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CVS Health is hiring a Nurse Consultant for a 100% remote Utilization Management role. You will apply clinical judgment to review inpatient and outpatient services, authorize care, and collaborate with providers while maintaining precise...

Cunningham Children's Home in Urbana, IL, is seeking a Nurse Case Manager to support youth with emotional, psychological, and physical care in residential programs. You will provide medical case management, screening, education, counseling, and...

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...

Description We are hiring for a part- time School Nurse Consultant, come join our team! This is a non-benefited position that works on an as needed basis. See CESA 6 Values Here See details and apply on our website.

CVS Health is seeking a Nurse Consultant for a 100% remote role. You will apply clinical judgment and evidence-based criteria to review inpatient and outpatient services, authorize care, and escalate cases as needed, while coordinating with...

Clinical Appeals Nurse We are seeking an experienced Clinical Appeals Nurse to support the appeal and grievance processes by analyzing and responding to adverse coverage decisions. This role involves clinical judgment, regulatory...

Utilization Management Nurse Consultant Clinical Precertification RN (Medicare- Complex Spine Team) We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At...

Clinical Nurse Professional Development Educator Advanced How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At...

Improve the lives of others while Caring. Connecting. Growing together. Job Description - Clinical Consultant RN, Medical Policy Writer - Remote (2389098) Clinical Consultant RN, Medical Policy Writer - Remote - 2389098 Optum is...

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.

Nurse Consultant/ Regional Director Of Clinical Operations Relocation to Southern New Mexico is required. The Nurse Consultant/ Regional Director of Clinical Operations position is comprised of two essential objectives; to partner...

The position is work from home with field visits. JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include...

Absolute Elder Care is seeking a Remote Nurse Consultant to provide compassionate and expert guidance to seniors and their families. This full-time, remote position includes conducting health care assessments, creating individualized care plans,...

MPHI, a Michigan-based public health institute, seeks a Nurse Consultant for Tuberculosis to coordinate clinical and educational TB elements across the state. The role requires a master's degree in nursing, public health, or a health field, with...

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...

WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure compliant patient care. The role emphasizes adherence to HIPAA, state and federal regulations, and a...

CorVel Corporation seeks a Care Advocate Nurse for a remote role focused on assessing injury severity, reviewing medical data, and supporting the Claims Management department as a nurse consultant. The position requires clinical nursing...

Utilization Management Nurse Consultant (RN) – Concurrent Review Remote | Acute Inpatient Utilization Management | RN Opportunity Are you an experienced RN with a background in acute care and utilization management? Join our team...

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 Utilization Review Nurse at the Utilization Management Hub, you will be a critical guardian of healthcare efficiency and quality, ensuring integrity in clinical...

Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in accordance with established standards of care, policies, and procedures. Demonstrates performance...

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 deeply, innovate with purpose, hold...

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

The Connection Center Virtual Registered Nurse (RN) delivers high-quality, patient-centered care remotely through telephonic and video interactions, covering the full nursing process from assessment to evaluation. Works with interdisciplinary...

The U.S. Department of Veterans Affairs is seeking a Remote Patient Monitoring (RPM) Home Telehealth RN Care Coordinator for the Central Arkansas Veteran Healthcare System in Little Rock, Arkansas. The role emphasizes leadership...