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Peraton's SafeGuard Services seeks a Nurse Reviewer to conduct medical record reviews, applying clinical judgment to claim payments and supporting fraud investigations. Telework is available from any state. The ideal candidate will hold a...

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

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Providing clinical review support on an as-needed basis, the part-time PRN Clinical Review Nurse (RN) will review medical records for medical necessity, authorization compliance, and payer guideline alignment while supporting appeal submissions...

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...

Get AI-powered advice on this job and more exclusive features. This range is provided by Medix. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $37.00/hr...

Greenlife Healthcare Staffing is looking for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical studies. With a...

Sinai Hospital's Utilization Review operates as a distinct specialty service line of physician advisors, nurses, and support staff who ensure hospital stays are clinically appropriate and fully covered by the patient's insurance. The team focuses...

The Center for Sports Medicine and Orthopaedics is seeking an RN/LPN for a part-time position to triage patients remotely in Chattanooga, TN. The Center for Sports Medicine & Orthopaedics is Chattanooga's leading provider of multi-specialty...

Description Location: UCHealth Anschutz Inpatient Pavilion - Aurora Department: Labor & Delivery Metro Denver Women and Infants (W&I) Float Pool RNs will support patients and teams at Highlands Ranch Hospital, Longs Peak Hospital, and University...

A healthcare technology company in the United States seeks a Triage Registered Nurse to provide effective telephone triage for patients. The ideal candidate will have a BSN, strong clinical assessment skills, and at least 2 years experience in...

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...

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 -...

The Triage Registered Nurse is responsible for identifying and coordinating patient/family needs and for providing preventive and supportive care to the terminally ill patient/family unit. The Triage Registered Nurse provides continuity of care to...

Inland Empire Health Plan (IEHP) seeks a Quality Program Nurse to implement and monitor quality management policies under the DHCS framework. Responsibilities include site reviews, medical record surveys, CAP oversight, and HEDIS data abstraction.

A healthcare quality organization is seeking a Nurse Reviewer to perform comprehensive medical necessity reviews for Medicaid claims. The ideal candidate will have a BSN and an active RN license, along with experience in medical record review.

A healthcare network is seeking a full-time Registered Nurse for Pre-Admission Testing (PAT) to work remotely. The role involves conducting comprehensive pre-operative assessments, coordinating with the medical team, and ensuring patient readiness...

UnitedHealth Group seeks an Inpatient Care Management Nurse to ensure proper utilization of health services for members. You will assess needs, plan care, and collaborate with physicians to expedite appropriate levels of care. The role...

Description We are looking for a full-time LPN passionate about all aspects of women's health to provide direct patient care as part of an interdisciplinary care team and to serve as the first line of communication with patients in...

A healthcare organization is looking for a Senior Clinical Reimbursement Analyst to provide analytical guidance across segments. This role requires reviewing Medicare/Medicaid documentation, ensuring accuracy in MDS coding, and training staff on...

Providence Home Services Oregon is seeking a Clinical Documentation Specialist, Registered Nurse (RN) for a full-time, day-shift remote role open to multiple states. You will review OASIS admission documents and Plans of Care to ensure CMS...

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...

Monovo is seeking a Remote Physiological Monitoring Nurse to join our dedicated team in delivering exceptional patient care. The nurse will monitor patient vital signs via RPM devices, educate patients, and collaborate with healthcare providers to...

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of the...

A healthcare company is seeking a Clinical Triage Nurse to assist with inbound patient calls, assess symptoms, and provide medical advice. The ideal candidate will have a valid RN license, strong communication skills, and the ability to work...