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Job Title: Nurse, Clinical Medical Review Location: Columbia, MD (Primarily remote, but hybrid) Duration: 6 Months Contract PURPOSE: We are seeking a qualified RN or LPN with experience supporting HEDIS reporting and abstraction processes in a...

Medix is seeking a fully remote Registered Nurse to perform clinical review and telehealth–style assessments from anywhere in the United States. You will review records, determine next steps, and escalate when needed, while supporting...

Hiring Registered Nurses (RNs) for Skilled Nursing Facility We are seeking compassionate RNs / Registered Nurses to work within our client's facilities, providing follow-through of the physician-established plan of treatment and working...

Prolific is seeking Registered Nurses to train and evaluate AI models. If successful, you'll be invited to join Prolific as a Domain Expert participant, where you'll get paid to train and evaluate powerful AI models. Researchers paying up...

Trillium Health Resources is seeking a Population Health Nurse to provide clinical care management and population health support for assigned members, focusing on prevention, wellness, and outcomes. The role uses nursing judgment as an RN to...

CVS Health is seeking an experienced Registered Nurse (RN) for Utilization Management in a remote, work-from-home role. You will review clinical data, apply guidelines and collaborate with care teams to ensure appropriate, high-quality,...

Telephonic Case Manager (RN) Immediate need for a talented Telephonic Case Manager (RN). This is a 06+months contract opportunity with long-term potential and is located in U.S(Remote). Please review the job description below and contact...

Guidehealth is a remote-first healthcare company seeking an experienced RN Case Manager with an Illinois license to join the Value Based Care Services team. The role focuses on improving member management, satisfaction, and cost effectiveness...

Humana is seeking a remote Utilization Management Behavioral Health Professional 2 in Indiana. The role requires an active RN license in Indiana, an ASN (BSN preferred), and 1+ year of clinical and managed care experience. You will...

Healthcare Management Solutions, LLC is seeking experienced CHSD Audit reviewers to conduct independent medical record reviews for the STS CHSD program. This remote, part-time role focuses on data accuracy, source verification, and adherence to...

Humana Inc seeks a Utilization Management Nurse to apply clinical nursing skills in coordinating, documenting, and communicating medical services and determinations. You will interpret criteria, policies, and procedures to provide the best care...

Job Description: RNs at Intermountain Healthcare are committed to providing patient centered care while demonstrating our values and mission. If you are interested in contributing to our mission of helping people live the healthiest lives...

Registered Nurse (RN) – Outpatient Clinic Location: San Jose, CA Job Type: Full-Time, Permanent Schedule: 40 Hours per Week Start Dates: Available Every Monday EMR: Epic Join a Patient-Focused Healthcare Team We are...

Sedgwick is recruiting for a US Telecommuter RN Telephonic Case Manager. The role focuses on coordinating medical services, advocating for injured employees, and facilitating recovery and return to work through telephonic case management.

100% REMOTE PAY: $47-$52/hr REQUIRED: Must have current RN licensing Post market medical device experience in either medical assessment, complaint handling, post market reporting – preference is actual medical device assessment Highly prefer...

JOB DESCRIPTION This RN will act as a Care Manager supporting our Michigan Medicaid members, identified with complex medical needs. The Medicaid Care Manager will support them to ensure a successful health outcomes. The position includes...

Utilization Review RN Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic...

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

Charlotte, North Carolina, United States IMPORTANT: after you apply, please check your email. We sendyou a link to complete your application - it is not considered until that laststep is done. If you do not see it, check...

Current Saint Francis Employees - Please click HERE to login and apply. Full Time Shift: 10a - 10p Minimum of 5 years bedside experience preferred. Critical Care RN experience required...

CVS Health is hiring a Registered Nurse in Utilization Management to apply clinical guidelines and coordinate care decisions. The role supports members by linking them to programs and resources while coordinating with providers and care teams.

Optum is seeking a Clinical Consultant RN, Medical Policy Writer for a remote role within the United States. You will lead clinical oversight of product medical policies, develop utilization guidelines, and support COE network criteria. The...

Registered Nurse (RN) For Immunization Program We are seeking Registered Nurses (RN) to support a large immunization program at retail pharmacy locations. The RN will administer state-approved immunizations, including pediatric...

Rogers Memorial Hospital seeks a Registered Nurse (RN, RN II, RN III) to provide professional nursing care in a remote capacity. The RN will perform comprehensive assessments, coordinate care, and collaborate with the health team to reach patient...

Overview The OP Care Management RN provides care management and population health services to patients. The primary target population served is the stratified risk patient or patients with high vulnerability at times of...