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CVS Health is seeking an Utilization Management Nurse Consultant (RN) for Medicare precertification, offering a remote, full-time weekday schedule. You'll review cases, coordinate treatments, and apply clinical judgment to support decisions...

Fully Remote: Clinical Documentation SpecialistFacilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical records 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...

CVS Health is hiring for an Utilization Management Nurse Consultant (RN) for remote work. The role focuses on concurrent review and ensuring timely, cost-effective care through evidence-based decision-making. Candidates need active RN...

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...

Aesthetic Registered Nurse $50/hr base + $5/hr weekend differential Fixed schedule No overnights You'll be the clinical expert patients trust to achieve results they didn't think were possible without surgery —...

Trillium Health Resources is seeking a Compliance Nurse to perform clinical compliance reviews and evaluate claims to ensure adherence to regulatory and coverage requirements. The role applies clinical judgment to assess documentation, determine...

Job Summary: As the leader of the health care team, provides professional nursing care, utilizing the nursing process in accordance with established standards of care, policies, and procedures. Demonstrates performance...

The North Carolina Department of Health and Human Services (DHHS) seeks a Nurse Consultant II (NS) in the Immunization Branch. The role delivers high‑level clinical guidance, conducts VFC site visits, and ensures nursing policies align with...

Job Description: The RN Program Coordinator is a hospital or care site level leader who provides specialized clinical expertise, consultation, education, and research within their designated area or specialty focus that may impact many or most...

Sentara Health Plans in Norfolk, VA is hiring a Clinical Claims Reviewer/RN for a remote role. The RN clinician will conduct utilization management, perform pre- and post-payment claim reviews, and handle authorization reviews across inpatient,...

Location: Illinois, IL Job Id:175 # of Openings:1 Full-time and Part-time availability POSITION OVERVIEW: We are seeking a compassionate and skilled Consult Liaison Psychiatric...

Clinical Nurse Professional Development Educator Advanced How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At...

CVS Health is hiring a full-time RN for healthcare services and utilization management. The role emphasizes assessing and coordinating care, applying clinical criteria, and communicating with providers to optimize member outcomes. The...

Are you looking for an exciting way to utilize your nursing skills and expertise to deliver quality nursing care in a remote setting? AccessNurse, where technology meets compassionate care, is looking for professional nurses & offering...

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and...

Comagine Health in Alabama is seeking Clinical Utilization Review Nurses (RN) to assess medical necessity and quality of care through prospective, concurrent, and retrospective utilization reviews. This is a full-time remote role supporting...

Iris Telehealth is hiring PMHNPs for 100% remote consult-liaison telepsychiatry in Texas. Earn $120/hr with a sign-on bonus, working 13–16 overnight shifts per month, including weekends. Roles require Texas PMHNP licensure, 2 years...

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...

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...

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...

Optum Home & Community Care, part of UnitedHealth Group, is hiring a Telephone Case Manager RN for remote work. The role supports a diverse member population with education, advocacy and connections to resources to stay well at home. The...

To support legal teams in medical malpractice cases, the fully remote Tennessee Licensed Liability Nurse Consultant will conduct thorough case reviews, analyze medical records, and prepare detailed reports while collaborating with attorneys and...

Spectrumforce Technologies, Inc. is seeking a Clinical Review Nurse - Concurrent Review for a 3-month contract to hire. The role is remote with work location listed as Remote-MS CST, schedule 8 am-5 pm Central time, with occasional weekend...

Guardian Life seeks an experienced RN Clinical Consultant to evaluate disability claims, analyze medical information, and provide clinical recommendations for claim decisions. You will collaborate with providers, claimants, and staff, ensuring...