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Bilingual Spanish/English Telephonic Triage RN will manage incoming calls in a full-time remote capacity, providing injury triage and support while following proprietary algorithms in a 24/7 Occupational Health call center environment.Key...

Working remotely on a full-time basis, the Remote Case Manager RN will manage comprehensive case management services for patients with chronic or catastrophic illnesses, ensuring high-quality, cost-effective healthcare while collaborating with...

Seeking a detail-oriented RN Clinical Quality Assurance Coordinator, this full-time remote position will manage quality assurance reviews of medical records, ensuring compliance with client specifications and maintaining high reporting...

To support client care authorization processes, the full-time Clinical Letter Writer will gather and review medical records, draft letters of medical necessity, and communicate with team members regarding client authorizations and recertifications...

To support multi-branch operations, the full-time Florida Licensed Home Health RN Manager will oversee clinical staff, manage home health programs, and ensure compliance with medical standards, working remotely on weekends from Friday to...

Working remotely on a contract basis, a Pennsylvania Licensed Care Management RN will evaluate members' clinical conditions, interact with providers for additional clinical information, and ensure compliance with medical appropriateness for...

Leading a team of clinical auditors, the full-time Registered Nurse Quality Analyst will ensure the accuracy and consistency of audits, mentor staff, and recommend process improvements while working remotely.Key responsibilitiesReview the accuracy...

Seeking a driven and detail-oriented Registered Nurse Clinical Quality Coordinator for a full-time remote position, responsible for performing quality assurance reviews of peer review reports, ensuring compliance with client specifications and...

Responsible for coordinating and managing in-patient and out-patient claims, the full-time Louisiana Licensed Utilization Review RN will ensure compliance with medical necessity and regulatory guidelines while working remotely.Key...

To support Medicaid members in receiving necessary services, the remote Wisconsin Licensed Personal Care RN will review prior authorization requests, determine medical necessity, and ensure compliance with state policy guidelines while...

Joining a Telehealth Clinical Team, the full-time temporary Telehealth Registered Nurse - Compact RN will provide patient-centered nursing support through telephone triage, clinical assessment, and care coordination in a remote environment.Key...

To support healthcare audit processes, the remote RN Medical Review Auditor will conduct clinical reviews and Appeals reviews of medical records, ensuring compliance with quality standards while serving as a subject matter expert in the field.Key...

Coordinating patient care and quality assurance initiatives, the full-time Missouri RN Quality Assurance Coordinator will manage chart extractions, documentation reviews, and develop educational components for patients and staff, with a flexible...

To support clinical auditing efforts, the full-time Registered Nurse Auditor will perform retrospective chart reviews on Readmission and Place of Service Claims, utilizing clinical guidelines and proprietary systems, while maintaining productivity...

To assist injured workers in receiving timely and appropriate medical care, the full-time Remote RN Telephonic Case Manager will assess, plan, implement, and coordinate care while working Monday through Friday from 8:30 am to 5:30 pm local...

To support members with chronic and complex health conditions, the seasonal, fully remote Senior Care Specialist (Registered Nurse) will conduct telephonic health assessments, develop individualized care plans, and coordinate services to promote...

To support patient care initiatives, the part-time per diem New Hampshire Licensed RN Utilization Reviewer will perform concurrent reviews of outpatient and inpatient claims, manage authorization reviews, and facilitate communication among...

To support a growing clinical operations team, the Remote RN Clinical Expert will deliver high-impact clinical work, manage complex clinical operations workflows, and provide quality oversight while collaborating with product and engineering...

Providing guidance and education to members, the full-time Remote Clinical Admin Nurse RN will act as a clinical resource in a customer service setting, addressing health questions and supporting members in managing their well-being while working...