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Yoh is seeking a Utilization Management Nurse Coordinator (RN or LVN) for a 6+ month remote contract with a managed care client based in Northern California. Training occurs onsite in Fairfield or Redding for three weeks, then transitions to fully...

Bring clinical insight, nursing expertise, and data-driven precision to a Hybrid/Remote Clinical Documentation Improvement Nurse Specialist career that combines meaningful patient impact, supportive leadership, modern healthcare technology,...

Freeman Health System is hiring for a remote/hybrid position in Utilization Review and Case Management. The role focuses on assisting Emergency Department patients with their social and discharge needs. Candidates must be licensed RNs with strong...

Cedars-Sinai is seeking an Utilization Management Specialist to support the UR team in a fast-paced, hospital setting. You will help ensure timely, accurate authorization workflows and regulatory compliance using EPIC/CS-Link and payer portals.

Delivering high-quality nursing care from a remote setting, the full-time Remote Care Nurse II will conduct patient assessments, develop care plans, and coordinate with multidisciplinary teams to optimize health outcomes using telehealth...

Managed Medical Review Organization seeks a licensed RN for a home-office, remote role focused on telephonic customer service and clinical documentation. The position emphasizes quality review, case management, and adherence to policy, with...

Medical Review Nurse (RN)Remote position, however candidates must reside in the State of TX or State of ILThis position is a contract for about 9 months.Pay: $41/hourRN working in the insurance or managed care industry using medically accepted...

Spectraforce Technologies, Inc. is seeking a Clinical Review Nurse for remote concurrent review responsibilities. The role assesses member health status, medical necessity, and appropriate care levels, contributing to discharge planning within...

Southcoast Health seeks a Team Lead-Centralized Clinic Support to join a remote role serving MA/RI communities. The role guides nursing staff, ensures clinical workflow compliance, and drives care coordination and patient safety across ambulatory...

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...

CorVel Corporation seeks a Nurse Trainer to develop and revise training materials for nursing staff in a clinical setting. You will organize curricula, assess effectiveness, and ensure new hires complete training and QA reviews. The role is...

Position: Remote Nurse Consultant Company Overview: Absolute Elder Care is a leading provider of in-home care services for seniors. Our mission is to provide compassionate, personalized care to help seniors maintain their...

Centene Management Company LLC is seeking a Licensed Practical Nurse to analyze prior authorization requests and determine medical necessity in New York. You will work with healthcare providers and the authorization team to ensure timely,...

Nurse Case ManagerPosition Type: Full-Time Contract RoleLocation: Work from homeWork Type: Remote Est. Pay Range: $35.00/hour – $38.46/Hour on W2 (USD) (all inclusive)Schedule: Mon-Fri 8am-5pm ESTRegistered Nurse with active state license in...

Health Care Service Corporation is hiring a Nurse Liaison I for Utilization Management & Quality Review. This remote nationwide role supports clinical review activities, benefit determinations and medical necessity assessments, ensuring compliant,...

Sentara Health Plans seeks an RN Clinician to perform utilization management and claim reviews across inpatient and outpatient settings. The role supports pre/post payment reviews and authorization assessments, ensuring compliance with policy and...

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

CVS Health is hiring a Nurse Consultant for a 100% remote Utilization Management role. You will apply clinical judgment to review inpatient and outpatient services, authorize care, and collaborate with providers while maintaining precise...

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...

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...

CVS Health is seeking a Nurse Consultant for Utilization Management in a 100% remote role. You will apply clinical judgment and evidence-based criteria to review inpatient and outpatient services, collaborate with providers to authorize care, and...

argenx SE is seeking a Nurse Case Manager to serve as the primary contact for patients and caregivers across the Western time zone. You will educate patients with gMG, review insurance coverage, and coordinate therapies to support adherence and...

Family Service of Rhode Island (FSRI) seeks a per diem School Nurse to join our multidisciplinary team in Exeter, RI. The nurse provides healthcare services to students and staff, manages health needs, responds to emergencies, and supports...

Prior Authorizations Nurse (RN) (Temporary) Remote in California OUR COMMITMENT TO A HUMAN HIRING PROCESS We believe every candidate deserves thoughtful consideration.That'swhy we do not use AI or automated...

WORK REMOTELY after training! CANDIDATE MUST RESIDE IN THE METROPOLITAN NEW YORK AREA! !! Process all requests for services in accordance with Medicare and NYS Medicaid guidelines as well as departmental criteria and...