Search Nursing Jobs

Essentia Health in Duluth, MN is hiring for a Health Services professional to conduct Managed Care Programs in coordination with third party administrators. You will help implement referral, prior authorization, and precertification processes...

Centene Corporation is seeking a Nurse Reviewer for remote work in the United States. The role involves performing concurrent reviews to determine appropriate level of care and discharge planning, with emphasis on medical necessity and care...

Brighton Health Plan Solutions is seeking an experienced Utilization Management Nurse to perform medical necessity and benefit reviews remotely, supporting both inpatient and outpatient cases. The role requires an active LPN license, strong...

HonorHealth is seeking an Utilization Review RN Specialist to review and monitor the utilization of health care services, ensuring medical necessity and appropriate levels of care. You will coordinate reviews for Medicare, AHCCCS, self-pay, and...

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...

Float Health is hiring a Recurring Care Specialist for a fully remote US-based role. You will coordinate nursing visits, interface with pharmacies, nurses, and patients, and manage scheduling and communications across platforms. The role...

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...

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...

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...

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...

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...

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,...

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...

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...

Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. You will work with physicians, case managers, and providers to ensure appropriate, cost-effective care for chronically ill and frail patients...

Utilization Review Specialist (RN) – Work From Home (Florida-Based Candidates Only)Concierge Home Care | Work From Home Opportunity – Must Reside in Florida At Concierge Home Care, we are growing and looking for an experienced...

Job Title: Utilization Management Registered Nurse (UM RN) – SNF / MLTC Location: Remote (Must reside in NY, NJ, or CT) Schedule: Monday – Friday, 9:00 AM – 5:00 PM Position Type: ...

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...

CVS Health is seeking a Utilization Management Nurse Consultant (Medical Review) to ensure members receive timely, medically necessary care through thoughtful clinical review and collaboration with providers. This fully remote role leverages your...

Maine Community Health Options is seeking a Clinical Specialist who provides clinical decision-making support and coordinates community resources to support medical management. This role analyzes documentation for medical necessity, collaborates...

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.

Elevance Health is seeking an experienced nurse to review complex cases for medical necessity, applying clinical guidelines and nursing judgment. The role involves collaboration with physicians, case managers, and Medical Directors to optimize...

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...

Opus Medical is seeking a Nurse Liaison to coordinate care and communicate crucial medical information in the United States, specifically in Pensacola, Florida. This remote role involves responsibilities like managing case plans, building...