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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...

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...

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...

Sentara Health is seeking a part-time Registered Nurse for a physician practice setting in a remote capacity. The RN will assess patients, assist with procedures, administer medications, and coordinate with physicians and staff to ensure...

Responsibilities Plans, implements, coordinates, and evaluates comprehensive care for designated patients to ensure quality of care and continuity of care delivery through telehealth platforms. QualificationsMinimum...

Memorial Hermann Health System is seeking a Clinical Documentation & Integrity Specialist for a remote role in Texas. The RN must hold a BSN or MSN and have at least five years of inpatient acute care experience, with ICU exposure preferred.

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...

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.

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...

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...

UnitedHealth Group is seeking a SSBV Clinical Claims Review RN for a remote role nationwide. You will perform administrative reviews of inpatient hospital claims, document determinations, and ensure accurate use of screening criteria to support...

Seeking an experienced Registered Nurse Medical Reviewer, the full-time remote position will manage the medical review of complex claims, pre-authorization requests, appeals, and fraud referrals, applying clinical expertise to determine medical...

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.

VHC Health in Arlington, VA is seeking a Virtual Nurse/Nursing Care Partner to provide indirect nursing care to assigned patients across inpatient units via remote technology. The role supports admissions, education and discharge planning with...

Responsibilities: How you'll change lives ...

Amerit Consulting is seeking an experienced Utilization Management Nurse (RN) in California for a remote 6-month contract. The incumbent will support inpatient utilization review, medical necessity determinations, and facility claims compliance,...

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...

Sentara Health Plans seeks an RN Clinician to perform utilization management and claim reviews across inpatient and outpatient settings. The role supports pre/post payment reviews and authorization assessments, ensuring compliance with policy and...

Ensemble Health Partners is seeking an experienced RN for Utilization Review to assess medical necessity and optimize hospital and patient care. This remote role involves coordinating with the FCC, care management, and interdisciplinary teams to...

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

Freeman Health System is hiring for a remote/hybrid position in Utilization Review and Case Management. The role focuses on assisting Emergency Department patients with their social and discharge needs. Candidates must be licensed RNs with strong...

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...

Molina Healthcare is seeking a Medical Review Nurse (RN) to review documentation for medical necessity and appropriate levels of care, using clinical knowledge and utilization review expertise. This remote US role offers a full-time schedule.

AmeriPharma is seeking an Parenteral Services Clinical RN Specialist to provide expert nursing support for TPN and parenteral therapies. The role emphasizes clinical education, care coordination, and collaboration with nursing, pharmacy, and...

Compassus is seeking a Remote Home Health Registered Nurse - Triage to triage patient and facility calls after hours and facilitate referrals as needed. This role supports field staff, coordinates admissions, and collaborates with physicians to...