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Humana is seeking a skilled Utilization Management Registered Nurse to interpret and coordinate medical services and benefit determinations for post-acute care such as SNF, Home Health, and DME. You will report to the Manager of Utilization...

Parenteral Services Clinical RN Specialist The Parenteral Services Clinical RN Specialist provides clinical support to the Parenteral Services team through advanced nursing expertise, education, care coordination, and operational...

Medica is seeking a Remote RN Care Coordinator to support Minnesota members with home-based assessments and telephonic care coordination. You will develop individualized care plans, coordinate services, and educate members on Medicare/Medicaid...

Abbott is seeking a per-diem RN trainer in the Durham, NC area to deliver Face-2-Face training for home testing customers. You will guide finger stick collection, explain PT/INR device use, and assist with reporting responsibilities. The...

Healthcare Management Solutions, LLC is seeking experienced CHSD Audit reviewers to conduct independent medical record reviews for the STS CHSD program. This remote, part-time role focuses on data accuracy, source verification, and adherence to...

UW Health in Wisconsin seeks a Telehealth Nursing Assistant (CNA/NA) to support remote care for critical patients within the eICU network. The role includes admitting, transferring and discharging patients via the eCareManager and ensuring...

JOB DESCRIPTION Must reside in Florida Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established...

The Veterans Health Administration is seeking a Registered Nurse (Case Manager/Care Coordinator) at the Charleston VA Medical Center in the Nursing, Specialty department. The role focuses on complex patient management, discharge planning, and...

Job Description Utilization Review RN - Remote. This position is Per Diem and will work 8-hour, Day shifts. Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA...

Dignity Health's Glendale Memorial Hospital unit seeks a Patient Care Assistant (PCA) to support nurses and healthcare teams with direct patient care, vital signs, ADLs, and safe, compassionate patient handling. The role emphasizes teamwork,...

Virtua Health is seeking a remote RN to support the application of medical necessity tools, ensuring compliance and achieving positive patient outcomes. You will collaborate with Physician Advisors, manage denials, and document review activities...

Overview Detailed review, analysis and extraction of clinical information from patient medical records and drafting of effective narratives for Medicare and Medicaid appeals documentation and briefs in support of denied cases under appeal...

Syneos Health, Inc. in Spain is seeking a Perm Part Time Research Nurse to support clinical trials in the Barcelona area. This remote role coordinates patient visits, data collection, and adherence to study protocols while maintaining regulatory...

Mass General Brigham Health Plan Holding Company, Inc. seeks a Nurse for utilization review to assess medical necessity and benefit coverage for ACO/HMO/EPO members. Remote with occasional on-site team meetings in Somerville, MA. Strong...

Overview Utilization Management for the assigned inpatient Care Management population. This position is designed to facilitate an effective process of the Mercy Care Management model; supporting quality patient care, safety and financial...

Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations. The role involves collaborating with medical leadership, reviewing cases for appropriate treatments,...

Building Location: Essentia Living Center Department: 3073090 NURSING HOME - FS SNF Job Description: Seeking a Certified Nursing Assistant to serve at Essentia Living Center, our long-term care facility located in Fosston, Minnesota. This CNA...

Job DescriptionMake a Difference Every Single Day at Cedars-Sinai!When the work you do every single day has a crucial impact on the lives of others, every effort, every detail, and every second matters. This shared culture of passion and...

Physicians East seeks a QEC Pre Procedure Screening Nurse for a part-time remote role based in Greenville, NC. The nurse will review patient charts, screen for procedural eligibility, and coordinate with physicians to ensure proper evaluation and...

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...

VA Greater Los Angeles Healthcare (VAGLAHS) seeks two RN professionals for Remote Patient Monitoring - Home Telehealth. You will oversee the nursing process, care coordination, patient education, and health promotion, collaborating with the...

JR0059223 Tele-Health Nurse (Remote/LPN) (Open) Full-time McKesson requires new employees to be fully vaccinated for COVID-19 as defined by the CDC, subject to applicable, verified accommodation requests. McKesson is in...

Registered Nurse Navigator - Cancer Center Exams - 10 Hour Days Do you have a passion for the highest clinical quality and patient happiness? Would you like to use your expert clinical competencies with an organization known nationally...

Community IV Nurse We are looking for an enthusiastic and patient focused Registered Nurse to join our growing Clinical Homecare Nursing Team as a Community IV Nurse. Working in partnership with NHS teams and healthcare professionals, you...

SafeGuard Services, a Peraton subsidiary, seeks a Nurse Reviewer Team Lead to oversee medical review for fraud, waste, and abuse. You will mentor the team, guide investigations, and ensure timely, high-quality referrals to law enforcement or other...