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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...

CVS Health is hiring for an Utilization Management Nurse Consultant (RN) for remote work. The role focuses on concurrent review and ensuring timely, cost-effective care through evidence-based decision-making. Candidates need active RN...

Molina Healthcare is hiring a remote RN Care Manager. Preference for candidates in Washington State. This role will be working Pacific Standard Time hours. This role supports Medicare members through telephonic case management and...

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...

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,...

hackajob is collaborating with Oracle to connect them with exceptional professionals for this role. About the team We're expanding our team to support a U.S. Federal healthcare client and are seeking experienced Registered Nurses with clinical...

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...

APremium Healthcare Solution, LLC is seeking a Virtual Nurse Consultant to provide remote nursing guidance and care coordination from a flexible, virtual setting in Conyers, GA. The role emphasizes high-quality patient outcomes and HIPAA-compliant...

Our client, a mutual benefit corporation and health plan provider, seeks an accomplished Registered Nurse (Utilization Management). *** Candidate must be authorized to work in USA without requiring sponsorship...

The Virtual Nurse, RN at MUSC coordinates and delivers professional clinical, quality, and educational services to patients engaging with MUSC via virtual care. This role reports to leadership within the MUSC Center for Telehealth and aims to...

Who We Are: Since 1985, BHCHP's mission has been to provide or assure access to the highest quality health care for all individuals and families experiencing homelessness in greater Boston. We care for over 11,000 homeless individuals each...

Immediate need for a talented Utilization Management RN - Prior Authorization. This is a 12+ Months Contract opportunity with long-term potential and is located in US (Remote). Please review the...

Valeris is seeking a Patient Support Nurse to engage patients from enrollment through treatment, addressing barriers and supporting therapy initiation. You will educate on treatment, navigate insurance, and triage to additional services as needed.

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.

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 you...

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.

Job Title: Clinical Quality Assurance Nurse Pay: see below Registered Nurse - $28.50/hr (Non-negotiable) LPN/LVN- $26.50/hr (non-negotiable) Regular Schedule after training: M-F...

Centene is seeking an RN with strong appeal review experience to act as liaison for statewide appeals, fair hearings, and review organizations. This fully remote role supports members and providers while ensuring compliance with State and NCQA...

CVS Health in Oklahoma is seeking an experienced Utilization Management Nurse Consultant (RN) for a 100% remote role based in Oklahoma. You will review medical necessity, coordinate care, support discharge planning and provide coverage...

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...

Iris Telehealth is hiring Consult-Liaison Psychiatrists to provide 100% remote evaluations and consultations for inpatient, ED, and ER settings from home. Georgia-licensed board-certified psychiatrists are sought, with at least 2 years of...

Serving as the strategic quality advisor for a portfolio of Value-Based Care organizations, the full-time Lead VBC Quality Consultant will analyze performance, develop quality improvement strategies, and partner with provider organizations to...

Essential Duties and Responsibilities: Review requests for services including admission, discharges and continued stays for adherence to clinical criteria, state and federal policy, and related requirements. Issue...

Alignerr is seeking a Nursing Informatics Specialist (AI Training) who brings clinical nursing expertise to evaluate and improve AI systems used in healthcare settings. Remote, hourly contract with flexible hours (10-40 hours/week), focusing on...

American Health Plans Franklin, TN 37067, USA Description American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for...