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Leading the RN-led Complex Care Management program, the contract-to-hire RN Case Management Director will oversee strategy, clinical workflows, and operational performance in a remote setting, ensuring adherence to NCQA standards and driving...

To support financial objectives, the full-time California Licensed Revenue Cycle Auditor RN will provide patient-focused, standardized revenue cycle support remotely while ensuring compliance and efficiency in processes.Key responsibilitiesConduct...

To support a growing virtual heart clinic, the full-time Bilingual Cardiology NP/PA will conduct clinical assessments and develop treatment plans for cardiology patients, primarily through virtual consultations, while working remotely across...

Providing advanced clinical appeal services, the full-time Remote Clinical Financial Case Manager RN will manage complex patient account denials, conduct clinical reviews, and assist in developing denial prevention strategies while supporting the...

Collaborating closely with the Chief Nursing Officer, the full-time remote Associate Chief Nursing Officer will lead nursing operations, manage a team of nurses, and assist in AI product development to ensure high-quality patient interactions and...

Seeking a remote California RN/LVN Utilization Management professional, the full-time nurse will review prior authorization requests for medical necessity across inpatient and outpatient services, applying CMS guidelines and Milliman Care...

Massachusetts RN Utilization Supervisor is a full-time remote position responsible for overseeing daily operations of Medicare Advantage utilization management staff, providing coaching and evaluation, and participating in organizational...

Providing advanced clinical appeal services, the full-time Ohio RN Clinical Case Manager will manage complex patient account denials, perform clinical reviews, and assist in the development of denial prevention strategies while working...

New York Licensed Practical Nurse Coordinator is a full-time remote position responsible for managing patient care coordination, communication with healthcare providers, and ensuring high-quality care services.Key ResponsibilitiesComplete...

Providing telephone triage assessments, the part-time WA State Licensed RN Call Assist will utilize clinical expertise to offer health advice to Primary Care patients remotely while documenting calls and ensuring superior customer service.Key...

To support a Substance Use Disorder Program, the full-time Tennessee Licensed Nurse Educator will provide nursing education and support to prenatal and postpartum clients through remote interactions while coordinating with healthcare providers and...

Overseeing the undergraduate nursing content ecosystem, the full-time California Licensed Nursing Content Manager will manage a team of part-time NCLEX Content Leads and contracted editors, ensuring the quality and accuracy of content across...

To maximize client savings, the full-time Illinois Licensed Nurse Auditor will remotely review medical bills, ensuring appropriate billing, coding, and treatment while maintaining compliance with fee schedules and identifying erroneous charges.Key...

Supporting high- and rising-risk patients, the part-time Nightingale RN Care Coordinator will leverage clinical expertise for comprehensive care coordination and chronic disease management while working remotely between 8:00 AM and 4:30 PM.Key...

To support clinical research initiatives, the full-time Ohio Licensed Research Nurse will provide patient care, conduct assessments, ensure compliance with regulatory standards, and guide research procedures, with opportunities for flexible...

Supporting daily utilization management operations, the full-time Texas Licensed Utilization Management LPN will review authorization requests, ensure compliance with health plan requirements, and maintain documentation accuracy while working...

Evaluating medical necessity and appropriateness for claims, the full-time State Licensed Legal Nurse will review liability demand packages, analyze medical records, and support negotiation and litigation efforts in a remote environment.Key...

Evaluating and managing catastrophic episodes of illness, the full-time remote South Carolina Licensed Stop Loss RN will facilitate cost estimates for underwriting, consult on claims, and provide case management oversight.Key...

Evaluating and managing catastrophic episodes of illness, the full-time South Carolina Licensed Stop Loss Nurse will provide case management oversight, facilitate cost estimates for underwriting, and consult on claims, all while working...

Referral Authorization Specialist is a full-time position responsible for processing and documenting referral or prior authorization requests, providing customer support for clinical areas and patients.Key ResponsibilitiesOversee data entry and...

Certified Charge Capture Analyst, a full-time remote position, is responsible for advising on charge codes, monitoring charge capture and revenue trends, and ensuring compliance with billing guidelines to enhance revenue generation.Key...

Leading a dedicated team in a full-time remote capacity, the Registered Nurse Manager, UM Operations will manage compliance and regulatory functions, oversee prior authorization processes, and implement strategies for the Utilization Management...

To support patient care initiatives, the full-time Bilingual LPN Care Coordinator will manage outbound phone calls to patients, addressing healthcare needs and facilitating access to resources in a fully remote environment.Key...

To support the education of future healthcare leaders, the part-time Arizona Licensed Nurse Educator will teach Advanced Pathophysiology and Pharmacology online, delivering high-quality instruction while maintaining compliance with accreditation...