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Program Integrity Clinical Compliance AuditorOptum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers.

JOB DESCRIPTION We are searching for six TX licensed RNs to work telephonically with our Medicaid members across the state. Three of the positions are open to RNs with at least two years of experience in in Behavioral Health or Substance...

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,...

Prime Staffing is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: Labor and...

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...

About HCSC At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be...

Allina Health is seeking a Nurse Informaticist to join the Information Systems Optimization Solutions team. The role focuses on integrating nursing practice with data science to improve patient outcomes and care quality across inpatient and...

IQVIA LLC is seeking a Flex Nurse Educator to support patient education remotely with in-field coverage as needed. The role emphasizes non-clinical, educational interactions and adherence improvement, while maintaining privacy and high educational...

Baptist Health is seeking a remote Clinical Documentation Specialist to evaluate physician documentation and ensure accurate illness severity portrayal for coding precision. The role requires an active Kentucky license and involves guiding...

Staffing Solutions Organization LLC (SSO) is seeking a Nurse Reviewer to conduct provider compliance reviews, onsite visits, and evaluate documentation to ensure adherence to state regulations and program requirements. You will work independently...

Family Service of Rhode Island (FSRI) seeks a per diem School Nurse to join our multidisciplinary team in Exeter, RI. The nurse provides healthcare services to students and staff, manages health needs, responds to emergencies, and supports...

argenx SE is seeking a Nurse Case Manager to serve as the primary contact for patients and caregivers across the Western time zone. You will educate patients with gMG, review insurance coverage, and coordinate therapies to support adherence and...

GQR Healthcare is seeking a travel nurse Correctional for a travel nursing job in Commerce, California. Job Description & RequirementsSpecialty:...

Arizona Arthritis & Rheumatology Associates, P.C. is seeking a Clinical Research Nurse to manage unblinded protocols, prepare investigational medications, and travel to multiple sites. The CRN will ensure compliance with protocols and SOPs, and...

LanceSoft is seeking a travel nurse RN Wound Care for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: Wound...

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...

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,...

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...

Effizotech is looking for a dedicated Patient Care Coordinator to join their team. This role involves coordinating patient appointments for infusion services while ensuring timely communication with patients. The opportunity offers the flexibility...

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...

Position: Clinical Professionals: Paid Study on Healthcare Software Workflows Type: Hourly Contract Compensation: $60/hr Location: Remote Role Responsibilities Navigate a...

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.

Review claims files to detect potentially fraudulent billing practices.Use medical terminology and coding to assess payment appropriateness.Write investigative summary reports and provide expert testimony.Requirements:Active RN license and 2+...

Synergy-Healthcare-USA-LL seeks an experienced, bilingual Spanish Nurse Case Manager to advocate for members and guide them through the healthcare and insurance landscape. The role supports remote work with occasional travel to client sites in...

WellSense Health Plan is seeking a Prior Authorization Clinician to review proposed hospitalization, home care, and inpatient/outpatient services for medical necessity and efficiency to ensure timely, appropriate care for members. The role...