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Brighton Health Plan Solutions, LLC is seeking an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely in North Carolina. You will use evidence-based guidelines and internal criteria to determine...

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.

Working remotely, the part-time Mississippi Licensed Clinical Review Nurse will review clinical records to assess member eligibility and appropriateness of services while coordinating with providers and members for additional information.Key...

State of North Carolina - Health & Human Services in North Carolina seeks a Nurse Consultant I who conducts regulatory nursing home inspections to ensure compliance with federal and state standards. The role involves travel across Central and...

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

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...

CSL Behring is seeking a Nurse Resource Navigator to provide personalized education and support on gene therapy for the Hemophilia B community across the East Coast. You will educate patients, healthcare professionals, and families, guiding them...

Why Brighton PRN/REMOTE At Brighton/Suncrest Hospice our goal is to change the expectation of hospice care in your area by providing exceptional care and service to our patients. This is achieved by allocating the resources to...

Ensemble Health Partners is seeking an RN Utilization Review quality professional to lead QA efforts within the VUR team. You will mentor staff, evaluate QA processes, and drive improvements across multiple clients and systems. The role...

A leading aesthetics company is seeking a Remote Travel Nurse Trainer for licensed RNs or APRNs. This full-time position involves creating training materials and conducting remote training sessions with occasional travel. The successful candidate...

Elevance Health is seeking a HEDIS Medical Record Review Project Nurse to support HEDIS data collection and quality review. This is a virtual, full-time role with required in-person training sessions; candidates must reside in Florida and be able...

CVS Health is seeking a Case Management Coordinator to support Aetna members by coordinating appointments, benefits education, and care planning. The role requires Illinois residency, ability to travel up to 50–75% in Kane and DuPage counties,...

Exceptional care starts with exceptional people. For us, this is more than a job– it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you...

DescriptionYour Role 100% Remote. You will triage calls from our clients in the following manner: 1) assess the needs utilizing injury algorithm guidelines; 2) give appropriate care advice, and 3) disposition to the appropriate...

Trusted is seeking an experienced nurse for this exciting travel nursing assignment. Trusted has streamlined the travel nursing experience by enabling nurses to apply directly to jobs without the need for recruiters. This unique approach provides...

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

Comagine Health is seeking an RN to perform Clinical Review work and QIDP reviews. The team member will serve as the QIDP (.5 FTE) and as a nurse clinical reviewer (.5 FTE). The role requires applying Alabama Medicaid criteria to determine medical...

Molina Healthcare is hiring a remote RN Care Manager. Preference for candidates in Washington State. This role will be working Pacific Standard Time hours. This role supports Medicare members through telephonic case management and...

Job DescriptionJob Summary Provides support for clinical facility site reviews. Under the supervision of leadership, uses clinical judgement within appropriate scope to independently conduct reviews and other monitoring activities...

River Valley Child Development Services Inc seeks a Child Care Nurse Health Consultant to provide technical assistance and develop trainings on health, safety, and nutrition for childcare providers in WV. This exempt, full-time role offers remote...

Trillium Health Resources is seeking a Compliance Nurse to perform clinical compliance reviews and evaluate claims to ensure adherence to regulatory and coverage requirements. The role requires an Associate's degree in Nursing, NC RN licensure,...

Abbott is seeking a CORONARY, CLINICAL SPECIALIST to promote vascular products through education and sales support within a defined territory. You will travel to hospital accounts to educate physicians, nurses and staff on product usage and...

Opus Medical is seeking a Nurse Liaison to coordinate care and communicate key medical information among the Injured Worker, Insured, and Carrier. This remote, field-based role involves regular local travel, ensuring successful rehabilitation and...

State of Georgia, Department of Behavioral Health and Developmental Disabilities, seeks a Level of Care Registered Nurse for the Region 5 Field Office in Savannah. The role is part-time with hourly compensation and quarterly travel to meetings.

Nurse Next Door is seeking a part-time Registered Nurse for New Mexico. You will deliver in-home nursing care, develop individualized care plans, and coordinate with a Care Designer to ensure a premium client experience while supporting families.