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Fully Remote: Clinical Documentation Specialist Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical...

Job Description Work Schedule: Day/evening, you will work eight 10-hour shifts per pay period including weekend rotation. Holiday rotation required. Hours are based off the operational needs of the...

Conduct prospective, concurrent, and retrospective reviews for medical necessity and appropriateness of services. Collaborate with UM Medical Director on reviews and final determination. Draft denial language to ensure...

Mercy is seeking an RN II in Advanced Primary Care to provide virtual chronic disease management in collaboration with physicians and advanced practitioners. You will establish patient relationships, monitor vitals, and support panel management,...

Sagility is seeking aSenior Care Specialist (Registered Nurse) to work from home, supporting Medicare/Medicaid populations with telephonic health assessments and personalized care plans. The role requires an active RN license, strong clinical...

CVS Specialty Pharmacy Nurse, Clinical Operations CVS Specialty Pharmacy provides medications and support for rare and complex conditions. The Nurse, Clinical Operations position is primarily responsible for supporting the clinical...

Job Description: To show our commitment to you and to assist with your transition into our organization, we will also offer up to a $15,000 sign-on bonus when applicable. Fifth floor is a 26-bed surgical floor that provides great care to...

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...

The Registered Nurse is responsible for overseeing the health, wellness, and psychiatric stability of patients receiving Full-Service Partnership (FSP) and broader outpatient behavioral health services. The position is primarily...

Job Opportunity Title RN Date Opened 03/18/2026 Job Type Local/Travel Contract Industry Health Care Work Experience 1+ year City Northridge State/Province California Country United States...

Job Summary: Under the direct supervision of a Registered Nurse or physician, performs a variety of patient care functions as assigned and in accordance with the legal scope of competency and within established standards of care, policies...

Provides direct nursing care including: assessment, plan of care, education, and evaluation for assigned patients. Performs patient duties necessary to maintain the flow of...

Sedgwick is seeking an RN Field Case Manager to join our nationwide team in a remote, home-based role with occasional travel. You will work with injured workers and medical providers to coordinate care, advocate for treatment, and support timely...

Registered Nurses| School Cases | 1 on 1 | Full Time | | Pediatrics | ASAP | 27402 Job Description: Are you a licensed RN with a passion for working with children? Do you want a role with a...

RN Status Review Specialist It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: Use your nursing expertise in a strategic, non-bedside role. As an RN Status Review Specialist, you'll evaluate patient...

A technology and business consulting firm is seeking a Clinical Medical Review Nurse to analyze health data and provide insights for internal stakeholders. The ideal candidate has a Registered Nurse license, along with four years of clinical...

Federal Hearings And Appeals is seeking a Remote RN Claims Reviewer to evaluate medical claims, determine approvals, denials, and appeals. You will review medical records, apply Medicare regulations, and cite supporting documentation from the case...

Los Angeles Community Hospitals is seeking a Clinical Educator - RN to plan, design and implement education programs for nursing staff. You will work with nursing directors to assess educational needs and develop orientation for new hires and new...

Elevance Health, Inc. is seeking a Nurse Case Manager I (RN) to perform telephonic care management for members with complex and chronic care needs. The role supports assessment, development, implementation, coordination, monitoring and evaluation...

$38-$52 per hour Fullerton, CA Contract Duration: 05 Months Job Description: We are seeking compassionate and dependable Registered Nurses (RNs) to join our nationwide...

Atrius Health in Massachusetts is seeking a Registered Nurse to deliver effective care within the GI/Anticoagulation Management Services team, combining nursing processes with evidence-based practice to ensure patient safety and quality outcomes.

Clinical Reviewer – Registered Nurse (RN) Comagine Health | Washington State | Remote / Work From Home This is an excellent opportunity for an experienced Registered Nurse who wants to transition from direct patient care into a...

BlueCross BlueShield of South Carolina, Palmetto GBA Medical Review team, seeks an RN Medical Reviewer II to apply clinical guidelines and protocols for medical reviews and payment determinations from a home office. This full-time role emphasizes...

Registered Nurse Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Encino Hospital Medical Center, a member of the Prime Healthcare Foundation, offers incredible...

HealthEdge Software, Inc. is seeking a motivated Utilization Review RN to perform prospective, concurrent, and retrospective review of inpatient and outpatient services to ensure medical necessity and appropriate level of care. This role...