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Job Summary: Collaborates with Education Consultants, Managers, CNS staff and Physicians to develop, design, deliver and evaluate/improve education strategies and special projects/programs based on clients departmental...

HealthHelp, a WNS company, seeks a Clinical Review Nurse for a fully remote role in the United States. You will perform prospective reviews for medical necessity on prior authorization requests across multiple specialty programs and refer...

Cabell Huntington Hospital is seeking a casual, as needed Virtual Integrated Care Coordinator (RN) for our CHH Virtual Integrated Care Department. This job is responsible for supporting and...

Amerit Consulting is seeking an experienced Utilization Management Nurse (RN) in California for a remote 6-month contract. The incumbent will support inpatient utilization review, medical necessity determinations, and facility claims compliance,...

Exceptional care starts with exceptional people. For us, this is more than a job– it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers...

JOB DESCRIPTION We are searching for six TX licensed RNs to work telephonically with our Medicaid members across the state. Three of the positions are open to RNs with at least two years of experience in in Behavioral Health or Substance Abuse...

CVS Health is seeking a Registered Nurse for Utilization Management to assess and coordinate healthcare services for members, applying clinical judgment and guidelines to render coverage decisions. Collaboration with providers supports care...

Remote Nursing OpportunitiesAre you looking for an exciting way to utilize your nursing skills and expertise to deliver quality nursing care in a remote setting? AccessNurse, where technology meets compassionate care, is looking for professional...

Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost-effective care to the members. Providence caregivers are not simply valued theyre invaluable. Join our team at...

What You'll Do As an Enrollment Nurse, your primary responsibility is enrolling patients in a chronic care management program. You'll call eligible patients, educate them about the program, answer questions, and assist interested patients...

Bestica is seeking a travel nurse RN Research / Clinical Research for a travel nursing job in Fullerton, California. Job Description & RequirementsSpecialty: Research /...

Patient Safety Infection Control Specialist RN - Dental Falls Church is an independent city in the Commonwealth of Virginia with a population of approximately 15,000. Falls Church is included in the Washington metropolitan area. Falls...

Redesigning heart health via virtual cardiac rehab for older adults.Mission-driven team of clinicians and engineers.Responsibilities:Review EMRs to determine eligibility and create orders.Conduct video intake assessments and treatment...

The North Carolina Department of Health and Human Services (DHHS) seeks a Nurse Consultant II (NS) in the Immunization Branch. The role delivers high‑level clinical guidance, conducts VFC site visits, and ensures nursing policies align with...

Guardian Life seeks an experienced RN Clinical Consultant to evaluate disability claims, analyze medical information, and provide clinical recommendations for claim decisions. You will collaborate with providers, claimants, and staff, ensuring...

Remote Care Manager (RN) - MUST LIVE IN TEXAS TX, United States Trending Job Description JOB DESCRIPTION We are searching for six TX licensed RNs to work telephonically with our Medicaid members across the state.

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...

Engage Consulting seeks an experienced MDS Nurse / MDS Coordinator for a full-time remote role supporting skilled nursing facilities with MDS assessments and reimbursement processes. The ideal candidate holds an active RN license with...

Comagine Health in Washington State is seeking an experienced registered nurse to join our remote clinical reviewer team. In this role you will assess medical necessity, appropriateness, and quality of care for Washington L&I contracts, applying...

Baptist Health is seeking a remote Clinical Documentation Specialist to evaluate physician documentation and ensure accurate illness severity portrayal for coding precision. The role requires an active Kentucky license and involves guiding...

Registered Nurse Navigator - Cancer Center Exams - 10 Hour Days Do you have a passion for the highest clinical quality and patient happiness? Would you like to use your expert clinical competencies with an organization known nationally...

Comagine Health is seeking a Clinical Reviewer (RN) remotely to support Washington state contracts. The role evaluates medical necessity and quality of care, collaborating with physician consultants and internal teams to ensure compliant,...

Cambia Health Solutions is seeking an Appeals Clinician I who will work from home within Oregon, Washington, Idaho or Utah. You will leverage clinical expertise to complete the clinical component of all appeal types to resolve member/provider...

Performance Home Health is seeking an experienced Referral Review Nurse to join our growing team. This role reviews incoming home health referrals, ensures complete documentation, identifies missing information, and coordinates with multiple...

U.S. Army Family Nurse Practitioners perform the highest level of quality care for Army Soldiers, retirees, and their families. If you are looking to combine your skills as a family nurse practitioner and your passion for patient care with the desire...