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You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh...

Join Equum Medical and be a driving force in revolutionizing acute care telehealth. As an innovative leader in the healthcare technology industry, Equum Medical is dedicated to transforming how patients access critical medical services.

Telephone Triage Nurse Line Advisor Apply today to join our 34,000+ employees and 5,000+ system providers working to build lasting relationships with the people we serve: our patients, our communities, and each other! Are you ready...

Telephonic Registered Nurse 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...

Remote Nurse Position in Michigan This position will be a remote role for Nurses in Michigan. Should have a valid MI RN License. Should have utilization management experience. Should have experience completing post-acute reviews for the...

Employment Type: Full timeShift: Day Shift Description: Purpose Work Remote Position (Pay Range: $36.8795-$47.8193) The...

To support healthcare revenue solutions, the full-time Remote Clinical Review Nurse will analyze denied insurance claims, draft persuasive appeal letters, and collaborate with legal teams to optimize patient care revenue without direct patient...

We are so glad you are interested in joining Sutter Health! Position Overview: Aids patients in obtaining the correct level of care with the appropriate provider at the right time. Provides advance clinical telephone...

Pre-Payment Review Nurse Consultant- Wisconsin It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible.

RN - Clinic Pulse Healthcare is currently seeking Travel Nurses for multiple positions in locations throughout the United States. Start Date: 07/06/2026 Duration: 91 days City: Los Angeles State: California Degree: RN Specialty:...

Role Overview Acts as a patient advocate by providing education, support, and interventions that lead to prevention and early detection of cancer, and navigating patients through diagnosis, treatment, and rehabilitation process. Performs...

Patient Support Nurse The Patient Support Nurse will provide support for Oncology patients and caregivers over the phone, by being able to speak to the end-to-end journey for patients in the context of the Oncology program specifics.

Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear and compliant clinical...

Description Location: UCHealth Anschutz Outpatient Pavilion - Aurora, CO Department: Hospital Based Sub-Specialty Work Schedule: Full Time, 80.00 hours per pay period (2 weeks) Shift: Days Pay: $38.91 - $60.31 / hour. Pay is dependent on...

Medical Review Nurse Analyst Our Medical Review Nurse Analyst - Registered Nurse (RN) is responsible for reviewing medical records to determine whether services are payable based on TRICARE policy, reference materials, and evidence-based...

Requisition Details GENERAL REQUISITION INFORMATION EEO Statement: UNMC is an Equal Employment Opportunity Employer, including an equal opportunity employer of protected veterans and...

Details Client Name CSMN - 1101180 - OBGYN Crisis Response Job Type Travel Offering Nursing Profession RN...

Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position, you will utilize your clinical judgement to approve or deny outpatient medical services for patients based on Medical...

Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit,...

Scion Nonprofit Staffing has been engaged to conduct a search for a Registered Nurse (RN) - Research for a mission-driven clinical research organization advancing equitable healthcare access and innovative treatment...

ECM Lead Care Manager The ECM (Enhanced Care Management) Lead Care Manager will outreach and enroll clients in enhanced care management and be responsible for overseeing the development and implementation of comprehensive care plans for...

Location: Avera McKennan Hospital Worker Type: Regular Work Shift: Rotating days/evenings ights/weekends/holidays (United States of America) Pay Range: The pay range for...

Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and quality improvement services for more than 50 years. We...

Clinical Nurse Specialist At Aspirion, our mission is simple and meaningful: to help healthcare providers get paid accurately, quickly, and transparently for the care they deliver. By combining deep human expertise with advanced...

Appeals Analyst We are currently hiring for an Appeals Analyst to join BlueCross BlueShield of South Carolina. In this role as Appeals Analyst, you will research the substance of complex appeal or retrospective review requests including...