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CVS Health is seeking a licensed RN Case Manager to work remotely across the United States, conducting telephonic case management for fully insured and self-insured clients with clinical judgment and collaboration with care teams. The role...

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...

Job ID: Posted: Location: Eden Prairie, Minnesota, United StatesSalary: $91,700 - $163,700/yearJob Area: Medical & Clinical OperationsCompany: UnitedHealth GroupOptum is a global organization that delivers care, aided by technology to help...

Kingman Healthcare Incorporated (KHI)Staff Position Description Position Title: Utilization Review Nurse Position Code: RN-6027 Department: Case Management Safety Sensitive: Yes...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...

Clinical Nurse Consultant At Bristol Myers Squibb, our employees often ask, "Who are you working for?"—a question that fuels collaboration, accountability, and urgency in our work. Our purpose-driven culture inspires us to discover,...

Case Manager Utilization RNWorks collaboratively with an MD to coordinate and screen for the appropriateness of admissions and continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the...

aitrainer is seeking a Remote Registered Nurse (RN) to conduct health screenings for a health study. This role involves remote assessments, eligibility determination, and scheduling onsite sessions, all while ensuring HIPAA compliance.

A healthcare staffing company is seeking a Clinical Review Nurse for Prior Authorization Review. This remote role demands conducting reviews, collaborating with healthcare teams, and ensuring compliance. Candidates need an active RN license and...

Titanium Healthcare is seeking an RN Clinical Consultant to lead clinical oversight within the Enhanced Care Management (ECM) program for Medi-Cal members in California. You will collaborate with Lead Care Managers and the interdisciplinary team...

BCBST BlueCross BlueShield of Tennessee, Inc. is hiring an Appeals & Grievance Nurse Analyst to review and process member and provider appeals, ensuring timely and compliant resolutions under CMS, Medicare, and TennCare guidelines. The role...

Santa Barbara Cottage Hospital is seeking a QIC Part A Nurse Consultant for a remote six-month assignment. The role focuses on reviewing determinations and rendering medical necessity decisions for Medicare State East cases, while resolving...

Type: Clinic Somerville , MA SkyBridge Healthcare is currently seeking Registered Nurse with Clinic experience for a 13-week contract in MA. SkyBridge Healthcare is a premier staffing firm dedicated to matching outstanding talent...

Syneos Health, Inc. in Spain is seeking a Perm Part Time Research Nurse to support clinical trials in the Barcelona area. This remote role coordinates patient visits, data collection, and adherence to study protocols while maintaining regulatory...

Utilization Review Nurse - RN | 100% Remote | Part-Time 10-20 Hours Per Week | Flexible Schedule | Evenings & Weekends Looking for a way to use your nursing experience without returning to a full-time bedside...

At St. Tammany Health System, delivering world-class healthcare close to home is our goal. That means we are committed to attracting and retaining the very best professionals for every position in our health system. We believe the pristine...

BlueCare | Clinical Nurse Consultant | Community Care Employment Status: Full time - 6 Month Fixed Term Contract Location: Network A scope – Remote Support, some travel across Network may be required (North QLD - Mackay to...

UW Health in Wisconsin seeks a Telehealth Nursing Assistant (CNA/NA) to support remote care for critical patients within the eICU network. The role includes admitting, transferring and discharging patients via the eCareManager and ensuring...

Highpoint Health Sumner is seeking a Registered Nurse (RN) Clinical Documentation Specialist to join as a remote FT (days). You'll contribute by applying plan-of-care interventions and driving patient-care innovations with advanced technology.

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing and evaluating care of patients. The staff RN utilizes the nursing process by use of...

ProMedica is seeking a Registered Nurse (RN) to join the Care Coordination team as the coordinator of a patient's plan of care. The RN will assess, diagnose, plan, implement, and evaluate care, working with patients, families, and the health care...

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...

PIH Health Downey Hospital is seeking an RN Case Manager to guide patients from pre-admission through post-discharge, ensuring smooth transitions and appropriate utilization of hospital services.You will focus on maximizing reimbursement from...

Public Health Nurse Employer: County of Los Angeles Salary: $105,247.44 - $157,542.24 Annually Location: Los Angeles County, CA Job Type: Full time Job Number: PH5230H Department: PUBLIC HEALTH...

Interventional Radiology RN This position is for an Interventional Radiology Registered Nurse. The role requires experience in an acute care setting. The ideal candidate must be able to work both day shifts and provide on-call coverage.