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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...

Optum is seeking a remote IRR Clinical Claim Review Nurse to perform clinical review of claims against medical records and guidelines. The role requires an active RN license, 2+ years of acute care clinical experience, and 1+ year in claim review...

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...

Essentia Health in Duluth, MN is hiring for a Health Services professional to conduct Managed Care Programs in coordination with third party administrators. You will help implement referral, prior authorization, and precertification processes...

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 consistent...

St. Tammany Health System in Covington, LA is seeking a Clinical Documentation Specialist - RN to work remotely. The CDS supports accurate representation of illness severity and risk adjustment through collaboration with physicians and care teams.

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.

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...

UCSF Health Medical Foundation is seeking an experienced Primary Care Telephone Triage Registered Nurse to work remotely from home. The role requires a California RN license, at least two years of full-time triage or acute care RN experience, and...

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...

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...

GQR Healthcare is seeking a travel nurse Correctional for a travel nursing job in Downey, California. Job Description & RequirementsSpecialty:...

As a Clinical Documentation Review Specialist (RN), you will help medical staff clarify patient records to ensure appropriate reimbursement and reflect care complexity. You will perform concurrent reviews and engage with physicians...

Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges.

Ssbv Clinical Claims Review RnOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the...

Ethos Risk Services is seeking a full-time Clinical Recruiter (REMOTE) to lead hiring for the Case Management division. You will own full-cycle recruiting for nurse case managers and other clinical pros, from posting to onboarding, ensuring a...

Health Care Service Corporation is hiring a Nurse Liaison I for Utilization Management & Quality Review. This remote nationwide role supports clinical review activities, benefit determinations and medical necessity assessments, ensuring compliant,...

Comagine Health in Washington State is seeking an experienced Registered Nurse to join our remote Clinical Reviewer team. The role focuses on assessing medical necessity, appropriateness, and quality of care through prospective, concurrent, and...

Medix is seeking a Remote Utilization Review Registered Nurse (UR RN) to bridge clinical care and hospital operations from a remote setting. Join a team optimizing patient care while safeguarding revenue integrity, with a compressed 4-day week,...

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...

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...

Housing Advocacy Vocational and Employment (HAVE) in Gaithersburg, MD is seeking a dedicated Registered Nurse/Delegating Nurse (RN/DN) to support individuals with developmental disabilities under Maryland's DDA program. Responsibilities...

Elevance Health is seeking a Clinical Review Nurse I to review and determine whether a claim meets the benefits the member carries. This virtual, full-time role offers flexibility with in-person training sessions and potential alternate locations...

Job Title: Clinical Quality Assurance Nurse Pay: see below Registered Nurse - $28.50/hr (Non-negotiable) LPN/LVN- $26.50/hr (non-negotiable) Regular Schedule after training: M-F...

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...