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To support the treatment of addiction and mental health issues, the full-time Remote Utilization Review Specialist will manage pre-authorizations and concurrent reviews, collaborating with case managers and the multidisciplinary treatment team to...

Utilization Review Nurse Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization Review Nurse, you'll play an important role in helping us offer customized, self-funded...

Case Manager Utilization RNWorks collaboratively with an MD to coordinate and screen for the appropriateness of admissions and continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the...

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...

Piper Companies is seeking a Clinical Appeals Nurse to join a leading health insurance organization for a contract remote opportunity located in North Carolina. The Clinical Appeals Nurse will serve as a clinical...

Utilization Management (UM) 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...

Concurrent Review Registered Nurse (RN) Location: Fully remote. Our client is seeking an experienced Concurrent Review Registered Nurse (RN) to join its Utilization Management team. In this role, you will perform concurrent...

Clinical Appeals Nurse We are seeking an experienced Clinical Appeals Nurse to support the appeal and grievance processes by analyzing and responding to adverse coverage decisions. This role involves clinical judgment, regulatory...

JOB DESCRIPTION AND POSITION REQUIREMENTSShape the next generation of forensic nursing, one exam at a time. SAFE-T System, within Penn State's Ross and Carol Nese College of Nursing, is seeking highly-skilled Sexual Assault Nurse...

JOB DESCRIPTION Opportunity in Southern California for an experienced Managed Care Leader to join our health plan in California. Candidates must have a minimum of 7 years of healthcare experience, 3 of those should be with a Managed Care...

Public Health Nurse Employer: County of Los Angeles Salary: $105,247.44 - $157,542.24 Annually Location: Los Angeles County, CA Job Type: Full time Job Number: PH5230H Department: PUBLIC HEALTH...

Company Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable,...

Exceptional care starts with exceptional people. For us, this is more than a job– it's a calling. It's waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you...

About This Role The Triage RN is responsible for delivering patient care remotely in accordance with established standards and policies, ensuring high-quality care and safety for patients. This per diem position is ideal for RNs seeking...

Clinical Research Nurse I Locations: Los Angeles, California Job Category: Registered Nurse Position Type: Full-Time Shift: Days Job Description Join a team that's...

CVS Health is seeking an ICM Care Manager to assess, plan and coordinate patient care from a home-based setting with 25-50% travel within Passaic County, NJ. The role requires an active NJ RN license and a minimum of 3 years clinical experience,...

Summary This opening is for a Hiring/Onboarding Event. After qualifications are verified, invited candidates in Los Angeles will attend in person; others may interview virtually. Date: Saturday, November 7, 2026 Time:...

Job Summary: Responsible for the oversight and management of skilled patients and temporary skilled patients in rehabilitation in contracted Skilled Nursing facilities; this includes checking benefits, managing up to discharge and issuing denial...

Virtual Pre-Admit RN As our Virtual Pre-Admit RN, you will conduct comprehensive pre-operative assessments, collect patient health histories, review diagnostic testing, and ensure patients are fully prepared for anesthesia and surgery. In...

JOB DESCRIPTION Opportunity in Southern California for an experienced Managed Care Leader to join our health plan in California. Candidates must have a minimum of 7 years of healthcare experience, 3 of those should be with a Managed Care...

Clinic Registered Nurse (RN) Setting: Healthcare Facilities Job Type: Contract - Full Time Pay: $55 / Hour Hours: 40.00...

Immediate need for a talented RN Case Manager. This is a 06+months contract opportunity with long-term potential and is located in U.S(Remote). Please review the job description below and contact...

Job Title: Clinical Prior Authorization Reviewer Job Description This role focuses on reviewing prior authorization requests to determine the medical necessity of services and the appropriate level of care. The position ensures that...

Job Description Work Schedule: 40% FTE, day shift working Monday - Friday, working 4, 4 hour shifts between 7a - 5p. This is a work from home position. Applicants hired into this position can work...

Job Description This position will be supporting Oregon Home Infusion Pharmacy. The Home Infusion Clinical Liaison position is responsible for creating and maintaining positive referral relationships in order to...