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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...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data...

Centene Corporation is seeking a Behavioral Health Utilization Review Specialist to support clinical reviews for mental health and substance use services. This role is remote within the Central Time Zone with a Monday–Friday schedule and...

Greenlife Healthcare Staffing is seeking a Registered Nurse Clinical Reviewer for a remote, full-time role with a nonprofit client in New York. The RN should have 1–3 years in utilization review, appeals, and prior authorization and be...

Job Summary and ResponsibilitiesAs our Educator in Critical Care Emergency, In accordance with our mission and core values of integrity, compassion, collaboration, and excellence, this position is established to serve as a consultant/resource...

*Job Summary and Responsibilities* As our Registered Nurse (RN), you will be a pivotal healthcare professional, delivering compassionate, high-quality care that truly impacts our patients' well-being and recovery. Every day, you will...

Registered Nurse (RN) - Utilization Management 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...

Lee Health is hiring for a Utilization Management RN position. This remote role begins onsite for the first 90 days and requires licensure in Florida. The nurse will perform utilization management duties, ensure regulatory compliance, and document...

Spectrumforce Technologies, Inc. is seeking a Care Manager (RN) to support Medicaid members remotely in Florida. The role involves reviewing referrals, proactive outreach, and guiding members through care management, education, and coordinated...

Alliance Liaison If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One! We strive to be an employer of choice and establish a reputation for being a talent rich organization where...

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...

Job Title Clinical Nurse Consultant Job Description Position Summary The Clinical Nurse Consultant provides relevant training and consultation on ICU Medical's clinical products/software and clinical services...

Nurse Consultant Polaris Group, the SNF Clinical branch of Assembly Health, is seeking a dynamic, client-focused Nurse Consultant. We are looking for a clinically trained professional who stays current on federal and state regulations,...

ProMedica is seeking a Registered Nurse (RN) to join the Care Coordination team as the coordinator of a patient's plan of care. The RN will assess, diagnose, plan, implement, and evaluate care, working with patients, families, and the health care...

TEEMA partners with a top healthcare organization to recruit a Clinical Quality Reviewer. You will review medical records for quality and utilization concerns, and prepare clear recommendations for quality improvement. Remote or onsite...

Cassia is seeking an experienced Minnesota RN to support RN Directors of Health Services in Assisted Living communities through a remote, part-time role. You will triage calls from clinical staff for urgent and emergent resident situations,...

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...

A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing...

To support a growing clinical operations team, the full-time Nurse Consultant II will provide professional nursing care remotely, focusing on member assessment, planning, evaluation, and evidence-based practice to enhance member experiences and...

BCBST BlueCross BlueShield of Tennessee, Inc. is hiring an Appeals & Grievance Nurse Analyst to review and process member and provider appeals, ensuring timely and compliant resolutions under CMS, Medicare, and TennCare guidelines. The role...

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...

CVS Health is seeking an experienced Utilization Management Nurse Consultant for a fully remote role across EST or CST zones. You will coordinate and document UM activities, ensuring safe, appropriate care and adherence to timelines while working...

Relocation to Southern New Mexico is required. The Nurse Consultant/ Regional Director of Clinical Operations position is comprised of two essential objectives; to partner with facilities as the primary clinical resource in...

Utilization Review Nurse - RN | 100% Remote | Part-Time 10-20 Hours Per Week | Flexible Schedule | Evenings & Weekends Looking for a way to use your nursing experience without returning to a full-time bedside...

Interventional Radiology RN This position is for an Interventional Radiology Registered Nurse. The role requires experience in an acute care setting. The ideal candidate must be able to work both day shifts and provide on-call coverage.