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A leading healthcare provider is seeking a Registered Nurse for their LTSS department in New York. This role involves providing case management services, evaluating medical services, and managing appeals for denied services. Candidates must...

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...

Prior Authorizations Nurse (RN) (Temporary) Remote in California OUR COMMITMENT TO A HUMAN HIRING PROCESS We believe every candidate deserves thoughtful consideration.That'swhy we do not use AI or automated...

Sedgwick is seeking a Utilization Review RN for a telecommuter role in Michigan. You will review treatment plans, analyze medical records, and determine appropriate care using evidence-based criteria within a collaborative environment.

Bestica is seeking a travel nurse RN Research / Clinical Research for a travel nursing job in Fullerton, California. Job Description & RequirementsSpecialty: Research /...

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...

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...

Staff Education RNCollaborates with Education Consultants, Managers, CNS staff and Physicians to develop, design, deliver and evaluate/improve education strategies and special projects/programs based on clients departmental goals and needs, as...

Description: FAMILY NURSE PRACTITIONER JOB SUMMARY Provides continuous and comprehensive services necessary for the promotion of optimal health, prevention and treatment, in an underserved community clinic. To perform a variety of advanced clinical...

Carle Health is seeking a Registered Nurse to support telehealth triage and care coordination. The role begins with six months of in-office training at our Champaign, IL location before transitioning to remote work. You will manage triage,...

Managed Medical Review Organization is seeking a skilled registered nurse for a remote, home-office role. The position emphasizes telephonic/customer service, accurate documentation, and clinical review duties without face-to-face patient contact.

Providence Tarzana Medical Center in Tarzana, CA is seeking a Certified Nursing Assistant for the Cardiovascular Unit. This Full-Time role requires CA Nursing Assistant Certification, BLS, and completion of the Nursing Assistant course, with...

Yoh is seeking a Utilization Management Nurse Coordinator (RN or LVN) for a 6+ month remote contract with a managed care client based in Northern California. Training occurs onsite in Fairfield or Redding for three weeks, then transitions to fully...

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...

Position Objective: To provide supervised medical services for patients with emphasis on acute/same day care. All duties are in collaboration with contracted physician; services are provided under the rules regulations, and policies...

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,...

Corrections Registered Nurse (RN)Setting: CorrectionsJob Type: TravelPay: $2400 / WeekHours:...

Job Summary This position is responsible for ensuring compliance with Utilization Management (UM) and Quality Review (QR) functions performed by the health plan. The role supports clinical review activities requiring 5+ years of...

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...

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

DescriptionYour Role 100% Remote. You will triage calls from our clients in the following manner: 1) assess the needs utilizing injury algorithm guidelines; 2) give appropriate care advice, and 3) disposition to the appropriate...

Molina Healthcare seeks a Remote RN Care Review Clinician for UM/Discharge Planning in California. You will verify medical necessity, review services against guidelines, and coordinate care across the delivery continuum to achieve quality...

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START Research's START Center for Cancer Research in Los Angeles is seeking a Clinical Research Coordinator, RN to support early-phase oncology trials. The role involves direct patient interaction, data collection, and ensuring protocol compliance...

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,...