurance Coordinator is responsible for ensuring case reports are of the highest quality and integrity and in full...

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...

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...

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...

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...

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving...

Registered Nurse (RN) - Utilization Management 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...

CVS Health in Maryland seeks a Registered Nurse to assess, plan, implement, and coordinate healthcare services and benefits for members. You will render coverage determinations using clinical guidelines and collaborate with providers to facilitate...

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...

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,...

Absolute Elder Care is seeking a Remote Nurse Consultant to provide expert guidance and support for in-home senior care. This full-time, remote role involves collaborating with families to manage health care needs, conducting comprehensive...

Job Title Clinical Nurse Consultant Job Description Position Summary The Clinical Nurse Consultant provides relevant training and consultation on ICU Medical's clinical products/software and clinical services...

A technology and business consulting firm is seeking a Clinical Medical Review Nurse to analyze health data and provide insights for internal stakeholders. The ideal candidate has a Registered Nurse license, along with four years of clinical...

Get AI-powered advice on this job and more exclusive features. Crossing Hurdles provided pay range This range is provided by Crossing Hurdles. Your actual pay will be based on your skills and experience — talk with your recruiter...

Care Management Nurse Consultant Competitive Compensation & Benefits Package! Position eligible for: Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan...

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 &...

Nurse Consultant Come join our Symbria Team! We are seeking a highly professional and dedicated individual to join our EMPLOYEE-OWNED TEAM as a Nurse Consultant in the pharmaceutical industry at our Pharmacy in Pennsylvania!

CEI is seeking an LPN to join a clinical review team handling utilization management across professional, inpatient/outpatient, and facility services. The role starts with onsite training in Columbia, SC, then transitions to remote work with...

Jobgether, on behalf of a partner organization, seeks an experienced Registered Nurse for a remote Utilization Management role. You will review cases, assess medical necessity, and support prior authorization decisions while collaborating with...

Central California Alliance for Health is seeking a Prior Authorizations Nurse (RN) for a temporary, full-time role. This remote-in-California position reports to the Utilization Management Supervisor and involves ensuring PA requests comply with...