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PACE Early Childhood Education Program Consultant PACE Early Childhood Education (ECE) Program provides high quality early childhood education and support services for children aged 0-5 years old children for economically disadvantaged...

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...

Comagine Health is seeking an experienced Registered Nurse to serve as a Clinical Reviewer for the Washington Labor & Industries (L&I) contract. This remote role utilizes nursing expertise to evaluate medical necessity and quality of care,...

Centene Corporation seeks a Nurse Reviewer to analyze prior authorization requests and determine medical necessity in line with regulatory guidelines and member benefits. You will collaborate with medical directors, providers, and the...

CVS Health is seeking a registered nurse to assess, plan, implement, coordinate and evaluate healthcare options for members. The role focuses on coverage determination and coordination within the utilization management framework. The...

Clinical Nurse Consultant At Bristol Myers Squibb, our employees often ask, "Who are you working for?"—a question that fuels collaboration, accountability, and urgency in our work. Our purpose-driven culture inspires us to discover,...

CVS Health is seeking an experienced RN Utilization Management Nurse Consultant for Medicare joint procedures. This remote, full-time role follows a Monday–Friday schedule (9:00 am–5:30 pm in your time zone) with occasional evenings/holidays,...

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...

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 seniors...

Job Responsibilities and Requirements KEY RESPONSIBILITIES *other duties as assigned* Job Summary: Reviews all medical (and other) documentation in claim files to answer the specific...

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...

Regional Nurse Consultant RN StoneGate Senior Living in Tulsa, OK is hiring a Regional Nurse Consultant RN for our Tulsa, OK region. A rewarding career is waiting for you at a great facility that specializes in long-term and...

Nurse Appeals Location: Nashville Tennessee (This role is open only to residents of Tennessee). Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum...

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...

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

Absolute Elder Care is seeking a Remote Nurse Consultant to provide expert guidance and support for in-home senior care. This full-time, remote role involves collaborating with families to manage health care needs, conducting comprehensive...

Utilization Management 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...

Guardian Life Insurance Company seeks an experienced RN Clinical Consultant to evaluate short- and long-term disability claims, analyze medical information, assess functional capacity, and support claim decisions. You will collaborate with...

A healthcare technology company seeks an experienced Registered Nurse for a remote role providing clinical technology services. This position is for independent contractors, focusing on chart reviews and clinical data analysis. Candidates should...

Guardian Life Insurance is seeking an RN Clinical Consultant to serve as a clinical expert supporting short-term and long-term disability claim evaluations. You will analyze medical information, assess functional capacity, and provide guidance to...

Diabetes Specialist Nurse Are you a passionate and experienced Diabetic Specialist Nurse looking for flexible and rewarding opportunities? We are inviting skilled professionals to join our Healthcare Professionals Network for a series of...

Nurse Consultant I (NS) The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health,...

Utilization Management 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...

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...

APremium Healthcare Solution, LLC is seeking a Virtual Nurse Consultant to provide remote nursing guidance and care coordination from a flexible, virtual setting in Conyers, GA. The role emphasizes high-quality patient outcomes and HIPAA-compliant...