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When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Schedule This is a per diem, fully remote opportunity offering flexibility and work-life balance. Minimum commitment of 16 hours per...

CVS Health is seeking an RN for utilization management, coordinating care and determining coverage for members. The role requires clinical judgment, strong communication with providers, and the ability to work in a fast-paced setting. The...

Cambia Health Solutions is seeking an Appeals Clinician I to work from home within Oregon, Washington, Idaho or Utah. You will complete the clinical component of all appeal types to resolve member and/or provider appeals, leveraging nursing...

Who We Are: Since 1985, BHCHP's mission has been to provide or assure access to the highest quality health care for all individuals and families experiencing homelessness in greater Boston. We care for over 11,000 homeless individuals each...

SaidGig is seeking an inpatient nurse to help develop and evaluate clinical AI products through ongoing annotation, review, and product-improvement work. This role benefits from consistent weekly participation and continuity over time.

About HCSC At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be...

Centene Management Company LLC is seeking a Licensed Practical Nurse to analyze prior authorization requests and determine medical necessity in New York. You will work with healthcare providers and the authorization team to ensure timely,...

HonorHealth is seeking an Utilization Review RN Specialist to review and monitor the utilization of health care services, ensuring medical necessity and appropriate levels of care. You will coordinate reviews for Medicare, AHCCCS, self-pay, and...

Location United States of America-USAUS Job Description Are you interested in joining a team of experienced healthcare experts and have the ability to shape and transform the healthcare delivery system? At our family of...

Essential Duties and Responsibilities: Review requests for services including admission, discharges and continued stays for adherence to clinical criteria, state and federal policy, and related requirements. Issue...

Description Current staff, faculty/adjunct at Herzing University: log into UKGand navigate to Menu > Myself>My Company > View Opportunities to apply using the internal application process. To participate in a remote work...

Centene is seeking a remote Utilization Review Nurse to perform concurrent reviews, determine appropriate levels of care, and support discharge planning for inpatient services. You will collaborate with Medical Affairs and care teams to ensure...

TriHealth is seeking a Clinical Documentation Specialist RN to review inpatient records, ensuring accuracy of diagnoses, severity of illness and quality measures. You will educate physicians and nurses, collaborate with coding staff, and drive...

Cincinnati Children's is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and education within the Utilization Review department.

Full-Time Hospice Intake & Admissions RN Are you an RN who values meaningful connections and wants to make a difference at one of life's most important moments? Join The Community Hospice as part of our Central Intake & Admissions Team,...

Lana'i Community Health Center is seeking a Clinical Support Registered Nurse (RN) to provide administrative and clinical support to medical providers, enhancing workflow and patient care. The role primarily involves remote support with occasional...

Clinical Documentation Integrity Specialist IIThe Clinical Documentation Integrity Specialist II (CDI) is responsible for utilizing independent clinical judgement in facilitating the integrity, overall quality, accuracy, and completeness of...

Job OverviewPay Range: $46.76hr - $51.76hrRequirement/Must Have5+ years Clinical nursing experience.2+ years Care Management.Bachelor's Degree in Nursing.In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required...

Allegheny Health Network is seeking an RN Clinical Document Specialist to support remote work from Pennsylvania within 50 miles of Pittsburgh or Erie. The role focuses on improving documentation accuracy to optimize reimbursement, with extensive...

Schedule: Flexible Shifts! You provide your manager with the days and start/end time you are available to complete your hours. All United States time zones are welcome. PRN opportunity to work 20-30hrs per week Job Location Type:...

Centene Corporation in the United States is seeking a Nursing professional to analyze prior authorization requests and determine medical necessity and level of care in line with standards and coverage. You will collaborate with medical teams to...

DispatchHealth seeks a Virtual Nurse Coordinator to join the Hospital at Home program. The RN delivers coordinated virtual and in-home acute care using clinical judgment, technology, and evidence-based practice to support safe, effective care at...

About the job Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark , General Catalyst , Peter Thiel , Adam D'Angelo , Larry Summers , and Jack...

Actalent is seeking a Case Management Nurse in Milwaukee, WI to coordinate comprehensive patient care and advocate for access to services across the continuum of care. The role blends direct client contact with care coordination, education,...

Ascension is seeking a Clinical Documentation Specialist to join the Clinical Integrity Documentation team in a remote, full-time capacity. The role focuses on admission reviews, DRG assignment, and ensuring documentation supports severity of...