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CVS Health is seeking a Nurse Consultant for a remote role focused on inpatient clinical reviews. The position emphasizes collaboration with hospitals and care teams to ensure appropriate levels of care and efficient discharge planning from a...

Clinical Documentation Improvement Specialist-RN- Remote The Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) assists with the identification of diagnoses, conditions, and procedures that are representative of the...

Actalent is seeking an LVN Nurse Consultant for a fully remote telephonic nursing position. You will contact patients or caregivers to ensure adherence to prescribed therapies and address issues they may encounter, including nursing home...

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.

CVS Health is seeking a Utilization Management Nurse Consultant to assess, plan, and coordinate healthcare services for members. This role involves 24/7 coverage with weekend/evening hours and requires strong clinical judgment and cross-functional...

DRG Specialist UPMC Corporate Revenue Cycle is hiring a DRG Specialist to work on inpatient auditing within our Coding Department. This position will be a work-from-home position working during standard business hours Monday through...

The Veterans Health Administration is seeking a Registered Nurse (Case Manager/Care Coordinator) at the Charleston VA Medical Center in the Nursing, Specialty department. The role focuses on complex patient management, discharge planning, and...

Healthcare Provider Solutions is seeking a Clinical Consultant to join our remote clinical consulting team. The role focuses on hospice quality assurance, chart reviews, and Medicare hospice issues, including ADR/UPIC/SMRC/OIG audits.

Children's Mercy Job Opportunity Do you envision finding a meaningful role with an inclusive and compassionate team? At Children's Mercy, we believe in making a difference in the lives of all children and shining a light of hope to the...

State of North Carolina - Health & Human Services in North Carolina seeks a Nurse Consultant I who conducts regulatory nursing home inspections to ensure compliance with federal and state standards. The role involves travel across Central and...

JOB DESCRIPTION Opportunity in Southern California for an experienced Managed Care Leader to join our health plan in California. Candidates must have a minimum of 7 years of healthcare experience, 3 of those should be with a Managed Care...

Humana is seeking a Utilization Management Nurse to support coordination, documentation, and communication of medical services and benefit determinations. This role suits experienced nurses who can work independently and make critical patient-care...

Regional Nurse Consultant (RNC)Sheridan Healthcare | Regional Corporate Clinical Role Shawnee Senior Living is proud to be part of the Sheridan Healthcare family of communities, a growing network of skilled nursing facilities throughout Illinois.

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

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...

Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET Medix is supporting a healthcare technology organization that is adding...

Overview St. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who...

Datavant is seeking a Coding Consultant Outpatient PRN to review medical records, assign accurate diagnoses and procedure codes, and ensure data quality for hospital statistics. This remote, part-time role requires AHIMA or AAPC credentials and 3+...

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...

Field Based Community Health Worker Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the...

Sagility is hiring an RN Utilization Management Reviewer for a fully remote, home-based role in the United States. You will perform day-to-day clinical and service authorization reviews for medical necessity and ensure compliance with CMS...

POSITION SUMMARY Under the supervision of the Vice President of Patient Care Services/ACNO, the lead wound care nurse will serve as a clinical resource to MLKCH staff on issues pertaining to patients with wounds, pressure...

Overview St. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who count on the...

Qlarant, a nonprofit organization, seeks a Nurse Specialist II to perform medical record and claims review for Medicare, Medicaid, and other data. This remote role in the United States involves ensuring adherence to guidelines while assessing for...

Spectraforce Technologies, Inc. is seeking a Clinical Review Nurse - Prior Authorization for a 12-month assignment. The role is remote (PST/CST) with scheduling across multiple shifts, supporting national guidelines and contractual requirements.