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Utilization Management - Clinical Nurse - Work from Home! Utilization Management - Clinical Nurse - Work from Home! Get AI-powered advice on this job and more exclusive features.Direct message the job poster from BroadPathGlobal Talent Attraction...

A healthcare staffing company is seeking a Remote Registered Nurse (RN) to specialize in triage on a PRN basis. Ideal candidates will have at least 1 year of nursing experience and an active RN license. Responsibilities include conducting patient...

Brighton Health Plan Solutions seeks an experienced Utilization Management Nurse (LPN) to perform medical necessity and benefit reviews remotely. You will work within UM processes, coordinate with partners, and ensure timely, compliant...

Rochester Regional Health is seeking a Registered Nurse for the Communications Center (Central Triage). The role combines in-person duties at the Riedman Center with a remote option after completing an in-depth training program. Expect 40...

University of Southern California is seeking a Patient Care Assistant to support nursing staff in patient care delivery and unit operations at Keck Hospital of USC in Los Angeles. The role emphasizes safety, documentation, and coordination with...

Gainwell Technologies LLC is seeking a Nurse Reviewer (RN) to perform clinical reviews remotely in the United States. Responsibilities include reviewing medical records, documenting findings, and supporting decision-making within healthcare...

Humana is seeking to fill the Compliance Audit Nurse role to audit care management activities and documentation for regulatory compliance. The position involves independent determination of appropriate courses of action, data collection and...

To support effective utilization management, the full-time remote Utilization Review RN will examine medical records, develop clinical reviews for authorization, and collaborate with interdisciplinary teams to optimize reimbursement and prevent...

Guidehealth is seeking an Utilization Management Registered Nurse to perform medical-necessity reviews and document findings for determinations. The role involves collaborating with medical leadership, reviewing cases for appropriate treatments,...

EMD Serono is seeking an experienced RN to join the Patient Support Hub as a remote RN, West Coast-focused. You will provide individualized clinical education, product training, and ongoing support to patients and caregivers, leveraging AI-enabled...

A leading health company is seeking a remote RN Case Manager responsible for assessing and coordinating case management activities for members. Candidates must possess an active RN license and have at least 3 years of acute care experience. Strong...

Back Medical Claim Review Nurse | Remote | Washington | Contract Business & Care Management Long Beach , California Contract Aug 11, 2026 Medical Claim Review Nurse | Remote (Washington) | Contract Walker Healthforce is seeking a...

A prominent healthcare organization is seeking a Telephone Triage Nurse Line Advisor in Saint Paul, Minnesota. The role requires a current Minnesota RN License and 3+ years of RN work experience. You will independently triage patient calls and...

Self Fund Health Nurse Navigator Remote · Full time The Nurse Navigator is a remote WI-based RN who acts as the member's single point of contact through the healthcare system — coordinating care, advocating for patients, and steering...

HealthDrive seeks a Remote Clinical Support Nurse (RN or LPN) to serve as the central hub for in-house NPs practicing in SNFs/ALFs. You will coordinate care, communicate with physicians, nurses, families, and pharmacies to prioritize needs and...

A national healthcare recruiting firm is seeking an experienced RN Case Manager in Sacramento, CA. In this telephonic role, you will assess and coordinate care for high-risk members. The ideal candidate will have an RN license and at least two...

A healthcare solutions provider is looking for a qualified RN to perform medical reviews and coordinate care for members. This role involves assessing service needs, engaging in patient education, and ensuring compliance with healthcare...

Providence Home Services Oregon is seeking a Clinical Documentation Specialist, Registered Nurse (RN) for a full-time, day-shift remote role open to multiple states. You will review OASIS admission documents and Plans of Care to ensure CMS...

THIS IS A REMOTE POSITION Part Time/Contract Position DUTIESAssess patient health problems over the phone and via secure videoSchedule appointments and refer patientsAdvise and monitor simple home...

Vaya Health seeks a Physical Health Registered Nurse to perform clinical reviews for authorization requests and medical necessity. You will reference standardized criteria and coordinate with physician peers when needed. This role is part of a...

A leading healthcare provider in Columbia, Illinois is seeking an RN Supervisor for the Patient Access Center, focusing on evening shifts. The role demands strong clinical judgment and communication skills to optimize patient admissions and...

Job ID: 26682 *Description* **Now offering sign-on bonuses up to $20,000** Under the supervision of an anesthesiologist, the Nurse Anesthetist (NA) will perform safe anesthesia care, consisting of the following: pre-operative...

Inland Empire Health Plan (IEHP) seeks a Quality Program Nurse to implement and monitor quality management policies under the DHCS framework. Responsibilities include site reviews, medical record surveys, CAP oversight, and HEDIS data abstraction.

A healthcare provider is seeking a Utilization Review Nurse to coordinate resources and ensure efficient delivery of home health care. This role involves monitoring patient admissions and ongoing care while ensuring adherence to guidelines. The...

Telenett is seeking a Remote Utilization Review Nurse to review medical records from a home office and determine medical necessity and care appropriateness. You will work with providers to develop compliant care plans and ensure high-quality,...