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Palo Verde Community College District is seeking an experienced Clinical Documentation Integrity (CDI) Specialist (RN) for a fully remote role based in the US. The position supports quality outcomes, reimbursement accuracy, and regulatory...

Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.00 - $34.00 / hour Department: HS -...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. **This position is remote. Candidates must be local to New England States for consideration** The Clinical...

Join to apply for the Nurse Advocate - Remote- Kansas role at Synergy Healthcare USA, LLC We are seeking an experienced Case Manager to join our growing team and serve as a Nurse Advocate for our new client and their employees.

Greenlife Healthcare Staffing is looking for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical studies. With a...

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...

Mist Registered Nurse (RN)Organization: SHSO-Population Health Services-UtahPosition Summary: The Multidisciplinary Inbasket Support Team (MIST) Registered Nurse is a highly skilled ambulatory care nurse who provides comprehensive, remote clinical...

RN/Managed Care Coordinator - Remote Healthcare Columbia , South Carolina Contract Hybrid Aug 28, 2026 Case Management - RN Job at a Glance Title: Medical Case Management Nurse Location:Must live...

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...

To support client care authorization processes, the full-time Clinical Letter Writer will gather and review medical records, draft letters of medical necessity, and communicate with team members regarding client authorizations and recertifications...

Humana is seeking a Utilization Management Nurse 2 to apply clinical nursing skills in coordinating, documenting and communicating medical services and benefit determinations. This remote role may require occasional travel to Humana's offices for...

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...

Optum is seeking an Inpatient Care Management Nurse to assess and interpret member needs, guiding utilization of health services to improve outcomes. You will collaborate with clinicians, perform case reviews, and support discharge planning from...

Job Title: Registered Nurse (RN) Disease Manager Job Overview: The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of patients with chronic or...

Qualifications Basic Requirements: English Language Proficiency In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English Graduate of a school of...

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.

Gainwell Technologies is seeking a Medical Reviewer (Registered Nurse) to support California healthcare programs. You will use clinical judgment to review medical records, healthcare services, claims, and authorization requests. You will...

This range is provided by Insight Global. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $140,000.00/yr - $170,000.00/yr Direct message the job poster from...

EMD Serono is seeking a RN Patient Support Specialist – West Coast to join the Patient Support Hub. This remote role delivers individualized clinical education, product training, and ongoing support to patients and caregivers, across multiple...

Illingworth Research Group is seeking a Per Diem Freelance Research Nurse to support patients in clinical studies by coordinating care and liaising with healthcare providers. The role involves guiding participants through study protocols,...

A healthcare staffing company is seeking a Clinical Review Nurse for Prior Authorization Review. This remote role demands conducting reviews, collaborating with healthcare teams, and ensuring compliance. Candidates need an active RN license and...

Broadway Ventures, a veteran-owned SDVOSB headquartered in Mississippi, seeks an experienced Registered Nurse to perform medical review of complex claims, pre-authorization requests, appeals, and fraud referrals. You will apply clinical expertise...

St. Louis Children's Hospital is seeking an RN for after-hours triage and nursing support via the Answer Line. The role involves assessing patient needs, guiding care plans, and educating families within established guidelines. Part-time...

Walker Healthforce, LLC seeks a Medical Claim Review Nurse for a fully remote contract based in Washington. The role focuses on retrospective medical necessity reviews, appeals, and payment integrity within Molina Healthcare of Washington.