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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...

Payrate: $41.00 - $43.00/hr Summary: The main function of the nurse is to provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and...

RN - Quality & Safety Improvement Consultant V, Patient SafetyOnsiteDowney, CATravel: Yes, 10 % of the TimePatient Safety Officer RN in acute care hospital setting. You will attend national safety goal monitoring committees, sit on nursing...

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,...

Guardian Life is seeking an RN Clinical Consultant to support disability claim evaluations, assessing medical data and functional capacity. You will collaborate with providers and claims teams to influence outcomes and return-to-work decisions.

PIH Health in Los Angeles is seeking an RN Peer Review Analyst responsible for retrospective medical record reviews, data compilation to validate quality and accuracy of documentation, and auditing charts for admission/continued stay. You will...

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 —...

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...

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...

Details Client Name Norris Healthcare Consultation Center HC3 Job Type Travel Offering Nursing Profession Nursing...

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...

Michigan Public Health Institute (MPHI) is seeking a Nurse Consultant - Tuberculosis to coordinate and enhance Michigan's TB program, connecting providers with TB experts and promoting best practices across the state. The role focuses on...

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...

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...

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...

Spectraforce Technologies, Inc. is seeking a Clinical Review Nurse for remote concurrent review responsibilities. The role assesses member health status, medical necessity, and appropriate care levels, contributing to discharge planning within...

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...

Optum is seeking a registered nurse in Hawaii to assess needs, interpret requirements, and identify solutions while working with minimal guidance. You will interpret clinical documentation, support care decisions, and coach peers as an expert...

UnitedHealth Group is seeking a Clinical Grievances Nurse to review retrospective cases for appropriate care and address members' immediate needs. The role embraces remote PST hours with an on-site base in Mesa, AZ, requiring CA residency and an...

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...

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 consistent...

Make written and oral reports/recommendations to the attending physician, Medical Director, or the DON concerning the status and care of the residents. • Agree not to disclose resident's protected health information and promptly report...

Workers' Compensation Care Coordinator Carisk Partners, a Best Places to Work award winning organization, is a specialty risk transfer, care-coordination company servicing insurers, government entities, self-insured plan sponsors and...

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...

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...