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To support a dynamic team, the full-time Clinical Quality Assurance Coordinator will ensure the quality and integrity of peer review case reports while working remotely, adhering to client agreements and regulatory standards.Key...

PIH Health seeks a Nursing Instructor to teach in the Associate Degree Nursing program at Cerritos College and PIH Health during academic breaks. The instructor will deliver didactic and clinical instruction, participate in curriculum development,...

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...

Job Title: Clinical Research Nurse Job Description The Clinical Research Nurse coordinates and supports complex clinical research protocols with a focus on Phase I rheumatology CAR T inpatient trials. This role combines patient-facing...

Medical Review Nurse III Fully Remote • Windsor Mill, MD Overview Salary Range $80,000.00 - $95,000.00 Salary Position Type Full Time Education Level 4 Year Degree Description At RELI Group, our work is...

LeaderStat is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Torrance, California. Job Description & RequirementsSpecialty:...

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...

CVS Health is seeking a Nurse Consultant for Utilization Management in a 100% remote capacity. The role reviews inpatient and outpatient services using evidence-based criteria, authorizes care with providers, and escalates cases as needed.

Registered Nurse (RN) - IRIS Self-Directed Personal Care (SDPC) Are you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live the lives that they choose? Then you'll want to keep...

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...

VitaCare Living in Stratford, Wisconsin seeks an experienced RN to serve as contracted RN Consultant, providing clinical oversight across assisted living and memory care communities. You will partner with local leaders to maintain survey readiness...

Find your calling at Mercy! Under the direction of the primary care operations team, the Primary Care Nurse works directly with Mercy Primary Care Providers to provide safe, timely, effective, efficient, equitable,...

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...

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...

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...

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...

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...

Remote Registered Nurse Position The position is 100% remote. Preferred locations are Northern VA and Central VA. The EST time zone is required. Must have acute care experience as an RN. Day to day responsibilities include working with...

RN Utilization Management Nurse Consultant (Medicare – Joint Procedures) 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...

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...

OverviewAs our Educator, RN in Periop, you will serve as a consultant/resource professional by providing staff development expertise as an educator, facilitator, change agent, leader, and researcher, ensuring educational initiatives are...

Molina Healthcare of California is hiring a Transition of Care Coach LVN/LPN . This role is remote; however, candidates must have a valid and unrestricted California LVN/LPN licensure. The hours will be Monday through Friday from...

Improve the lives of others while Caring. Connecting. Growing together. Job Description - Clinical Consultant RN, Medical Policy Writer - Remote (2389098) Clinical Consultant RN, Medical Policy Writer - Remote - 2389098 Optum is...

Job Description Join a team that's shaping the future of pediatric care. Children's Hospital Los Angeles is consistently ranked among the top 10 children's hospitals in the nation, delivering world-class care through more than 350...

Job Title: Clinical Quality Assurance Nurse Pay: see below Registered Nurse - $28.50/hr (Non-negotiable) LPN/LVN- $26.50/hr (non-negotiable) Regular Schedule after...