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HealthHelp, a WNS company, seeks a Clinical Review Nurse for a fully remote role in the United States. You will perform prospective reviews for medical necessity on prior authorization requests across multiple specialty programs and refer...

Who We Are: Since 1985, BHCHP's mission has been to provide or assure access to the highest quality health care for all individuals and families experiencing homelessness in greater Boston. We care for over 11,000 homeless individuals each...

Iris Telehealth is hiring Consult-Liaison Psychiatrists to provide 100% remote evaluations and consultations for inpatient, ED, and ER settings from home. Georgia-licensed board-certified psychiatrists are sought, with at least 2 years of...

The Virtual Nurse, RN at MUSC coordinates and delivers professional clinical, quality, and educational services to patients engaging with MUSC via virtual care. This role reports to leadership within the MUSC Center for Telehealth and aims to...

Mitchell International is hiring a Remote Medical Claims Consultant to analyze medical records and bills for relatedness and causality for clients. You will prepare medical evidence and organize case materials while reviewing chart status and...

Cambia Health Solutions is seeking an experienced Utilization Management Nurse to support our Clinical Services team. You will perform prospective, concurrent, and retrospective reviews to ensure medical necessity and appropriate care, while...

CVS Health is seeking a QM Nurse Consultant to apply specialized clinical knowledge and drive quality improvement across patient care. The role emphasizes data analysis, regulatory compliance, and developing quality assurance programs, with a...

CVS Health is seeking an Oncology Nurse Consultant (RN) for a 100% remote role spanning the contiguous U.S. You will lead clinical care coordination and utilization management within the Oncology Care Model, guiding members through diagnosis,...

American Health Plans Franklin, TN 37067, USA Description American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for...

Molina Healthcare is seeking an RN licensed in Wisconsin for a remote IRIS Self-Directed Personal Care (SDPC) RN role. You will oversee care for IRIS participants, perform assessments, provide training, and ensure compliance with program...

Sedgwick is hiring for a Clinical Consultation Triage Nurse in a remote, full-time role. You will triage calls, assess needs, and provide care guidance to determine the appropriate level of care, while supporting return-to-work goals. The...

Centene Corporation is seeking a Licensed Practical Nurse (LPN) or Registered Nurse (RN) for a remote case management role in Pennsylvania. The selected candidate will perform concurrent reviews, determine appropriate care levels, and assist with...

Cabell Huntington Hospital is seeking a casual, as needed Virtual Integrated Care Coordinator (RN) for our CHH Virtual Integrated Care Department. This job is responsible for supporting and...

Managed Medical Review Organization is seeking a licensed RN to join our team for remote, home-office work. This role emphasizes telephonic customer service, accurate documentation, and clinical review of medical records with no face-to-face...

Comagine Health, a national nonprofit healthcare consulting organization, seeks a Clinical Reviewer (RN) to support the Washington Labor & Industries contract. This remote role leverages nursing expertise to evaluate medical necessity and quality...

Comagine Health is seeking a Clinical Reviewer (RN) to evaluate medical necessity, quality and appropriateness of services under the WA L&I contract. This remote role supports case reviews across inpatient, outpatient, and complex imaging by...

About Us At Prenuvo, we are on a mission to flip the paradigm from reactive "sick-care" to proactive health care. Our award-winning whole body scan is fast (under 1 hour), safe (MRI has no ionizing radiation), and non-invasive (no...

About Us At Prenuvo, we are on a mission to flip the paradigm from reactive "sick-care" to proactive health care. Our award-winning whole body scan is fast (under 1 hour), safe (MRI has no ionizing radiation), and non-invasive (no...

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving...

Remote Nursing OpportunitiesAre you looking for an exciting way to utilize your nursing skills and expertise to deliver quality nursing care in a remote setting? AccessNurse, where technology meets compassionate care, is looking for professional...

Comagine Health in Washington State is seeking an experienced Registered Nurse to join our remote Clinical Reviewer team. The role focuses on assessing medical necessity, appropriateness, and quality of care through prospective, concurrent, and...

Job Title: Clinical Quality Assurance Nurse Pay: see below Registered Nurse - $28.50/hr (Non-negotiable) LPN/LVN- $26.50/hr (non-negotiable) Regular Schedule after training: M-F...

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...

Comagine Health is seeking a Clinical Reviewer (RN) remotely to support Washington state contracts. The role evaluates medical necessity and quality of care, collaborating with physician consultants and internal teams to ensure compliant,...

Engage Consulting seeks an experienced MDS Nurse / MDS Coordinator for a full-time remote role supporting skilled nursing facilities with MDS assessments and reimbursement processes. The ideal candidate holds an active RN license with...