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JOB DESCRIPTION Opportunity in Southern California for an experienced Managed Care Leader to join our health plan in California. Candidates must have a minimum of 7 years of healthcare experience, 3 of those should be with a Managed Care...

Fully Remote : Clinical Documentation Specialist Job Description Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers.

Job Title Day to Day Responsibilities Research and design treatment/care plans to promote quality of care, cost-effective health care services based on medical necessity complying with contract for each appropriate plan type.

Allegheny Health Network seeks an RN Utilization Review professional to obtain pre-certifications, coordinate authorizations and manage denials for a seamless patient care continuum. You will liaise with third party payers, clinicians and care...

Registered Nurse (RN) - Utilization Management Location: Remote in NJ Job Duration: 3 months contract (possible extension) Schedule: Regular Business Hours Pay Rate: $40/hr. on W2 Job Description: ...

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...

Open Non-Competitive Job Opportunity Exam Number: Y5135L Filing Start Date: 03/03/2026, 8:00 A.M., PT Filing Dates: 03/03/2026, 8:00 A.M., PT, Until The Needs Of The Service Are Met And Is Subject To Close Without Prior Notice.

Tele-PCU-Split Unit Tele-PCU-Split into 3 units: Tele I-7th & 8th floor, Tele II- 6th floor (split into 6 Central and 6 North) # Beds- Tele I- 44 beds double occupancy rooms, Tele II- 32 beds split into 2 units- 20 beds on 6 Central, 12...

The Connection Center Virtual Registered Nurse (RN) delivers high-quality, patient-centered care remotely through telephonic and video interactions, covering the full nursing process from assessment to evaluation. Works with interdisciplinary...

Compliance Nurse 2 - Long-Term Care Program (NW Region) Join Team Georgia and impact lives everyday while receiving a robust benefits package designed for every stage of your career! The Georgia Department of Community Health (DCH)...

Emblem Home Health in Phoenix, AZ is seeking an RN Clinical Intake Coordinator for a Friday–Monday shift, four 10-hour days. The role includes patient intake, referral coordination, and admissions, with Saturdays and Sundays eligible for remote...

Position Title: Remote Telephonic RN Case Manager Mandatory Requirement: Must hold an Active Compact RN License and/or an Active California (CA) RN License to be considered. Pay Rate: $48.00 – $50.00 per hour...

Hone is a virtual medical clinic for men's/women's health, hormones, weight loss, and longevity.We are remote-first and fast-growing, focused on candid communication and joy.The Role:You will manage patient-doctor communications and clinical...

Job Description: The Registered Nurse (RN) is a professional caregiver who assumes responsibility and accountability for assessing, planning, implementing and evaluating care of patients. The staff RN utilizes the nursing process by use of...

Anchor Health Registered Nurse Are you looking for a workplace where you can make a genuine difference? Company culture that feels supportive, genuine and appreciative of all? Anchor Health is committed to the communities of which we...

Your job is more than a job You overthink every care option and scenario because, as a Care Manager, you're the hub of your patient's case management and care plan. You assure quality through the continuum of care, collaborate with members...

Position Overview As an extension of the providers care team, the Remote RN is responsible for providing telephone communication and assessment of patient's needs. This requires the application of a variety of procedures, policies, and/or...

A national healthcare recruiting firm is seeking remote workers fluent in Spanish for a role supporting HEDIS project management. Responsibilities include coordinating the collection and abstraction of medical records, participating in vendor...

Nurse Advocate Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris...

Job Title: Registered Nurse - Care Management (Day Schedule) Location: 100% Remote - United States Employment Type: Full-Time W2 Hourly Compensation: $40 per...

Travel Clinic Registered Nurse (RN) - $2,549 per week in taxable pay and non-taxable stipend amount. Pay rates are subject to confirmation with tax free stipend determined for qualified candidates. KPG Healthcare is currently seeking an...

Centene Corporation in Wisconsin is seeking an Appeals Liaison to coordinate statewide appeals, fair hearings, and external reviews. You will ensure letters meet State and NCQA requirements and work with Medical Directors to clarify medical...

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end...

Job Description Registered Nurse (RN)- Torrance,CA Local Pay: $56.75/hour - (W2) Join our team and make a meaningful impact by delivering exceptional care in a professional...

Sagility is hiring an RN Utilization Management Reviewer for a fully remote, home-based role in the United States. You will perform day-to-day clinical and service authorization reviews for medical necessity and ensure compliance with CMS...