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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...

Claims Medical Review Nursing Consultant Job No: 544045 Work Type: Full-time Location: REMOTE OPTIONS, VARIOUS-STATEWIDE, PHOENIX Categories: Healthcare/Medical Support Level,...

CVS Health Corporation is seeking a Utilization Management Nurse Consultant (UMNC) for a 100% remote role. You will coordinate, document and communicate utilization/benefit management activities, ensuring appropriate care and timing of services...

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...

Cambia Health Solutions is seeking an experienced Utilization Management Nurse to support our Clinical Services team. You will perform prospective, concurrent, and retrospective reviews to ensure medical necessity and appropriate care, while...

CorVel Corporation seeks a Care Advocate Nurse for a remote role focused on assessing injury severity, reviewing medical data, and supporting the Claims Management department as a nurse consultant. The position requires clinical nursing...

Actalent seeks an LVN Nurse Consultant for a fully remote, contract-to-hire role based in Dallas, TX. Schedule is M-F with daytime CST hours; pay is 29.00 USD per hour. The role focuses on telephonic patient support, therapy adherence, and...

JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and...

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...

Details Client Name PIH HEALTH Job Type Travel Offering Nursing Profession Registered Nurse Specialty...

100% REMOTE PAY: $47-$52/hr REQUIRED: Must have current RN licensing Post market medical device experience in either medical assessment, complaint handling, post market reporting – preference is actual medical device assessment Highly prefer...

Are you an experienced MDS nurse who enjoys solving problems, supporting teams, and making an impact across different skilled nursing environments? Health Dimensions Group (HDG)—a nationally respected leader in senior care consulting and...

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...

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

BJC HealthCare is seeking a registered nurse to join a remote Utilization Review team. The role supports multiple hospital units with no patient communication, and it is designed for local remote work with weekend rotation. Responsibilities...

Benefits We Offer: Comprehensive health, prescription, dental, vision, life, and disability plans Competitive pay rates Referral opportunities ? Refer a friend & Cash in! Travel reimbursement and per diem...

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted,...

The Veterans Health Administration at the Charleston VA Medical Center seeks a Nurse Manager (RN) to lead and supervise designated units within Community Care. The role emphasizes staff development, evidence-based practice, and collaboration with...

Humana is seeking a Utilization Management Nurse to support coordination, documentation, and communication of medical services and benefit determinations. This role suits experienced nurses who can work independently and make critical patient-care...

Saint Joseph Health System is seeking an RN Utilization Review specialist for a part-time, remote PRN role that requires on-site training in Mishawaka, Indiana. The position emphasizes reviewing medical necessity, insurance requirements, and...

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.

Cunningham Children's Home in Urbana, IL, is seeking a Nurse Case Manager to support youth with emotional, psychological, and physical care in residential programs. You will provide medical case management, screening, education, counseling, and...

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...

The position is work from home with field visits. JOB PURPOSE: This position is responsible for conducting medical management and health education programs for customers on government health care programs. Accountabilities include...

1st TIME OK/ 2 YR EXP required for Utilization Review RN every other weekend required or more depending on unit needs no call or floating required MUST HAVE experience with Milliman Care Guidelines and Acute Hospital Experience!! The Emergency...