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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...

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...

The Licensed Vocational Nurse is responsible for providing direct or indirect nursing care to patients who present with urgent, emergent, or potential health problems;...

Optum CSP CC role opens opportunities to guide comprehensive oncology care management across the U.S. You will work with oncology nurse case managers, social workers, and medical directors to ensure evidence-based, patient-centered care for...

Greenlife Healthcare Staffing is looking for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical studies. With a...

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...

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...

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...

UnitedHealth Group is seeking a Transitional Care Nurse Liaison to educate and support high-risk patients during transitions from acute care. You will work with Boulder Community Health and partners to reduce readmissions through patient...

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...

MaziCTools is seeking a Freelance Utilization Management Nurse Consultant to work remotely in the United States. This full-time role requires an active RN licensure and 3+ years of clinical experience. Responsibilities include assessing healthcare...

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...

Utilization Review Specialist (RN) – Work From Home (Florida-Based Candidates Only)Concierge Home Care | Work From Home Opportunity – Must Reside in Florida At Concierge Home Care, we are growing and looking for an experienced...

A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and...

Kaiser Permanente in Los Angeles is seeking an experienced RN for a case management role within a multidisciplinary team. You will assess patient needs, develop individualized care plans, and coordinate access to services across physicians,...

Comagine Health is seeking Clinical Utilization Review Nurses (RN) licensed in Alabama for a remote, full-time role. You will assess medical necessity and quality of healthcare services through prospective, concurrent, and retrospective reviews to...

Registered Nurse Dialogue is the #1 virtual care provider in Canada. By developing our Integrated Health Platform, we provide exceptional online health and wellness programs to organizations that want to improve the wellness of their...

JOB DESCRIPTION Job Summary Work Location: California - Ability to work remote, but selected candidate must reside in the state of California. This position requires California RN Licensure. Candidates must...

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...

Home Health Clinical Referral NurseOrganization: SCAH-Sutter Care at Home - UTPosition Overview: The Home Health Clinical Referral Nurse serves as the initial point of contact for potential home health patients, working closely with our clerical...

Job Description The Research Nurse Coordinator III is responsible for all activities associated with clinical study coordination, subject enrollment, data management/integrity, regulatory compliance, project/study evaluation...

Description We are hiring for a part- time School Nurse Consultant, come join our team! This is a non-benefited position that works on an as needed basis. See CESA 6 Values Here See details and apply on our website.

Alignerr Corp. is seeking a Nursing Informatics Specialist (AI Training) to review and evaluate AI-generated clinical content. You are an RN with informatics experience and will train AI systems for healthcare workflows, EHRs, and nursing...

Expedite Healthcare Solutions is seeking a local contract nurse RN Case Manager, Acute Care Case Management for a local contract nursing job in West Hollywood, California. Job Description & Requirements Specialty: Acute Care Case Management...