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Centene Corp. is hiring a Quality Improvement Coordinator II to conduct reviews of delegated entities for quality, service performance and utilization, and to lead clinical quality initiatives across provider sites. The role involves...

CVS Health is seeking a remote Appeals Nurse Consultant to review and resolve clinical appeals with sound clinical judgment and regulatory knowledge. The role supports a remote team with standard Monday–Friday hours and occasional on-call.

A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and...

Guidehealth in the United States seeks an experienced RN Case Manager to work remotely with Illinois licensure. You will oversee member management, promote wellness, and support cost-effective care within a value-based care framework.

To support a growing healthcare team, the full-time Remote RN Care Manager will manage an assigned patient panel, focusing on individual healthcare needs, collaborating with interdisciplinary teams, and advocating for patients while working...

Area Quality Specialist Registered Nurse Find your purpose giving patient care teams the knowledge and tools they need to better care for patients as an Area Quality Specialist Registered Nurse! This is a rare opening on a...

CVS Health is seeking a Case Management Coordinator in Illinois to support members with scheduling, benefits education, and access to care. The role requires clinical experience and an active RN license in Illinois. You will work from home...

*Job Summary and Responsibilities* As our Registered Nurse (RN), you will be a pivotal healthcare professional, delivering compassionate, high-quality care that truly impacts our patients' well-being and recovery. Every day, you will...

The VITAS Telecare RN is a member of the interdisciplinary team who is the pivotal person responsible for identifying the physical, psychological, social, and spiritual needs of those patients and families needing assistance after normal business...

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...

A leading health care provider is seeking a Massachusetts Telehealth Nurse to assist patients in accessing care through phone consultations. Candidates must have a valid RN license in Massachusetts and 3+ years of clinical experience. The ideal...

Physician Care Coordination Consultants (PC3) is seeking an Appeals Nurse Manager to lead the clinical appeals function within a remote healthcare revenue cycle environment. You\'ll oversee a team of Appeals Nurses, establish standardized...

Job Description Summary The Curriculum Coordinator supports the planning, development, implementation, and continuous improvement of the College of Nursing curriculum through collaborative partnerships with faculty and academic teams. This...

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...

About This Role The Case Manager Extended Care Coordinator RN is responsible for overseeing and managing skilled patients in rehabilitation at contracted Skilled Nursing facilities. This role is ideal for those who excel in coordinating care and...

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...

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...

Job Description Harborview Medical Center's Stroke Center has an outstanding opportunity for a Registered Nurse (RN) - Nurse Navigator. WORK SCHEDULE Full-time, 100% FTE, 40 hours per week...

MES Solutions is seeking a self-driven RN or LPN to join as Clinical Quality Assurance Coordinator. This 100% remote role focuses on reviewing peer reports, ensuring accuracy, and aligning with client agreements, regulatory standards, and state...

Santa Barbara Cottage Hospital is seeking an experienced RN/LPN to perform remote clinical reviews for appeal cases. You will review medical records, apply InterQual criteria, and prepare clinical determinations for physician review. The...

Northwell Health is seeking a Licensed Practical Nurse to provide diverse patient care within an assigned unit under the direct supervision of a Registered Nurse. Responsibilities include administering general nursing care, coordinating with the...

Job OpportunitySeeking a compassionate and driven Registered Nurse (RN) Care Manager to join our team in a role designed for nurses who are ready to expand their impact beyond the traditional clinical setting. This position offers the opportunity...

Employment Type: Full time Shift: Night Shift Description: Position Summary: Reviews assigned cases applying specific criteria and payor guidelines and communicates this review to...

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry‑leading solutions to build an integrated care model that holistically addresses an individual's...

Become a part of our caring community Humana Gold Plus Integrated is seeking a Field Care Manager Registered Nurse (RN) to assess and evaluate member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members and...