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St. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who count on the hospital for high...

Staffmark Group is recruiting a Registered Nurse for a remote role. Primary duties include reviewing peer review reports, ensuring evidence-based rationales, and ensuring compliance with client, contract, and regulatory standards. The ideal...

Job Title: Registered Nurse (RN) Disease Manager Job Overview: The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of patients with chronic or...

Job Description \n WellBe Senior Medical is seeking a Registered Nurse (RN) Home Health for a nursing job in Lawrenceville, Georgia. Job Description & Requirements\n \n Specialty: Home Health \n Discipline: RN \n Duration: Ongoing \n Employment...

University of Miami Health System seeks a full-time Utilization Review Case Manager to work remotely. The role reviews patient charts for prior authorization, concurrent and retrospective utilization, coordinating with the care team for timely and...

Care Management Coordinator/RNLocation: 100% Remote Duration: 3+ Months (FT conversion)This is a Utilization Management RN part time position - working every other weekend (2 days a week in a 2 week cycle). Must be available M-F 8:30-4:30pm for...

Job Description \n \n Perm Staff Jobs is seeking a Registered Nurse (RN) Case Management for a nursing job in Aurora, Colorado. Job Description & Requirements\n \n Specialty: Case Management \n Discipline: RN \n Duration: Ongoing \n Employment...

Pay Range: $35.92 - $53.88 A successful candidate's actual pay rate will be based on several factors including relevant experience, skills, training, certifications and education. This position is responsible for the coordination of patients...

UnitedHealth Group is seeking a Utilization Review Nurse, RN to perform inpatient utilization management in California. The role involves reviewing inpatient criteria, preauthorizations, and ensuring medical necessity while applying evidence-based...

Working as a Nurse Case Manager at Cunningham Childrens Home means youll be part of team that is dedicated to supporting youth in critical need of emotional, psychological, and physical care. Located in Urbana, IL, Cunningham Children's Home is a...

Job Summary: Collaborates with Education Consultants, Managers, CNS staff and Physicians to develop, design, deliver and evaluate/improve education strategies and special projects/programs based on clients departmental...

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

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...

Cadence in Dallas, TX is seeking an RN Supervisor to lead a remote team of Registered Nurses in a high-volume triage environment. This role demands strong clinical judgment, operational management, and performance coaching to maintain quality...

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...

Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.00 - $34.00 / hour Department: HS -...

Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant...

UnitedHealth Group is seeking a Care Coordinator to manage a panel of members with chronic and complex health needs, delivering person-centered care and coordinating with the care team. This remote-friendly role supports Medicaid/Medicare...

The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nations top hospital systems for best...

CVS Health is seeking an experienced Utilization Management Nurse Consultant for a 100% work-from-home, full-time position open to MST/PST residents. You will coordinate and document utilization and benefit management activities, ensuring timely,...

Mist Registered Nurse (RN)Organization: SHSO-Population Health Services-UtahPosition Summary: The Multidisciplinary Inbasket Support Team (MIST) Registered Nurse is a highly skilled ambulatory care nurse who provides comprehensive, remote clinical...

Overview Position Type: Full time Job Title: Care Review Clinician I Location: 100% Remote (Must reside in one of the following states: NV, AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater-NYC), OH,...

To support effective utilization management, the full-time remote Utilization Review RN will examine medical records, develop clinical reviews for authorization, and collaborate with interdisciplinary teams to optimize reimbursement and prevent...

Remote position, however, candidates must reside in the State of TX or State of IL. This position is a contract for about 9 months. Pay: $41/hour Job Responsibilities: RN working in the insurance or managed...

WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of...