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Registered Nurse As the leader of the health care team, provides professional nursing care, utilizing the nursing process in accordance with established standards of care, policies, and procedures. Demonstrates performance consistent with...

UnitedHealth Group is seeking an HSS Clinical Coordinator RN to conduct clinical reviews and evaluations related to Medicaid appeals, ensuring compliance and accuracy in assessments. This remote role is ideal for experienced RNs seeking meaningful...

Sentara Health is hiring a part-time Registered Nurse for a physician practice/ambulatory clinic. The role supports chronic disease management, patient education, and care coordination, with duties including triage, documenting in the EHR, and...

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Humana is seeking an Utilization Management Administration Coordinator to provide non-clinical support for policies ensuring appropriate care for members. This fully remote role sits within Home Solutions, supporting the Skilled Nursing Facility...

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...

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

To ensure timely and accurate care decisions, the full-time Utilization Review Nurse LVN/LPN will perform clinical reviews for medical necessity and benefit coverage, applying clinical guidelines and maintaining compliance in a remote work...

Job Description 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 for excellence in cancer treatment,...

UnitedHealth Group is hiring for a Dallas-area role that supports care coordination and member advocacy in a dynamic community health setting. The position emphasizes person-centered planning, resource connection, and cross-disciplinary...

Sentara Health is seeking a part-time Registered Nurse for a physician practice setting in a remote capacity. The RN will assess patients, assist with procedures, administer medications, and coordinate with physicians and staff to ensure...

Kaiser Permanente in Downey, CA seeks an experienced Registered Nurse to coordinate discharge planning and post-acute care. Works with MDs to assess admissions and plan appropriate levels of care, ensuring safe transitions and cost-effective care.

Provides direct nursing care including assessments, care plan, education, and evaluation for assigned patients. Performs patient duties necessary to maintain the flow of...

Humana's Utilization Management Registered Nurse uses clinical nursing skills to interpret and support coordination, documentation and communication of medical services and benefit determinations for post-acute care (SNF, Home Health, DME). You...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

CVS Health in the United States is seeking an experienced registered nurse to assess, plan, implement, coordinate, monitor, and evaluate options to ensure appropriate healthcare services and benefits for members. You will interact with providers,...

Supporting a high-volume Prior Authorization and Appeals team for pharmacy benefits, the full-time Remote Prior Authorization LVN will process and communicate commercial prior authorizations, manage calls, and review clinical criteria while...

Align yourself with an organization that has a reputation for excellence! Cedars-Sinai was awarded the National Research Corporation's Consumer Choice Award 19 times for providing the highest-quality medical care in Los Angeles. We also were...

UnitedHealth Group's UnitedHealthcare is seeking a Registered Nurse for a Weslaco, TX area role. The RN will assess, plan, and implement person-centered care, linking members with resources across financial, psychosocial, and community services,...

Sentara Health in Williamsburg, VA is seeking a qualified Quality Assurance Coordinator to join our Home Care team on a full-time, day shift. This remote position emphasizes ensuring that Home Care products and services meet quality standards and...

Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in accordance with established standards of care, policies, and procedures. Demonstrates performance consistent...

Job Description Provides direct nursing care including assessment, plan of care, education, and evaluation for assigned patients. Performs patient duties necessary to maintain the flow of patient care as well as coordinates...

Humana Inc is seeking a Telephonic Nurse Care Manager to support patients remotely, coordinating post-acute services and admissions. You will assess needs, educate on care options, and work with the clinical team to ensure timely and appropriate...

JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

CVS Health is seeking an experienced Registered Nurse for Medicare Precertification Utilization Management in a remote, full-time weekend schedule. The role emphasizes ensuring appropriate care, coordinating with providers, and applying guidelines...