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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...

University Hospitals is seeking a Registered Nurse to collaborate with the health care team to coordinate admissions, continued stays, and level-of-care decisions. You will communicate with patients and families to ensure timely care and proper...

Emanate Health in Covina, CA, seeks a Utilization Review Nurse to evaluate medical records and determine medical necessity using policies and guidelines for urgent and standard reviews. You will document decisions and support claims reviews,...

100% REMOTE PAY: $47-$52/hr REQUIRED: Must have current RN licensing Post market medical device experience in either medical assessment, complaint handling, post market reporting – preference is actual medical device assessment Highly prefer...

**JOB SUMMARY** This job works with appropriate departments in the areas of compliance, process improvement, medical record review and coding, and member and provider satisfaction for all product lines. Recommends and implements process...

Job Title : Registered Nurse (Navy Nurse Corps) Category / Component : Officer • Both Overview Navy Nurse Corps officers deliver professional nursing care to service members, families, and global communities in leading edge military medical...

Lee Health is hiring for a Utilization Management RN position. This remote role begins onsite for the first 90 days and requires licensure in Florida. The nurse will perform utilization management duties, ensure regulatory compliance, and document...

Provide essential clinical and administrative support to a remote healthcare team across Canada. Manage laboratory results, pharmacy communications, referrals, and patient follow-ups. Requirements: Current...

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...

At UK King's Daughters, we're not just a healthcare facility - we're a family of dedicated professionals who share a passion for making a meaningful difference in the lives of our patients. We're more than just a place to work; we're a place to...

Optum is seeking a Fertility Utilization Management RN to work remotely within the United States. You will assess and determine the appropriateness of inpatient and outpatient services, translating clinical concepts into practical care-management...

Registered Nurse (RN) For Utilization Management Team We are seeking a Registered Nurse (RN) to join our Utilization Management team. In this role, you will perform concurrent reviews, prior authorizations, medical necessity reviews,...

Remote Utilization Review Registered Nurse (UR RN) Are you an experienced RN looking to transition away from the bedside while still making a massive impact on patient care? We are seeking a dedicated Utilization Review Nurse to join our...

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability,...

Opco-Skilled-Management- is seeking a Central Intake Nurse to coordinate initial and ongoing referral documentation from physicians, insurers, and providers to determine service appropriateness and facility placement. You will develop patient care...

Job Title: Nurse, Clinical Medical Review Location: Columbia, MD (Primarily remote, but hybrid) Duration: 6 Months Contract PURPOSE: We are seeking a qualified RN or LPN with experience supporting HEDIS reporting and abstraction processes in a...

Details Client Name Dignity Health California Hospital Medical Center Job Type Travel Offering Nursing Profession Nursing...

Field Nurse Case Manager - Glendale, CA Introduction At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it's our purpose. Every...

Supports the values of service excellence, teamwork, and integrity while managing patient care.Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers.Qualifications:Requires a current RN license, nursing diploma or...

Pay Package: Total weekly gross $ 2979 for 40 hrs Job Description: Tittle: RN Case Manager Location: Mission Hills, CA 91345 Duration: 13 weeks Guaranteed hours: 40 hrs Shifts: Day Job Description: Start Date:...

JOB DESCRIPTION - REGISTERED NURSE (A) Job Summary: The Registered Nurse provides patient care on a supplemental basis to our client facilities. With the delivery of safe, quality patient care as...

Compassus is seeking a Hospice RN Clinical Coordinator to oversee administrative and management functions in the absence of the Director of Clinical Services. May carry caseload and ensure compliance with state and federal regulations. Remote role...

Cunningham Children's Home is seeking a Nurse Case Manager to support youth in emotional, psychological, and physical care within residential settings. The position emphasizes remote on-call consultations to ensure accessibility without mandatory...

Overview Our client is a trusted leader in healthcare services, dedicated to improving outcomes for patients and providers through innovative solutions and high-quality care. Join a team committed to making a meaningful difference in the...

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...