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Absolute Elder CareLos Angeles,CA
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,...
Molina HealthcareLos Angeles,CA
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...
University of Minnesota School of NursingLos Angeles,CA
CVS Health is hiring a full-time RN for healthcare services and utilization management. The role emphasizes assessing and coordinating care, applying clinical criteria, and communicating with providers to optimize member outcomes. The...
OracleLos Angeles,CA
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...
4004 Aetna Medicaid AdministratorsLos Angeles,CA
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...
Remote ServicesLos Angeles,CA
Jushi Holdings Inc. seeks a Medical Professional to deliver patient consultations and guidance on medical cannabis within a compliant, patient-first framework. The role emphasizes HIPAA-compliant care, accurate information, and collaboration with...
Pyramid ConsultingLos Angeles,CA
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...
ActalentLos Angeles,CA
Fully Remote: Clinical Documentation SpecialistFacilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical records to...
AlignerrLos Angeles,CA
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...
Guardian LifeLos Angeles,CA
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...
Amerit ConsultingLos Angeles,CA
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,...
State of North CarolinaLos Angeles,CA
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...
LogoslabsLos Angeles,CA
Jushi Holdings Inc. seeks a Medical Professional to deliver patient consultations and guidance on medical cannabis within a compliant, patient-first framework. The role emphasizes HIPAA-compliant care, accurate information, and collaboration with...
Molina HealthcareLos Angeles,CA
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...
SedgwickLos Angeles,CA
Sedgwick is hiring for a Clinical Consultation Triage Nurse in a remote, full-time role. You will triage calls, assess needs, and provide care guidance to determine the appropriate level of care, while supporting return-to-work goals. The...
Marshall Health NetworkLos Angeles,CA
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...
Centene CorporationLos Angeles,CA
Centene Corporation is seeking a Licensed Practical Nurse (LPN) or Registered Nurse (RN) for a remote case management role in Pennsylvania. The selected candidate will perform concurrent reviews, determine appropriate care levels, and assist with...
CVS HealthLos Angeles,CA
CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant. The schedule is Monday–Friday, 9:00am–5:30pm in the candidate's time zone. This is a work-from-home role in a 24/7 operation with holiday/evening hours.
MUSCLos Angeles,CA
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...
4004 Aetna Medicaid AdministratorsLos Angeles,CA
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...
JobgetherLos Angeles,CA
Jobgether is seeking a Coding Consultant Outpatient – PRN based in the United States. This remote, part-time role focuses on accurate outpatient coding, review of documentation, and ensuring proper APC and reimbursement details. The...
4062 Aetna Resources, LLCLos Angeles,CA
CVS Health is seeking a registered nurse to assess, plan, implement, coordinate and evaluate healthcare options for members. The role focuses on coverage determination and coordination within the utilization management framework. The...
TeamHealthLos Angeles,CA
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...
IstssLos Angeles,CA
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...
American Health PlansLos Angeles,CA
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...

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