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Nurse Consultant/ Regional Director Of Clinical Operations Relocation to Southern New Mexico is required. The Nurse Consultant/ Regional Director of Clinical Operations position is comprised of two essential objectives; to partner...

Supports the values of service excellence, teamwork, and integrity while managing patient care.Acts as a liaison among patients, caregivers, multidisciplinary teams, and payers.Qualifications:Requires a current RN license, nursing diploma or...

Job ID: 33380 *Description*There's nothing more exciting and rewarding than being able to make a significant, positive difference in someone's life. At UCLA Health, you'll experience this joy every day while also enjoying the positive,...

Appeals Nurse Consultant We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care...

Claims Medical Review Nursing Consultant Job No: 544045 Work Type: Full-time Location: REMOTE OPTIONS, VARIOUS-STATEWIDE, PHOENIX Categories: Healthcare/Medical Support Level,...

Utilization Management Nurse Consultant (RN) – Concurrent Review Remote | Acute Inpatient Utilization Management | RN Opportunity Are you an experienced RN with a background in acute care and utilization management? Join our team...

TEKsystems seeks a Clinical Quality Assurance Coordinator to ensure high-quality, compliant case reports. This remote, contract-to-hire role supports the Quality Assurance Department from Dallas, TX, handling QA questions and providing guidance.

CVS Health Corporation is seeking a Utilization Management Nurse Consultant (UMNC) for a 100% remote role. You will coordinate, document and communicate utilization/benefit management activities, ensuring appropriate care and timing of services...

A technology and business consulting firm is seeking a Clinical Medical Review Nurse to analyze health data and provide insights for internal stakeholders. The ideal candidate has a Registered Nurse license, along with four years of clinical...

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...

RN Utilization Review Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic...

CVS Health is seeking a Nurse Consultant for Utilization Management in a 100% remote role. You will apply clinical judgment and evidence-based criteria to review inpatient and outpatient services, collaborate with providers to authorize care, and...

Registered Nurse Specializing In Utilization Review Join our team as a Registered Nurse specializing in Utilization Review, where you'll play a crucial role in patient care management. What You'll Be Doing Conduct...

BJC HealthCare is seeking a registered nurse to join a remote Utilization Review team. The role supports multiple hospital units with no patient communication, and it is designed for local remote work with weekend rotation. Responsibilities...

Humana is seeking a Utilization Management Nurse to support coordination, documentation, and communication of medical services and benefit determinations. This role suits experienced nurses who can work independently and make critical patient-care...

CorVel Corporation seeks a Care Advocate Nurse for a remote role focused on assessing injury severity, reviewing medical data, and supporting the Claims Management department as a nurse consultant. The position requires clinical nursing...

1st TIME OK/ 2 YR EXP required for Utilization Review RN every other weekend required or more depending on unit needs no call or floating required MUST HAVE experience with Milliman Care Guidelines and Acute Hospital Experience!! The Emergency...

Cunningham Children's Home in Illinois seeks a Nurse Case Manager to support residential programs with medical case management, screening, education, counseling, and medication management. The role involves coordinating with community providers...

hackajob is collaborating with Oracle to connect them with exceptional professionals for this role. Description We're on a journey to advance how health happens with technologies that empower patients, support clinicians, inspire innovation, and...

The Veterans Health Administration at the Charleston VA Medical Center seeks a Nurse Manager (RN) to lead and supervise designated units within Community Care. The role emphasizes staff development, evidence-based practice, and collaboration with...

Details Client Name Providence Health & Services, Southern California Job Type Travel Offering Nursing Profession RN...

We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

100% REMOTE PAY: $47-$52/hr REQUIRED: Must have current RN licensing Post market medical device experience in either medical assessment, complaint handling, post market reporting – preference is actual medical device assessment Highly prefer...

WPS Health Solutions in Columbus, OH, is seeking an Appeals Nurse to review medical records and Medicare claims for first-level appeals to determine medical necessity and coverage alignment. The role collaborates with Appeals Examiners to...

About This Role The Clinical Consultant RN, Medical Policy Writer role at UnitedHealth Group involves providing clinical leadership for assigned Optum products, focusing on the development of clinical utilization management guidelines and...