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Job Title: Clinical Review Nurse (Remote) Position Summary: We are seeking a detail-oriented and clinically skilled Clinical Review Nurse to join our team in a fully remote role. The Clinical Review Nurse is responsible for conducting...

Job Description Cedars-Sinai has been named to the Honor Roll for the ninth consecutive year and tied for #1 in California and Los Angeles in U.S. News & World Report's "Best Hospitals 2024-25" rankings, as well as placed...

Position Summary Utilization management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours. Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate,...

An educational institution in Kentucky is seeking a Nurse Coordinator for the Human Development Institute. This full-time position involves reviewing care assessments, providing technical assistance, and requires 8 years of related experience and...

Fully remote (never coming onsite) Description: The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan...

CareXM is hiring a Remote Registered Nurse (RN) for early morning triage on a part-time schedule. The role focuses on secure, compassionate after-hours triage for hospice and home health partners, conducted entirely from the nurse's home.

Job Description Pre-Authorization RN Compensation Salary Range: $90,000 - $108,000 per year Bonus / Commission (if applicable): This role is eligible...

Consulting Rn For North Dakota CGM Services Med Supply US is an ACHC-accredited, Medicare-enrolled mail-order supplier of continuous glucose monitors serving patients nationwide. We're expanding into North Dakota and need an ND-licensed...

Job Title: Specialized Licensed Vocational Nurse (LVN) - Trach & Vent Support Compensation Range: $30 - $40 per hour (Dependent on experience) Schedule: Monday to Friday, School Hours...

JOB DESCRIPTION Must reside in Florida Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and...

Make a Meaningful Impact as a Field Registered Nurse Are you an RN looking for a rewarding career outside of the hospital? Join Maximus and help Massachusetts residents access the care and services they need to live safely and independently...

A healthcare solutions provider is looking for a qualified RN to perform medical reviews and coordinate care for members. This role involves assessing service needs, engaging in patient education, and ensuring compliance with healthcare...

A global talent management firm is seeking a Utilization Review Nurse for a contract role based in Pennington, NJ. The role involves performing utilization management, reviewing medical records, and coordinating discharge planning. Candidates must...

Remote RN Case Manager (Texas Residents Only) Are you an experienced Registered Nurse looking to transition from bedside care into a role focused on care coordination, member advocacy, and improving health outcomes? This fully remote...

WHO WE ARE At Polaris Pharmacy Services, we're more than a pharmacy - we're a dedicated partner in care, transforming how patients experience long-term, post-acute, correctional, PACE, and specialty pharmacy services. As industry leaders,...

$40/hour - Contract for 6 months Must reside in TX Full time remote Candidates must be based in TX. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical...

Utilization Management Admissions Liaison RN II (Nights) Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13180 Salary...

UnitedHealth Group is seeking a Registered Nurse Clinical Annotator to support AI-driven prior authorization in healthcare. You will interpret clinical data, apply guideline-based criteria, and ensure accurate annotations for model training. This...

Job Requirements Education & Experience Bachelor's Degree in Nursing (BSN) – Preferred Acute care facility experience – Preferred Previous hospital/acute care nursing experience...

A leading health care provider is seeking a Massachusetts Telehealth Nurse to assist patients in accessing care through phone consultations. Candidates must have a valid RN license in Massachusetts and 3+ years of clinical experience. The ideal...

A healthcare company is seeking a compassionate and detail-oriented RN Triage Nurse for a remote role based in Charlotte, NC. Ideal candidates will have at least 5 years of experience in nursing, particularly in emergency departments or call...

Nurse Case Manager II The Nurse Case Manager II is responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and...

Registered Nurse – Utilization Review (Remote) This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS).

Requisition Details GENERAL REQUISITION INFORMATION EEO Statement: UNMC is an Equal Employment Opportunity Employer, including an equal opportunity employer of protected veterans and...

Job Description Insight Global is seeking a skilled and compassionate Registered Nurse to join an innovative integrative wellness practice client of ours in Beverly Hills. This is a part-time position working two days a week to...